Mommy Makeover is a term used to describe the universe of post-pregnancy surgeries that return a mother to her pre-pregnancy state and oftentimes even better than that. Women who have had one or multiple pregnancies normally consider some or all of these surgeries. There are the five basic elements to the Mommy Makeover:
- Tummy tuck or abdominoplasty with repair or the abdominal musculature;
- Liposuction to get rid of baby fat that just will not go away;
- Breast augmentation, breast lift or both;
- Labiaplasty which includes tightening of the vaginal opening; and
- Treatment of facial hyperpigmentations that are a result of pregnancy hormones such as the mask of pregnancy often found on the face and referred to variously as calasma or melasma.
WHAT IS A TUMMY TUCK?
A tummy tuck or abdominoplasty is the surgical procedure that flattens the abdomen, gets rid of loose skin, and corrects the separated abdominal musculature referred to as rectus diastasis, which means separation of the rectus abdominal muscles. The belly button or umbilicus is reshaped and brought out through new skin, which is very often smooth and free of stretch marks. Of course, we remove as much extra skin and fat as possible but it is much less important how much we remove as what we leave. It is our feeling that surgery does not end at surgery; it only ends once the scar is as good as it can get. We often place tape on the abdominoplasty incision for up to two to three months post surgery to get the best result; this is all included in the original price. Added benefits from abdominoplasties are 1) correction of abdominal musculature often takes tension off the back muscles therefore correcting post pregnancy lower back pain, 2) pulling down the abdominal skin also pulls up the vulva and all of the external female organs to include the urethra. Depends (adult diapers) were invented for older women who had multiple pregnancies; the problem is the urethra loses its normal kink and therefore, these women get stress incontinence. They laugh, they pee, they cough, they pee. An abdominoplasty very often corrects this post-pregnancy problem. Finally, 3) the clitoris in a woman who has had multiple pregnancies and lots of loose skin usually falls between the legs. An abdominoplasty corrects this, pulling it into a much more favorable location.
WHAT IS LIPOSUCTION?
Liposuction is a technique for sucking out excess fat, either that produced by pregnancy or that which was already there prior to pregnancy. The most common areas done with a Mommy Makeover are hips, inner thighs and axillary breast tissue (that stubborn fat that hangs over your halter top or bra straps in front of your armpits). Liposuction has been in the U.S. since 1982 when it was first introduced by its French inventor at a plastic surgery meeting in Honolulu in the fall of 1982. Liposuction and its benefits are well known to most Americans. Done at the time of an abdominoplasty or breast surgery, it helps get rid of bulges which were made worse after pregnancy.
Most women have lost volume from their pre-pregnancy breasts after one or more deliveries. This loss of volume is very disappointing to most mothers and is a direct result of the nature of the cells that produce babies’ milk. These cells very often shrink up after nursing creating a very deflated appearance to the breast. Breast augmentations are discussed more at length here.
Breast lifts fall into four major categories post-pregnancy. 1) the deflated breast. Very often patients come in thinking they have droopy breasts when in fact they only have loss of volume and have good position to their nipples with relationship to the fold at the bottom of the breast, called the inframammary fold. Therefore a subpectoral silicone breast augmentation will often give the patient all the lift they require. 2) The Dual Plane Mastopexy. In specific cases, we can lift the position of the nipple and give the appearance of a breast lift without any external scars. In this procedure, the implant is placed below the muscle in the usual fashion but a release of the breast tissue and nipple from the pectoralis muscle allows an upward repositioning of the nipple on the mound created by the implant. 3) The Benelli Mastopexy is a very specialized lift which allows the surgeon to lift the breast and lift the nipple with a single incision just at the edge of areola. This procedure is best used for mild to moderate droop or ptosis, which is the scientific word for droop. Also see Dr. Schlesinger’s video of the Benelli Mastopexy here. Finally, the Standard Mastopexy with implants is necessary when the nipple is below the inframammary fold. This situation rarely lends itself to a Benelli Mastopexy, therefore a Standard Lift is required. There are four basic problems in the droopy or ptotic breasts 1) the areola are normally too big, 2) the areola are normally too low on the mound, 3) the breasts are hanging on the chest wall and 4) there is no fullness in the upper quadrant. The first three problems with ptotic breasts can be corrected by a Standard Breast Lift and/or a Benelli Mastopexy, the fourth requires a breast implant.
Because the baby is cradled below the breast, and causes downward pressure on the nipple while nursing, this often leads to a downward tilt of the nipple due to stretching of the brown area around the nipple referred to as the areola. A crescent shaped areolar reduction hidden at the upper end of the nipple can quickly and easily correct this problem. Elongated nipples can be shortened using a very simple and 100% successful technique.
Labiaplasty is a technique for removing overly large labia minora or the internal labia. Many techniques are available but my favorite is a wedge resection, which leaves no visible scar, gets rid of redundant labia, and is almost pain-free.
POST-PREGNANCY FACIAL HYPERPIGMENTATION
The mask of pregnancy and other facial dark areas can be treated by a cream which bears Dr. Schlesinger’s name: the Schlesinger Melasma Cream. A pharmacy in Aiea compounds this for our office and the success rate to date has been 100%. This is also very useful in post-surgical hyperpigmentations.
If you would like to find out more about our Mommy Makeover Honolulu and Mommy Makeover Hawaii procedures, please contact us by filling out the form to the left or calling us at 1.808.597.8835.
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