Mommy makeover is a combination of two or more surgeries to improve a woman’s post-pregnancy body. Examples of the most common procedures include tummy tuck to tighten the abdomen, some type of breast enhancement to correct the sagging or empty-looking upper breast pole, and liposuction of the abdomen and flanks.
To shed light on the issue, renowned body contouring plastic surgeon Dr. Tarick Smiley has shown some photo samples of his best mommy makeover results.
Patient no. 1 sought Dr. Smiley’s expertise to correct her barrel-shaped abdomen caused by previous pregnancies. Instead of just removing the excess fat, the celebrity plastic surgeon has also tightened the pair of vertical muscle running between the sternum and the pubis area.
With muscle repair, Dr. Smiley was able to create a corset-like effect, which has been further complemented by liposuction of the flanks. The idea was to create a smoother, more feminine curve between the hips and the waist.
To further achieve a more feminine waistline, the surgeon also created a new smaller navel.
Patient no. 2 received breast lift and tummy tuck, a common mommy makeover combo. She has been considered as a good candidate for breast lift alone approach (no implants) because her “starting” anatomy involved having a sufficient breast tissue coverage; hence, by simply transposing some of the lower pole tissue into the upper pole Dr. Smiley was able to create better mid and upper cleavage.
Like most patients of Dr. Smiley, she also had muscle repair during her tummy tuck. This is a critical step to eliminate the fullness of her anterior abdomen and to correct the barrel-shaped torso.
Patient no. 3 received tummy tuck complemented by liposuction of the flanks, navel repair, muscle plication/repair, and pubis lift. It is important to note that the mons pubis may sag due to pregnancy, weight fluctuation, or aging.
The idea of a simultaneous pubis lift is to create a smooth transition between the lower abdomen and the mons pubis. This is done by re-anchoring the mons into the deeper tissue before the hip-to-hip incision is closed with sutures.
Just like the rest of Dr. Smiley’s patients, her tummy tuck scar is positioned very low that it is concealed even by a scanty or low-cut underwear. With time, the scar is almost always expected to fade into the background.
Thigh lift after massive weight loss is typically beyond cosmetic improvement. A good number of patients also seek the procedure to find relief from non-healing skin irritation and tissue breakdown caused by the redundant skin rubbing each other every time they walk and move around.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley says that thigh lift after massive weight loss is commonly combined with tummy tuck and buttock lift. By simply extending the hip-to-hip incision of tummy tuck around the entire waistline, surgeons can reshape the outer thigh, anterior abdomen, and buttocks all at the same time.
Despite the contouring effects of the aforementioned technique (which is referred to as 360 degree lower body lift), patients with healing problems and other “risk factors” may have to stage their surgery to minimize risk of complications.
This is the typical incision pattern used in outer thigh lift surgery.
As a stand-alone procedure, the incision pattern used in thigh lift will depend on the location and the extent of redundant skin. For instance, the outer thigh requires an incision starting from the hip down to the groin and so the resulting scar lies precisely at the “panty line.”
Meanwhile, the inner or medial thigh lift requires incisions starting from the groin down to the knee and so the resulting scar is on the inner aspect of the thigh.
This is the actual scar resulting from a medial or inner thigh lift surgery.
Compared to other body contouring procedures, recovery from thigh lift is generally “tougher” because of the increased swelling due to gravity and the full weight of the legs. Hence, the first two weeks are the most critical period, requiring the patient to be extra cautious when moving.
The patient must move carefully and slowly to avoid pulling on the incisions. It is important to note that wound dehiscence (reopening) requires longer time to heal.
After two weeks, most patients can slowly increase their activity without causing an elevated heart rate. Over-exertion must be avoided for an additional 4-5 weeks to prevent more swelling and healing problems.
Most patients are advised to take 3-4 weeks off so they can focus on their recovery. Furthermore, protein supplements along with superb diet (more fresh fruits and vegetables and whole grains, while avoiding too much fats and sodium) can help patients improve their healing.
Oftentimes, thigh lift after massive weight loss is followed by other body contouring surgeries such as tummy tuck, arm lift, or back lift.
The reasons for arm lift surgery are generally cosmetic related, i.e., remove the excess skin and fat in the upper arm lift and achieve a more balanced silhouette. While the vast majority of people seeking this procedure are massive weight loss patients, those who want to correct skin laxity due to natural aging can also benefit from it.
And because the reasons for arm lift surgery are primarily anchored to aesthetic improvement, it is rarely covered by health insurance. Nonetheless, some massive weight loss patients can expect relief from skin irritation and poor hygiene once the redundant tissue has been removed.
Arm lift surgery typically used an elbow-to-armpit incision placed on the inner aspect of the arm for optimal scar concealment. However, some patients may require their scar positioned more posteriorly, and thus more visible, to achieve a more natural arm contour.
Placing the scar more posteriorly has also been found to promote better scarring as compared to the inner aspect of the arm because it allows the surgeon to close the wound with less “surface” tension, according to California Surgical Institute website.
Occasionally, arm lift surgery is combined with liposuction to further contour the upper arm. It is highly recommended to use microcannula—i.e., stainless steel probe with a diameter that is 2.2 mm or less—because it removes excess fat in smaller bits, therefore giving the surgeon a much greater control.
And with greater control offered by microcannulas, the results tend to be smoother and more natural compared to larger cannulas.
As with any form of body contouring procedure, the patients’ reasons for arm lift surgery must be highly personal; the decision to have the surgery should not come from anyone else, including their loved ones and family.
To shed light on the possible “emotional and psychological benefits” from body contouring surgeries, one study examined massive weight loss patients who have had tummy tuck. It has suggested that patients who had the procedure were more successful in keeping their weight stable than those who did not.
The researchers concluded that the cosmetic improvements could serve as a strong motivation to stick to a healthy lifestyle/long-term weight management.
Liposuction after weight loss not only deals with “stubborn” fats, which do not respond to further dieting and exercise; most patients also have contour deformities due to the redundant skin and soft tissue laxity.
Massive weight loss, which is clinically defined as 50 percent or greater loss of the excess weight, can also lead to a deflated-looking appearance, which is more pronounced in the buttocks, facial region, and breasts.
As a stand-alone procedure, liposuction may not provide optimal outcome in MWL patients who generally require excision-based body contouring surgeries that may include tummy tuck, buttock lift, thigh lift, and arm lift.
Some surgeons prefer liposuction performed simultaneously with some type of excision-based plastic surgery after weight loss. They argue that a combo procedure is reasonably safe with proper patient selection, management of risk factors, close monitoring, and keeping the surgery under six hours.
Others prefer staging each surgery, performing liposuction at least six months prior to an excision-based body contouring. Dr. Tarick Smiley, a leading Beverly Hills plastic surgeon, says this approach favors patients who “need a great deal of work.”
Proponents of the staged-procedure suggest that it could minimize risk of healing problems since the amount of surgical trauma and bleeding is “controlled.”
Despite varying views on simultaneous liposuction and staged surgery, the latter approach is generally favorable if MWL patients will also require tummy tuck in which a horizontal incision within the lower abdomen is used.
By removing the excess fat in the abdominal area, and waiting for several months to see how much skin retraction or slackening will occur, doctors are able to assess the most ideal tummy tuck scar in terms of its length and placement.
Dr. Smiley says that most MWL patients require debulking or large volume liposuction in which 4 liters or more of fat is removed in one day. Because of the increased risk of fluid imbalance, this approach entails a hospital stay, as opposed to a same-day operation in “standard” liposuction.
The renowned Beverly Hills plastic surgeon further adds that previously obese individuals have fat that is more fibrous, making liposuction more difficult. Nevertheless, certain procedures can address this “challenge” such as the use of microcannulas and tumescent fluids.
Microcannulas are suction probes with an outside diameter that is 2 mm or less, thereby they provide more control and accuracy than large cannulas. Also, surgeons use less force when extricating the fatty tissue with these flexible tubes.
Plastic surgery for men must take into consideration certain factors such as the masculine beauty ideal, underlying anatomies like skin thickness, ethnicity, and personal goals of each patient.
Inland Empire plastic surgery expert Dr. Tarick Smaili explains what makes plastic surgery for men different from women’s.
(Photo credit: imagerymajestic at FreeDigitalPhotos.net
In facial rejuvenation surgeries such as facelift and brow lift, surgeons follow certain guidelines. For instance, men generally require a more conservative approach than women—i.e., minimal lifting of the forehead area and less work on the lower face—to preserve their masculine appearance.
An over-aggressive brow lift often results in effeminate appearance (high and more arched eyebrow) instead of a masculine brow, which appears lower and “heavier” than women’s.
The same rule applies to body contouring surgeries for men, such as liposuction and pec implants, in which the goal is to recreate the ideal masculine silhouette, or the V-shaped, athletic-looking body.
Men’s skin is generally thicker and more vascularized (more blood vessels), so they are more prone to hematoma or pooling of blood under the skin than women. For this reason, proper dissection is more important than ever when treating male patients during facelift, brow lift, and rhinoplasty (nose job).
To minimize bleeding at the time of surgery and postop hematoma, all patients are required to avoid blood thinners (aspirin and aspirin like products), certain herbal supplements, and tobacco products a few weeks before and after surgery.
Aside from gender-appropriate results, plastic surgery for men must also respect the patient’s ethnicity and his cultural based standard of beauty. This is particularly true of rhinoplasty, eyelid surgery, and other procedures that involve ethnically sensitive areas of the face.
It is important to note that what works for Caucasian patients do not always apply to people of Hispanic, Asian, and African background.
Cosmetic plastic surgery is a highly individualized procedure in which the goal is to make the patient’s happy and possibly improve his body image and self-esteem. For this reason, good communications are of paramount importance to achieve satisfying results.
Meanwhile, anyone who exhibits signs of body dysmorphic disorder, schizophrenia, and other mental issues is a poor candidate for any type of elective surgery.
Plastic surgeries are generally reserved for well-rounded and emotionally stable patients who know how to make an informed decision.