Mommy makeover surgery is any combination of body contouring surgeries performed simultaneously to improve the post-pregnancy body of patients. Common combination procedures include tummy tuck with liposuction of flanks, tummy tuck with some type of breast enhancement, and breast lift with implants.
The results of body contouring surgeries are near permanent, provided that the patient manages her weight through regular exercise and superb diet. It is important to note that fad diets and pills almost always don’t work long term and so weight management should be a lifelong commitment, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
After muscle repair, precise skin removal, and liposuction along the flanks, this patient is ecstatic with the results.
To shed light on the issue, Dr. Smiley has recently posted several mommy makeover surgery pictures on his Snapchat.
One patient received tummy tuck to remove the redundant skin between her mid and lower abdomen. To further achieve a flatter contour, the underlying muscle between the sternum and below the navel was tightened with the use of internal permanent sutures known for their additional strength (compared with absorbable sutures).
To further achieve a more feminine silhouette—i.e., cinching effect on her waistline—she also received liposuction along her flanks. Dr. Smiley started off the surgery with this procedure so he could tighten and pull more skin during tummy tuck.
When looked closely, the “after” photo (taken six months postop) reveals some muscle definition, which contributes to the more athletic but still feminine appearance of the abdomen. Furthermore, the new navel looks smaller and more proportionate compared with the “before” photos.
Tummy tuck and breast lift give this patient a more feminine and more youthful physique.
The second sample of mommy makeover surgery pictures shows a patient who had tummy tuck and breast lift performed simultaneously. Due to her underlying anatomy—there is a great distance between the lowest rib and hip—Dr. Smiley was able to significantly “reshape the sides” or flanks, leading to the hourglass appearance of her body.
And as seen from the “after” photos, tummy tuck has given her a flatter tummy, a significant improvement from her previous barrel-shaped torso.
To further complement the cinching effect of tummy tuck, she also had a breast lift in which her actual breast tissue, not just the skin alone, was elevated and reshaped with the use of internal sutures. Aside from the perkier appearance, Dr. Smiley has also created better cleavage and additional upper pole fullness of the breast.
Upper pole fullness after breast augmentation can be achieved with precise physical examination of the breasts. The idea is to identify the “challenges” and anatomical variables that must be overcome to achieve the best shape and projection possible.
Of course, the patient must be able to describe in details her cosmetic goals and expectations. Hence, patient-doctor communication plays a crucial role in the satisfaction rate, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
Dr. Smiley has recently posted a series of Snapchat videos showing one patient whose primary goal was to achieve increased upper pole fullness after breast augmentation.
While the patient’s pre-operative breasts had adequate soft tissue, they were remarkably pendulous that her areola sagged a few centimeters from its breast fold (or submammary crease). Further aggravating the sagging appearance was the deflated or “empty” upper breast pole.
Due to the extent of her breast sag, Dr. Smiley performed the standard breast lift technique in which an incision goes around the areola’s perimeter, down the midline, and then across the breast fold. The resulting scar from this method resembles an anchor, and so it is also aptly named as anchor lift.
before and after photos
Despite the growing popularity of modified breast lift techniques, the patient remained suited for the standard incision pattern because her areola required more than 5 cm of elevation, something that cannot be achieved with shorter incisions.
The anchor lift has allowed Dr. Smiley to remove some tissue and skin at the bottom of the breasts before lifting and reshaping the remaining tissue with the use of internal sutures. But as a stand-alone procedure, breast lift cannot give ample fullness on the upper poles of the breast—this is where implants become helpful.
Because the patient was more concerned about the final breast shape and fullness of the upper pole, a smaller or conservative-sized implant would suit her.
While showing the patient’s before and after photos, Dr. Smiley said “there is no significant change in her breast volume even with the use of implants, although the upper pole has received significant improvement in terms of looking full and youthful.”
Crescent lift with implants basically involves slight elevation of the areola and a simultaneous breast augmentation. It is important to note that it only suits patients who do not require an actual breast lift.
Breast lift surgery, in the truest sense of the term, elevates the breast tissue with internal sutures. At the same time, the nipple area is repositioned higher, making sure that it lies above the submammary fold, to achieve more proportionate, perkier results.
Meanwhile, a crescent lift does not involve actual elevation of the breast tissue. Basically, it just raises the nipple area slightly with the creation of a concave shaped incision at the upper border of the areola; hence, the resulting scar precisely lies at the dark-light skin junction and is almost invisible when completely healed.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos to demonstrate crescent lift with implants.
The patient shown in the videos has no “real” breast ptosis (sagging), which is medically defined as having a nipple area drooping below the submammary fold. However, she could benefit from a slight elevation of her areola and so Dr. Smiley performed a simultaneous crescent lift.
Some surgeons are hesitant to use the crescent lift due to the perceived risk of areola distortion (it may appear asymmetric, wider, or elongated after surgery). However, Dr. Smiley said in the video that poor results generally arise when excessive tension is put on the skin.
In the video, Dr. Smiley is seen closing the concave shaped incision with the use of absorbable suture. But instead of “picking up” the skin, all the stitches were made “inside” or beneath the skin layer.
Meanwhile, the skin’s edges were simply allowed to “kiss other” so the scar will remain thin and inconspicuous as it lies precisely at the areola’s border.
“Favorable or invisible scar can be achieved if there is no or very little tension on the skin. We simply respect the skin during wound closure,” he said in the Snapchat video.
The Benelli lift with breast implants basically accomplishes two things: create an “illusion” of a perkier appearance, and provide more breast volume.
The term “illusion” is an appropriate way to describe the effects of Benelli lift, which unlike the standard breast lift, does not manipulate and reshape the actual breast tissue. It simply relies on repositioning the areola higher on the breast.
Meanwhile, a standard breast lift actually “lifts” and re-anchors the sagging breast tissue.
For this reason, the Benelli lift only suits patients with pseudo or fake breast ptosis or sagging—i.e., the upper breast pole appears “empty” but the areola has not yet sagged below the breast fold.
To demonstrate the effects of Benelli lift with breast implants, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos involving the technique.
The patient shown in the video had enlarged areolas, which were positioned lower than ideal, although they had not yet drooped beyond the breast crease. Moreover, her breast size was disproportionately small for her body and thus she requested for a simultaneous augmentation surgery.
Dr. Smiley started off the surgery with the creation of a smaller areola. He used a round cookie-cutter device to make an imprint of the new areolar complex. Then, he created an oblong-shaped incision outside of the same cut.
With the aforementioned incision pattern, Dr. Smiley was able to remove some of the dark pigmented skin of the areola, ultimately reducing its size. Of course, he lifted it a few centimeters from the breast crease to achieve a perkier, more youthful appearance.
According to studies, the ideal distance between the nipple and the sternal notch (visible dip between the neck and the collarbone) is between 17-21 cm. But if there is a larger gap, the breasts are perceived to be saggy.
After improving the shape, size, and placement of the areola, Dr. Smiley positioned the implants to give the patient more breast volume. These prostheses are propelled into their pockets through the previously created incision around the nipple area, thus avoiding additional scar.
The resulting scar from the Benelli lift, meanwhile, lies precisely at the dark-light skin junction and so it will blend into the background after six to 18 months, Dr. Smiley said in one of his Snapchat videos.
Breast lift with tummy tuck is a common mommy makeover combo surgery. Because of the operation’s extent, this is only reserved for healthy patients who can handle the ensuing recovery, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
Dr. Smiley has recently posted on his Snapchat account a case study involving a female patient who requested breast lift with tummy tuck.
The patient flew from Hawaii to have her surgery conducted by the celebrity plastic surgeon who performs over a hundred mommy makeover surgeries every year. (In one Snapchat video post, he revealed that he has already operated on more than 7,000 tummy tuck patients.)
The patient had large areola that aggravated the appearance of her drooping breasts. For this reason, Dr. Smiley recommended reducing her areolar complex to achieve a more proportionate, youthful result.
Using a cookie-cutter device, he delineated the new smaller areola by removing some of the dark-pigmented skin from its border.
After reducing the areola—ensuring that the resulting scar lies precisely at the dark-light skin junction to make it undetectable—Dr. Smiley then used vertical incisions between the nipple area and the breast crease to elevate the tissue, leading to a perkier appearance.
To further achieve impressive breast contour, Dr. Smiley placed incisions parallel to the breast crease; hence, the resulting scar lies precisely at the natural skin fold for its optimal concealment.
(Note: The overall shape of the scar resembles a nautical anchor, thus most surgeons call this breast lift technique as anchor lift.)
While the vertical scar of the anchor lift is in a more obvious location, Dr. Smiley says it generally heals and blends nicely into the background after 6-12 months. However, this is only possible with proper wound closure technique in which there is no or very little tension on the skin surface.
Aside from closing the wound in several rows to eliminate superficial tension, Dr. Smiley says he prefers absorbable sutures, which are known to promote favorable scars and are less likely to cause the appearance of “railroad tracks.”
After breast lift, Dr. Smiley proceeded to tummy tuck in which he used a hip-to-hip incision to remove the sagging skin and repair the abdominal muscle that had become separated due to pregnancy. The resulting scar has been made very low that the patient can wear a scanty two-piece bikini without any problem.
Overtime, the hip-to-hip tummy tuck is expected to fade and shrink almost to the width of a human hair.
Once the incisions from mommy makeover surgery are fully healed, Dr. Smiley recommends the use of silicone sheet and gel; the goal is to hydrate the scar and allow it to fade into the background.
The exact instructions as regards to breast lift wound care may differ from surgeon to surgeon; nonetheless, there are generally agreed upon guidelines such as preventing or treating infection immediately, avoiding over-exertion while healing is not yet complete, just to name a few.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says that aside from the quality of breast lift wound care, the suturing technique will also play a critical role in the prevention of wound separations and healing problems.
The goal is to eliminate most of the tension on the skin surface by placing it on the deeper tissue, says Dr. Smiley.
Aside from meticulous wound closure technique, risk factors such as obesity, smoking, serious medical conditions, and use of aspirin and other drugs with blood thinning properties must be eliminated or at least controlled well ahead of the surgery.
In standard breast lift (i.e., anchor or T-shaped incision technique) wound separation is not uncommon in the T junction (or the area where the vertical incision meets the horizontal incision along the submamammary fold) because of the opposing tension. Hence, patients who only need mild to moderate tissue elevation is encouraged to choose the modified form in which the inframammary crease incision is eliminated, a technique referred to as lollipop lift.
Meanwhile, Dr. Smiley explains the postop care that can prevent or at least reduce risk of wound separations.
- Prevent or treat immediately signs of infection
Persistent swelling, pus or foul discharge, fever, and increasing pain are common signs of infection. To prevent this complication, a good rule of thumb is to achieve one’s optimal health well ahead of the surgery.
The use of antibiotics and good hygiene (washing one’s hands before and after changing the dressing) can also reduce risk of infection and its subsequent problems such as wound separation and poor healing.
The truth is, patient cooperation will also play a crucial role in the prevention of complications. It is important to avoid heavy lifting and strenuous exercise for a minimum of three weeks postop to avoid wound separations, persistent swelling, and other things that could compromise one’s recovery.
- Avoid premature removal of sutures
Non-dissolvable stitches, which are usually used to “hold” the superficial layer of the wound, should not be removed prematurely lest wound breakdown may occur.
Furthermore, certain suturing techniques such as monofilament are believed to be less prone to “spitting.”
The general rule of thumb is to avoid smoking three weeks before and after surgery to give the body ample time to flush out the effects of nicotine, which is a strong vasoconstrictor (it shrinks the blood vessels that the nutrient supply going to the wound is greatly diminished).