Preparation for mommy makeover surgery is critical to achieve optimal results and reduce risk of complications. The idea is to help the patient reach her highest normal range of health, says leading Inland Empire plastic surgeon Dr. Tarick Smiley.
Mommy makeover is considered a “large” surgery because it typically combines two or more procedures in one surgical setting. Common combo techniques include breast augmentation with lift, tummy tuck with some type of breast enhancement, and tummy tuck with liposuction of the flanks.
While any body contouring surgery entails being near one’s ideal weight, drastic weight loss in the month leading up to the operation is greatly discouraged because of the ensuing malnutrition, muscle loss, and possible dehydration (due to low calorie diet), which can all affect healing.
If the patient is overweight, weight loss should happen gradually (just 1-2 lbs. per week) and is started way ahead of the surgery.
Following superb diet months prior to surgery can also make a huge difference in healing. A good rule of thumb is to increase protein consumption (it should account for 15-25 percent of the total calorie intake) and avoid or at least limit processed carbs and foods high in refined sugar, sodium, and fats.
Some doctors recommend supplementation about a month before and after surgery to ensure that their patients are getting enough iron, vitamin A, vitamin C, vitamin B12, and other micro-nutrients that play a critical role in healing.
Before taking any supplementation or herbal remedy, a prudent patient should always ask for her doctor’s permission first. It is important to note that some vitamins and supplements are known to increase bleeding or interfere with anesthesia or painkillers.
Aspirin, non-steroidal anti-inflammatory drugs, anticoagulants, and some antidepressants can also increase bleeding and aggravate the amount of postop bruises. The general rule of thumb is to avoid them 2-3 weeks ahead of the surgery and about a week afterward.
Smoking also has detrimental effects on healing. Not only it increases the risk of bleeding, infection, and skin necrosis, it also makes smokers susceptible to heart disturbances and lung-related problems following a surgery. For this reason, complete cessation for a minimum of three weeks before and after surgery is critical.
Lab screening is another important aspect of preparation for mommy makeover. It is ideally performed not later than 10 days prior to surgery to ensure the patient has achieved her optimal health.
Mommy makeover revision surgery becomes necessary because of three basic reasons: inadvertent pregnancy, significant weight fluctuations, and botched results from the initial procedure.
A mommy makeover surgery is any combination of body contouring procedures that generally focus on improving the appearance of abdomen and breasts, areas that are highly susceptible to the effects of pregnancy.
Leading body contouring expert Dr. Tarick Smiley says all efforts are made to avoid the need for mommy makeover revision, adding that it always starts with proper patient selection—i.e., the patient must be near her ideal weight and is done having children.
Nevertheless, “inadvertent” pregnancy and drastic weight fluctuations do happen, which can change if not reverse the results of tummy tuck, breast augmentation, and breast lift, which are the three most common mommy makeover procedures performed by the celebrity plastic surgeon.
Oftentimes, mommy makeover revision is possible provided that the patient’s weight has been stable for at least six months and/or she has fully recovered from the “trauma” of childbirth (it takes about 6-12 months); however, a longer waiting period is deemed necessary if one chooses to breastfeed.
It is important to note that the hormones that trigger the body to produce milk have some effect on skin elasticity or shrinkage; hence, the patient must wait at least six months after weaning, says Dr. Smiley.
All efforts are made to avoid additional scars in mommy makeover revision, so the surgeon would simply use the previous incision sites. However, some patients may have to accept a longer scar to achieve the optimal breast shape or to preserve the natural curves and contours of their tummy.
For instance, a patient who previously had a mini tummy tuck (its scar is typically 4-6 inches in length) but later gained weight or became pregnant may need her scar extended from hip to hip, which is the standard technique, to achieve a flatter abdomen and a narrower waistline.
Also, a patient who had a modified form of breast lift (less scarring) may have to accept the scars from the standard technique (it uses an anchor-shaped incision for additional lifting effect) if she requires a more extensive revision.
In the event of botched mommy makeover surgery, Dr. Smiley says it is of critical importance to wait at least six months before a revision is attempted. The idea is to wait for the skin to relax and the implants (in the case of breast augmentation surgery) to settle.
Performing revisions too soon is like “hitting a moving target,” hence the results are harder to predict, he explains.
Mommy makeover combination procedure aims to reverse the effects of pregnancy such as sagging breasts, barrel-shaped abdomen, and exercise- and diet-resistant fats. But to achieve long-lasting results, the patient should be near her ideal weight and is done having children.
While mommy makeover combination procedure performed in Los Angeles plastic surgery is highly individualized due to varying anatomies and cosmetic goals, most patients choose to combine some type of breast enhancement surgery (implants and/or lift) and tummy tuck.
The combination of breast enhancement surgery and tummy tuck makes sense: The patient will only pay for one anesthesia and surgical facility fee. Another bonus is that she will experience recovery just once.
Despite the benefits of mommy makeover combination procedure, it remains in the patient’s best interest to limit it to less than 4-6 hours to reduce the risk of complications related to bleeding, fluid imbalance, and high surgical trauma. This safety guideline applies to all elective surgeries.
While healthy young patients might be allowed to have breast enhancement, tummy tuck, and liposuction all at the same time, they might be required to have an overnight stay just to err on the side of safety.
Patients who need a great deal of work (e.g., full tummy tuck with flank liposuction and breast augmentation with lift) are generally advised to have their surgeries in sequence to avoid poor healing and increased risk of deep vein thrombosis or blood clots in legs that could travel to the lungs.
Full tummy tuck in itself is an extensive procedure that many surgeons suggest to only perform liposuction along the waistline once the patient has fully recovered from the initial surgery. However, the ideal approach and “timing” will depend on several variables such as the patient’s health, amount of surgical trauma, and operative time.
Breast lift and augmentation surgery are also routinely combined, although in some occasions it is better to perform them in sequence. This is particularly true for women with significant ptosis (droop) and/or there is a desire for larger implants.
Larger implants can lead to excessive tension on the breast lift incisions (around the areola, along the submammary fold, and vertically between the nipple and the breast crease), which ultimately affects healing. In this scenario, it is best to perform each surgery at least six months apart.
However, patients who want a conservative amount of augmentation and only require minimal lift can have combo procedure without having to worry about the increased risk of complications.
Mommy makeover breast augmentation may pose some unique challenges because pregnancy is known to cause breast involution—i.e., enlargement and eventual “shrinkage” of breasts after childbirth/breastfeeding. To a certain degree, this may contribute or result in skin laxity, empty-looking upper cleavage, and/or breast sagging.
The aforementioned side effects of pregnancy are more apparent in women who were unable to control their weight.
photo credit: canfieldsci website
Mommy makeover surgery is a general term used to describe any body contouring procedure whose aim is to reverse the effects of pregnancy. And because the breasts are particularly susceptible to physical “changes,” breast augmentation is one of the most commonly sought procedures to date.
Contrary to popular belief, breast augmentation is not only accomplished by placing implants to add more volume. It is also critical to reshape the breasts or address pre-existing condition such as sagging or deformity to achieve optimal results from the surgery.
As previously mentioned, pregnancy could affect the shape, projection, and appearance of the breasts. For this reason, experts at the California Surgical Institute highlight the importance of lengthy discussion and comprehensive physical exam to achieve results that will satisfy both the patient and her surgeon.
While not a “strict” rule, silicone implants favor a lot of patients seeking mommy makeover breast augmentation to compensate for their tissue or skin laxity, which makes them susceptible to visible rippling and palpability. These implants are filled with silicone gel that feels like the glandular tissue and fat.
Saline implants, meanwhile, are filled with water-like solution; hence, the risk of rippling and palpability is perceived to be greater. As a result, most surgeons only use them in women with sufficient soft tissue coverage (at least a full B cup) and will almost always position them beneath the chest muscle, as opposed to above this anatomical layer (with only the tissue and skin encasing them).
Should there is a true case of drooping in which the nipple falls at the level of or beyond the submammary fold, a simultaneous breast lift is performed with mommy makeover breast augmentation. This ancillary procedure reshapes the actual tissue with the use of internal sutures, instead of remodeling just the skin, which over time settles.
Sometimes, it is better to stage mommy makeover breast augmentation and breast lift; this is particularly true for women who need a great deal of work. The idea is to minimize tension on the skin and injury to the blood supply, leading to more predictable healing and better cosmetic results.
Mommy makeover surgery photos can reveal a lot about the surgeon, particularly his personal style, artistic skills, “focus” of his practice, experience, among others.
The procedures that are commonly labeled as mommy makeover surgery, e.g., tummy tuck, breast lift with or without augmentation, and abdominal liposuction require deep understanding of the anatomical limits, and the beauty ideals and body proportions as well to produce results that will satisfy the patient.
Adding up to the challenge is that each patient has personal goals and may have a different interpretation of “natural looking.” For this reason, experts at the California Surgical Institute advocate clear and honest communication between surgeons and patients.
To improve communications, a surgeon’s mommy makeover surgery photos are particularly helpful as they can serve as a tool that would guide his patients to settle for more realistic goals and expectations.
And with an extensive collection of mommy makeover surgery photos, the patient is most likely to find “subjects” whose body frame (height, weight, and body shape) and/or pre-existing condition (e.g., saggy, large breasts) are almost similar to hers, thus allowing her to visualize the likely outcome of her own surgery.
The before-and-after photos can also help patients select the “right” doctor as they can shed some light on the latter’s experience and the focus of his practice. Ideally, the surgeon must present hundreds if not thousands of pictures, which might be a good indication that he performs the sought procedure on a regular basis for many years.
It is important to note that experience plays a critical role in the surgeon’s ability to produce good results from the cosmetic point of view. Other important variables include board certifications, reputation, training, education, and quality of patient care.
Meanwhile, a surgeon who is only able to show a few mommy makeover surgery photos may not have enough experience and thus he is less likely to predict accurately the final outcome and to pinpoint anatomical challenges. These two factors play a critical role in patient satisfaction.
While a good surgeon will make every effort to listen to his patients’ input to make them happy with the postop results, to some extent his personal style will show through in some aspects. For instance, leading Beverly Hills plastic surgeon Dr. Tarick Smiley makes every effort to hide “reminders” of the surgery by placing the tummy tuck incision very close to the bikini line. His guiding principle is to contour the body in a way that there are no or very little surgical stigmata.
There are several mommy makeover payment plans available for women seeking plastic surgery to reverse the effects of pregnancy such as drooping breasts and apron-like skin in the abdomen.
Despite the proliferation of mommy makeover payment plans, Los Angeles plastic surgeon Dr. Tarick Smiley says the patient must be realistic when it comes to the amount she can really afford without compromising her “financial health.”
With the growing popularity of plastic surgery, most medical credit cards today also cover its cost, with some of them even offering introductory zero percent interest rate for the first six months. If this is followed by a moderate rate increase, many surgeons agree that this would be a great “deal” under most circumstances.
But as with any financing option, some companies have been accused of doing misleading marketing ploys and “dishonest” lending practices, e.g., the interest was applied to the entire loan, as opposed to the remaining balance only, in the event of missed payment.
In addition, some cards have large penalties, as high as 30 percent in some cases, if the cardholder misses a payment.
Another good financial option is to tap one’s existing credit card, assuming that it provides a reasonable interest rate. However, the patient should realize that any large purchase, which mommy makeover surgery falls under such category, could tie up her credit line.
To avoid financial woes, Dr. Smiley advises his patients to choose medical or regular credit cards whose interest rate is not more than 10 percent, and to avoid making another large purchase.
Another option is to ask for “secured” personal loans from banks, which generally offer fixed interest rates, thereby the patient could easily assess her ability to pay on time. However, in the event that she is unable to pay on time, she may lose the property she has offered up as a collateral.
“Unsecured” personal loans, meanwhile, usually come with higher interest rates; however, these may vary depending on the borrower’s creditworthiness.
As of this writing, most plastic surgeons require full payment prior to surgery, although some offer payment plans that work within their patients’ budget. It is important to note that inability to make the payments could affect the relationship with the doctor, which is imprudent because follow-up visits are almost always necessary.
And lastly, cash savings can also be tapped to pay for one’s surgery. While this financing option does not come with interest rates and late payment fees, it remains ideal to maintain a balance that is at least six months’ worth of living expenses to anticipate “emergencies.”