Postpartum Plastic Surgery a.k.a. Mommy Makeover | Elizabeth A. Kinsley, MD

Postpartum Plastic Surgery a.k.a. Mommy Makeover

You’re a new mom! Congrats! However, along with the incredible joy comes the not-so-great discovery that your breasts now look like they belong to your old Aunt Edna, your tummy has enough extra skin to donate to a burn unit, and the spider veins on your legs look like a road map of the US. There’s no need to panic, and don’t start hating on your husband because (a) he looks the same no matter how many children he has, and (b) he keeps saying you look great and you know you don’t. Unless you went completely crazy with the weight gain during your pregnancy, with the help of a mommy makeover, you can be looking awesome in no time.

First things first. Give your body enough time to recover from the pregnancy. Growing a human being in your body for ten months is no small feat, so give yourself a minimum of six months before you consider the need for any surgery. This is the time for good health, diet and exercise, and enjoying the new baby. Before you consider a mommy makeover, your weight should be within a 10–15 lb range of your pre-pregnancy weight, depending on your height and body type. You should also wait several months after you stop breastfeeding.

Let’s go from the top down with mommy makeover options and take a look at your breasts. Frequently, all that is needed is volume replacement done with a breast augmentation. Many women are shocked that their breasts after pregnancy are smaller than before pregnancy. This happens as breast tissue involutes or simply shrinks up. Breast augmentation is an easy operation that takes about 45 minutes and only requires a weekend to recover. If you find that your breasts sag a bit, you may require a lift in addition to implants. A mastopexy, or breast lift, tightens the skin, lifts the nipple area, and restores some perk. This adds a little to the surgery time, but recovery is still fairly easy.

The second aspect of a mommy makeover is an abdominoplasty. The abdomen, or tummy area, is where most of the pregnancy damage is done. Two things happen that NO amount of exercise or diet will correct or improve. First, your abdominal muscles get stretched apart, especially near the belly button. This is called a diastasis, and it is what makes some women look 3–4 months pregnant when they’re not. On a man, the rectus muscles may be 2–3 millimeters apart, but after a baby, these muscles on some women may be 2–3 inches apart. Second, the skin stretches. The amount of excess skin will vary depending on your genetics and weight gain. You will see some shrinkage in the first few months after the baby, but most women will have lax skin in this area that persists. The cure for these two issues is an abdominoplasty, or a tummy tuck.

A tummy tuck removes the excess skin and tightens the muscle. Frequently women will look better after this step of the mommy makeover than they did before pregnancy, as a tummy tuck contours the waistline and hips and makes the tummy super flat and tight. A quick word about a mini tummy tuck. Some women want to avoid the scar from a full tummy tuck and request a mini. However, in my opinion, limiting the scar limits the results. A mini tummy tuck tightens the lower abdomen and removes a little excess skin, but since most of the laxity is above and below the belly button, the upper abdomen is still lax and appears even larger when only the lower is tightened. Ask yourself, when you’re sitting down and not holding anything in, if you like how your tummy looks with no scar. The scar from a tummy tuck is usually hidden in the bikini line, so for most women, it’s a good trade-off. The operation takes 1–2 hours and is done as an outpatient procedure. During recovery, it takes about 2 weeks to return to light activity, and 6–8 weeks before returning to full workouts.

While not a surgical component of the mommy makeover, spider veins and other issues can usually be addressed in the office with various laser treatments or injections (sclerotherapy). A word of caution: there is no treatment that works for stretch marks, so don’t let someone take your money with a laser treatment or some other voodoo. Often the stretch marks on the tummy, if confined to the lower abdomen, will be removed with the excess skin during a tummy tuck. Stretch marks elsewhere will fade with time, but will be there forever. (Sorry!)

So, the mommy makeover usually includes a breast augmentation and/or lift, a tummy tuck, and some liposuction for contouring the hips, waist, and thighs. These can be done together as an outpatient procedure, which usually takes 3–4 hours total. Generally, recovery time is not increased by adding more procedures. Most women will tell me that a mommy makeover is the best thing they’ve ever done and that they wish they had done it sooner. Good luck!


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