Anatomy of A Plastic Surgery Mommy Makeover
By Karen M. Horton, MD, MSc, FRCSC
What is the “Mommy Makeover”?
Mothers devote so much of themselves and their resources to their children, from time and energy to money and miles on the car. Moms feel good about this, knowing that every sacrifice is more than worthwhile to keep their family healthy and happy. But sometimes, in all mothers do, their own well-being gets a little forgotten. What if you could take great care of yourself and raise your children too? That’s exactly the philosophy behind “Mommy Makeover” cosmetic surgery. More than ever, exciting surgical options are available to reverse the unwanted effects of childbearing and age.
A Mommy Makeover is a cosmetic surgery procedure(s) aimed at making a mother look the way she did before she had children, or perhaps even better than before! Many of today’s moms don’t feel they should sacrifice the way they look just because they’ve had children. Women usually desire to have their abdominal contour and tone and breasts back the way they were prior to pregnancy. The American Society of Plastic Surgeons (ASPS) reports that demand for those three procedures rose by 11 percent for women ages 20 to 39 between 2005 and 2006.
Aimed at mothers, the Mommy Makeover usually involves a breast lift with or without breast implants, in addition to a tummy tuck if desired and/or liposuction of localized fat deposits that are resistant to a healthy diet and regular exercise. These procedures are intended to eliminate slackened skin as well as reduce stretch marks and pregnancy fat.
Pregnancy affects each woman differently, with age and genetics playing a role in how the body recovers. Some women easily get their pre-pregnancy bodies back when they have completed childbearing. However, most women have permanent changes after pregnancy, such as stretch marks, breast deflation or drooping, extra abdominal skin and/or loss of abdominal muscle tone, known as “rectus diastasis”“(permanent separation of the rectus abdominis muscles). Repeated pregnancies and magnify these changes.
Most of these changes to a mother’s body cannot be fully corrected by diet and exercise, or by lifestyle choices. This article will review the surgical options available for moms to rejuvenate their bodies when they have finished childbearing.
BREAST REJUVENATION
Breast Lift (Mastopexy)
Pregnancy and breastfeeding contribute to deflation and drooping of the breasts. Natural loss of skin elasticity with age, gravity and other factors such as weight loss permanently affects the shape and firmness of the breasts.
A breast lift, or mastopexy, reshapes the breast, removes excess skin, lifts breast tissue and moves the nipples and areolae to a more youthful position. The areola is often reduced in size as well. In some instances, an implant is also inserted at the same time to achieve more projection and volume with the lift. While these are all physical results that occur from breast lift surgery, what breast lifts really do is help a patient feel better about their feminine shape and contour.
Incision lines are permanent, but are generally hidden in the breast crease, at the junction of the areola and breast skin, with a vertical scar beneath the areola. Surgery takes two to three hours on average and may be done as an outpatient procedure (no overnight stay).
Image from the American Society for Aesthetic Plastic Surgery (ASAPS), 2007.
Usually, suction drains are placed to gently remove wound fluid. These small tubes are in place for up to a week after surgery, and are painlessly removed in the office. Dissolving sutures (stitches) are generally used for all types of plastic surgery, with suture knots trimmed in the office at two weeks.
Breast lift side effects can include temporary discomfort, bruising, and swelling. Breasts may be temporarily numb, and healing skin may look and feel dry. Scars fade over the first year, and scar therapy is initiated at a few weeks after surgery to help flatten and fade scars while they are maturing over the first year. Fortunately, scars are in locations easily concealed by clothing, even low-cut necklines and swim suits.
Results of a breast lift are permanent. However, gravity, weight changes and age will continue to act on the breasts, as in all areas of the body and can create the need for eventual revision after many years.
Breast Augmentation
Augmentation of the breast (a “boob job”) consists of insertion of a prosthesis (implant) inside the breast to enlarge the breast or to add volume that has been lost after pregnancy or breastfeeding. The implant expands the breast area to give a fuller breast (increased cup size), give a better contour, and more cleavage that before surgery. A good Plastic Surgeon will emphasize realistic results and help you choose a shape and size that is safe and healthy for your height and frame.
Image from the American Society for Aesthetic Plastic Surgery (ASAPS), 2007.
Implants can be filled with either saline (salt water) or silicone gel, and can be smooth-shelled or textured, round or shaped, with low-, medium-, or high-projection, and come in a variety of sizes. Breast implants are inserted through a variety of incisions, most hidden in natural creases of the body. They may also be placed either in the subglandular position (beneath the breast tissue) or submuscular position (behind the breast tissue and pectoralis major muscle).
Your Plastic Surgeon will explain in detail the many options available for breast implants, and the advantages and disadvantages of each type. Surgery takes one to two hours on average, and is often done as outpatient procedure. If other procedures are done at the same time (tummy tuck, liposuction), an overnight stay is often recommended for safety and comfort.
Breast implants are safe, and are the most extensively tested medical device available. Temporary symptoms after surgery can include discomfort, bruising, soreness, swelling, temporary change in nipple sensation and breast sensitivity. You can still have mammograms with implants in place; the technician will perform special views to ensure all breast tissue is properly evaluated. There has been a significant amount of controversy over the use of silicone in breast implants, with sensationalization of these devices by the media.
Breast Reduction
A breast reduction treats typical symptoms of hypermastia such as back pain, neck or shoulder pain, shoulder grooving, rashes beneath the breasts, and inability to fit clothing or to do physical activities due to the large size of the breasts. The size of the breasts can be reduced by up to half their volume.
The breasts are automatically lifted, and the nipple and areola are lifted to a higher position. The areola diameter is also usually reduced. Liposuction of fat rolls at the side of the breasts or in the armpit area may also be recommended to best improve the breasts’ contour.
