Mommy make overs —- what you need to know
An experienced plastic surgeon’s viewpoint by
Dwight V. Galloway M.D.
In recent years the combination operation of abdominoplasty, breast augmentation with lift and liposuction has been used to help correct some of the worst changes to women’s bodies caused by pregnancy, child birth and breast feeding. The press and others have called this ”mommy make overs”. With 2 surgeons working together, but separately, this procedure can be accomplished in less than 3 hours, an acceptable time for a very safe general anesthesia. An overnight stay in the hospital is usual since the abdominal portion of the operation includes repair of the stretched muscle and midline tissue and includes an overnight urinary catheter (so you do not have to get up the first night after surgery). The problems on the breast include a marked enlargement of the breast tissue with stretching of the skin and areola in preparation for breast feeding. When this is concluded the breast volume reduces and many times it is well below what it started with and so the skin and areola hang on the abdomen. Restoring the volume can be accomplished by an implant and elevation of the nipple-areola complex and tightening of the skin requires a mastopexy. The entire abdominal skin and muscle is tremendously stretched and often overcomes the skin’s elasticity with resultant stretch marks. The lower skin and fat can hang over the pubis and make underclothes and bathing suits unsightly with the resultant loss of self image. Dressing to hide the new self image compounds the problem. The lower abdominal muscle and midline tissue makes the lower abdominal “pooch” even worse. Just as important as the appearance is the loss of support to the intestines by the over stretched muscles which must work harder all day and result in chronic low back pain which most people and physicians do not attribute to the pregnancy changes and many chiropractic treatments and even back surgery are done without relief. When they awaken from anesthesia for the abdominoplasty then pain is “magically” gone and never returns. They can do sit-ups again and forget their chiropractor. The abdominoplasty removes all the skin with the worst stretch marks and the overhanging skin and fat. The scars from both the breast surgery and abdominoplasty need to be covered by clothes usually. You cannot depend on them becoming “hairline” but sometimes that does happen. In general this surgery should wait for about 6 months after delivery and about 2 to 3 months after stopping breast feeding.