There is a growing mommy makeover trend: Today’s patients are more well versed in plastic surgery that they are demanding for more natural and more proportionate results.
Mommy makeover surgery, which is basically a marketing term, refers to multiple surgery procedures that restore or at least improve the post-pregnancy bodies of patients. Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says the most common “combination surgery” involves tummy tuck and some type of breast enhancement.
Dr. Smiley, who regularly posts Snapchat videos to spread patient awareness and to share his knowledge with medical students and colleagues, has provided a list of mommy makeover trend that generally favors “subtle” and “realistic” results.
- Curvier and slender waist with tummy tuck
In the past, most patients simply wanted the removal of their apron-like skin that hangs from their abdomen. But nowadays, women are more fastidious in terms of cosmetic results—they want the “corset effect” on their waistline.
To achieve a curvier and more defined waistline, Dr. Smiley highlights the importance of suturing the pair of splayed abdominal muscle, which prior to pregnancy is lined up closely side-by-side.
But during pregnancy that causes the abdominal wall to expand, the fascia (connective tissue) holding it together becomes weak, leading to a gap that could even become palpable. This gap is also causing the barrel-shaped waist that used to have an hourglass figure.
For additional contouring effect, Dr. Smiley pulls and tightens the abdominal skin “centrally.” And if needed, he also performs liposuction of the flanks to achieve a more hourglass figure.
- Breast augmentation beyond size increase
Modern breast augmentation is focused not just on size increase, but also on the final shape and projection. The goal is to achieve the most natural results possible, which all boils down to implants settling in their most ideal position.
Due to the growing demand for natural and “realistic” breast augmentation results, it is now commonly performed together with breast lift. The idea is to achieve optimal breast shape so the “fullness” will look natural.
Dr. Smiley warns that failure to address pre-existing sagging or asymmetry can lead to surgical stigmata like “Snoopy deformity,” excessive lateral bulge, and bottomed-out appearance.
Aside from breast lift, other common ancillary procedures of implants include areola reduction and fat transfer.
- Fat transfer for a more feminine figure
Fat transfer has revolutionized the way surgeons perform body contouring surgery, particularly buttock augmentation.
The growing popularity of fat transfer is attributed to the refinements in the purification techniques, allowing surgeons to increase the survival rate to more than 70 percent. It is important to note that any amount that remains about three months after injection is expected to persist long term.
Fat transfer as a way to augment the buttock is also a powerful body contouring procedure. Because it involves liposuction (in order to harvest the “unwanted” fats), it can contour the waistline at the same time, which in turn results in a more hourglass figure.
Mommy makeover recovery tips all aim to keep the swelling, bruising, and pain to a minimum. Nonetheless, the “specifics” may differ from patient to patient due variables such as individual health, type of surgeries involved, and presence of risk factors (e.g., longer operative time and medical conditions).
Leading Los Angeles plastic surgery expert Dr. Tarick Smiley has shared his mommy makeover recovery tips that can help patients bounce back quick after their operation.
Photo Credit: Exparel website
(Note: All his patients are required to pass lab screening to ensure that they can handle mommy makeover surgery, which is basically a combination of two or more procedures that aim to reverse the effects of pregnancy. For most of his patients, some type of breast enhancement with tummy tuck is the most common “combo surgery.”)
Keeping the amount of postop pain is one of the critical factors that can guarantee a quick recovery. When patients feel no or very little pain, they breathe better and move with more ease, which then promote healing.
Dr. Smiley injects Exparel into the abdominal muscle right after tummy tuck surgery when the patient is still on the operating table. This drug contains bupivacaine, which causes temporary numbness in the area and so the patient relies less on oral painkillers, which may cause nausea, lethargy, and constipation.
Exparel can numb the injection site for up to four days, says the leading plastic surgeon.
Multiple surgeries typically entail a more challenging recovery as compared to “single operation.” Hence, it becomes more important than ever to have a competent adult who is committed to stay with the patient for at least 1-2 days after surgery.
Occasionally, it is more ideal to stay for a few days in a licensed recovery facility, which is staffed by specially trained medical professionals who will monitor the patient’s health before she is able to return home to recover.
It is important to note that for 2-3 weeks, the patient’s main focus should be her recovery. For this reason, she needs someone to take care of her small children and do all the daily chores until she has recovered fully to do all these tasks without compromising her healing.
Dr. Smiley provides all his patients with a list of supplies they will need for their recovery. This can range from ready-to-eat foods, bottled water, pain medications, to compression garments
Recovery from mommy makeover surgery—a combination of body contouring procedures that can reverse the effects of pregnancy—may vary greatly from patient to patient. Nonetheless, patients are generally advised to avoid strenuous activities and heavy lifting for six weeks to prevent healing problems.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley says most of the pain will come from muscle repair performed during tummy tuck, a surgery that contours the frontal and lateral aspect of the waist. The discomfort from breast enhancement such as breast lift and augmentation, meanwhile, is much easier to control.
To minimize the postop pain resulting from tummy tuck, which in turn can promote healing, Dr. Smiley says he always injects Exparel into the abdominal muscle at the very end of his surgery. The effects of this numbing medication can last for up to four days, allowing his patients to reduce their use of narcotics or even avoid them altogether.
In the first few days postop, Dr. Smiley recommends his patients to arrange for help at home so they can focus on their recovery instead of stressing over routine chores like childcare, cooking, driving kids, etc. Simply put, they need all the help they can get during the initial healing phase.
Taking care of small children (under the age of 2) at home is particularly discouraged during the initial healing stage. For this reason, mommy makeover really requires advanced planning for a more convenient recovery.
Patients should also expect lethargy that can last 4-6 weeks and so they may need to sleep more; additionally, they may lack the energy to do their usual activities, he adds.
In general, young patients bounce back sooner than older patients, although recovery from mommy makeover surgery still boils down to individual healing. For this reason, the celebrity plastic surgeon requires lab screening to ensure that they are healthy enough to handle the surgery and the ensuing recovery.
When going back to “desk” work, Dr. Smiley typically recommends 1-2 weeks off; however, some patients file for a longer leave or choose to work part time until they regain their preoperative energy level, which can take up to six weeks.
The topic involving mommy makeover safety protocols is quite extensive and “hifalutin” and so leading Beverly Hills plastic surgeon Dr. Tarick Smiley has only focused on the most important issues, which he has explained on his recent Snapchat videos.
The celebrity plastic surgeon regularly posts videos and images involving different plastic surgery procedures on his Snapchat account and other social media platforms as a way to help raise patient awareness and safety.
(Note: Mommy makeover is a combination of body contouring surgeries that reverse the effects of pregnancy. Arguably, the most common “combo procedure” is tummy tuck with some type of breast enhancement, or liposuction.)
Dr. Smiley, a board-certified plastic surgeon who has performed thousands of mommy makeover surgeries, says the first step to ensure patient safety is to conduct lab screening.
The extent or “specifics” of lab screening may depend on the medical history of the patient; hence, no one should hide or omit any part of this critical information to avoid complications or less than optimal results.
Dr. Smiley says that after passing his lab screening, his board-certified anesthesiologist also conducts his own physical exam to further ascertain that the patients are healthy enough to sustain the surgery and its ensuing recovery.
To further ensure mommy makeover safety, he oversees his four surgery center facilities, all of which have been fully accredited by state health regulators. Accreditation means that they adhere to the strictest patient safety standards; are staffed by licensed medical practitioners; and follow the guidelines to prevent infection and contamination.
Even the ventilation systems of his four accredited facilities are designed to curb air-borne pathogens, says Dr. Smiley.
One of the challenges of mommy makeover or any multiple surgeries procedure is the increased bleeding. Hence, Dr. Smiley may use an equipment called Cell Saver, which is particularly helpful in large volume liposuction.
Cell Saver collects the red blood cells from the fluids removed during liposuction so these can be re-infused into the patients and thus no significant blood loss has occurred. Ultimately, they experience quicker recovery and avoid lethargy and dizziness, which usually follow after a multiple plastic surgery procedure.
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.
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.