You have had your children, and you love being a mom; you just don’t want to look like one. When you look in the mirror, you just don’t see the youthful body you feel like you should still have. Instead, your breasts are smaller and maybe droopy, your stomach bulges, and you have stretch marks. You work out, but the results just aren’t good enough.
If this sounds like you, maybe it’s time to consider a “mommy-plasty.” The idea is one operation to get our Dallas mommy makeover patients back in shape and to reverse some of those changes that occur as a result of pregnancy. Surgery like this is extremely common and usually addresses a woman’s breasts and abdomen at the same time.
Effects of Pregnancy
Pregnancy has different effects on everyone. Some more fortunate women can have several children and look like they did before. Other women are dramatically affected. While genes are obviously important, other factors include the number of pregnancies, the size of the babies, the amount of weight gained during the pregnancy, and age during the last pregnancy. A woman’s breasts and abdomen are the two areas most adversely affected by pregnancy.
Most women’s breasts get larger during pregnancy and then “involute” or reduce in size after breast-feeding is finished. Frequently, there is also excess skin resulting in what most patients call “droopiness” and what plastic surgeons call “ptosis”.
Pregnancy causes stretching of both abdominal skin and muscle. With each successive pregnancy, a woman tends to acquire more excess lower abdominal skin. Frequently, this extra skin will be of diminished quality and have stretch marks. Likewise, the rectus muscles (muscles in the middle of the abdomen) thin out and separate to allow the abdomen to accommodate a baby.
After the delivery, the muscles do not completely return to the previous position and shape. This condition often gets worse with each pregnancy and the resultant muscle laxity and malposition is why women “show” earlier in each pregnancy. Following pregnancy, most women are unable to restore the desired shape to their abdomen, even with exercise, due to the malposition of their abdominal muscles. Various forms of abdominoplasty are designed to reconstruct the abdominal muscles and remove the excess skin.
Breast surgery following pregnancy is designed to restore shape and volume and, sometimes, to remove extra skin.
If a woman’s breasts are simply too small and not droopy, a standard breast augmentation will restore size and shape. A breast implant, either saline or silicone, can be used to restore the desired amount of volume. These implants are usually placed behind the muscle.
Breast Lift (Mastopexy):
If a woman’s breasts are droopy and of adequate volume, various forms of mastopexy or breast lift may help. The purpose of the lift is to raise the nipple higher on the breast and improve shape by removing excess skin. In cases where a woman is too large, excess breast tissue can be removed at the same time. Contrary to what most of our Dallas mommy makeover patients think, the nipple is always left attached in a breast lift to preserve sensation.
If ptosis or droopiness is mild, the incision can be limited to around the areola and is known as a periareolar mastopexy. Here, a ring of skin is removed from around the areola thus reducing the size of the areola and lifting the breast a small amount. This usually results in some temporary puckering of skin around the areola and some breast flattening, but the lift has the advantage of minimal scarring.
If ptosis is more significant and the nipple is below the level of the fold underneath the breast, it is usually necessary to have an additional vertical scar beneath the areola. Many people do not like this incision and choose to accept residual ptosis rather than accept the scar.
When ptosis is more advanced and the nipple is virtually at the bottom of the breast, subtle procedures are usually inadequate. It is almost always necessary to perform an “anchor” type incision to treat this degree of ptosis.
Combined Augmentation and Breast Lift:
Frequently, loss of volume and droopiness are both present and a patient may elect to have an augmentation and a lift at the same time. While this procedure is more complicated, it can accomplish a significant amount of rejuvenation in one step. This is one of the more unpredictable procedures in plastic surgery due to the fact that implants can settle postoperatively and skin usually stretches some also. Surgical revisions are commonly needed to obtain a very good result. Depending on an individual patient’s breasts, it is sometimes wiser to perform these procedures in a staged manner, doing a lift first followed by an augmentation in two to three months.
Following pregnancy, some women have breasts that are too large and need a breast reduction. The primary purpose of a breast reduction is to make a woman’s breasts smaller. In doing so, most techniques also lift the breast while elevating and reducing the size of the areola. Contrary to what most patients think, the nipple and areola are almost always left attached to the breast so sensation can be preserved as well as the ability to breast-feed. How much smaller a breast gets depends on the wishes of the patient as well as their overall size. As a general rule, for a breast reduction to be paid for by a health insurance company, about 500 grams need to be removed per breast. In rough volume terms, this is about 16 ounces, which is a substantial amount in most women. Since so much mass is removed, many women experience improvement in symptoms related to large breasts such as back, neck, and shoulder pain. Likewise, athletic activities are easier and clothing can fit better.
Breast reductions almost uniformly require incisions around the areola and down the front of the breast; frequently, there is also an incision in the fold underneath the breast, which is known as the “anchor” incision.
Most abdominal treatments are directed at removing excess skin and repositioning abdominal muscles, two things that cannot be accomplished with diet and exercise.
While everyone wants a short incision for their abdominoplasty, the length of the scar is determined by the amount of skin to be removed: the more skin, the longer the incision. In some cases, very little skin removal is needed, and the muscles can be repaired through a very short incision in what is called a “mini-tummy tuck.” More commonly, a significant amount of skin is removed and the incision is long.
Repairing the muscle involves directly suturing the muscles back together. While this is the source of the majority of discomfort in an abdominoplasty, it is the major benefit of the surgery. Frequently, some liposuction is also done to remove excess fat around the waist.
Dallas Mommy Makeover Consultations
The ideal patient for a “mommy-plasty” is a woman who is in good health, close to their target weight, and plans to have no more children. Such a patient will benefit the most from a procedure that offers such a substantial change in one operation. Contact our Dallas office to schedule your mommy makeover.
Mommy-plasty is real surgery and involves risks such as bleeding, infection, and scarring. Results vary. Dr. Pin will be happy to discuss these and other risks of mommy-plasty.