Mommy Makeover Toronto
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A mommy makeover is a surgical procedure that addresses the abdomen and breasts, features which change following pregnancy and breastfeeding.  The abdomen expands during pregnancy and often exceeds the skin’s ability to fully retract following delivery.  This often leads to redundant skin and soft tissues as well as a rectus diastasis, which refers to gapping between the rectus abdominus muscles in the midline.  This muscle separation may contribute to a rounded appearance of the abdominal wall and decrease core abdominal strength.

A mommy makeover is performed under general anesthetic in an operating room setting.  Contour improvement may be achieved through abdominoplasty and cosmetic breast enhancement – whether augmentation, mastopexy (breast lift), augmentation-mastopexy (breast lift with implants), or fat grafting depending on each patient’s unique presentation and surgical goals.

As a female plastic surgeon, Dr. Power is approachable and strives to make patients comfortable throughout every stage, from initial consultation through surgery and post-operative care.  Dr. Power is sensitive to patients’ insecurities and listens to their goals from a common feminine perspective.

What are common concerns of patients considering a Mommy Makeover?

Patients considering a mommy makeover commonly express concerns regarding loose skin and soft tissues of the abdomen as well as changes in breast appearance following pregnancy and breastfeeding.  Breasts often develop ptosis (droopiness) and lose volume, particularly in the upper pole.

Unfortunately even when following a regimented exercise routine and healthy diet, the abdomen and breasts often do not return to their pre-pregnancy appearance following delivery and completion of breastfeeding.  Stretch marks commonly appear, which shows that the skin has lost elasticity and has stretched beyond its ability to fully tighten.

Who is a suitable candidate for a Mommy Makeover?

A suitable candidate for a mommy makeover procedure is a healthy non-smoker who has achieved a healthy and stable body mass index (BMI) following delivery and completion of breastfeeding.  BMI should be less than 30, ideally closer to 25, before proceeding with surgery to lower risk of complications and to achieve the best possible aesthetic outcome.  Body weight should be stable for at least 6 months before surgery.  If weight loss occurs after surgery, the breasts may lose further volume and loose abdominal skin may recur.  Surgery should also be deferred if planning future pregnancies since the aesthetic benefits of surgery would be compromised.

What are different types of Mommy Makeover?

Mommy makeover refers to surgery on body features that change during pregnancy and breastfeeding, specifically the breasts and abdomen.  A full tummy tuck is generally required for contour improvement of the abdomen following pregnancy.  A mini tummy tuck does not address the rectus diastasis and may achieve only a limited resection of loose skin.  Skin and soft tissue redundancy is typically more pronounced following pregnancy than what a mini tummy tuck may address.

Options for cosmetic breast enhancement vary between patients based on clinical presentation and aesthetic goals.  Breast augmentation using implants may be performed to achieve greater breast volume, but will not correct breast ptosis that often develops following breastfeeding.  Fat grafting may be alternative option to enlarge the breasts if sufficient donor tissue is available.  A breast lift alone may be performed if a patient wishes to correct ptosis and not increase breast volume.  To achieve both augmentation and a lift, augmentation-mastopexy (breast lift with implants) may be performed.  This is one of the more complex types of plastic surgery due to considerations relating to blood supply as well as nipple and breast mound position.  The breast lift and implants essentially oppose one another; the breast lift tightens the skin envelope, while the implant places it under greater tension.  It may be recommended to stage this procedure in certain cases to achieve a more predictable result with lower risk of complications.

What to expect after a Mommy Makeover?

Following surgery, you will awaken in the recovery room.  It is generally recommended to stay overnight for observation and pain control given the extent of surgery.  Two overnight nurses will stay with you until discharge the following morning.  You will gradually begin to sip fluids and then diet will be advanced as tolerated.  It is recommended to begin walking short distances soon after surgery to lower risk of venous thromboembolic events (DVT or pulmonary embolism).  Your abdomen will be supported by an abdominal binder, which should be worn full-time except when showering over the first 6 weeks following surgery.  You may resume showering the day after surgery, gently washing your surgical sites with soap and running water.  Prescription pain medication may be required for a few days post-operatively.  It is recommended to wean these medications as soon as possible to lower risk of associated complications.  Drains will be in place for the abdominal surgical site, which remove fluid deep to the skin flap.  Output gradually decreases over the first week or so after tummy tuck.  You will be instructed how to empty and record drain output before discharge home.  The drains will be removed when appropriate within a week or two during follow up visits.

What is the anticipated recovery after Mommy Makeover?

Prescription pain medication may be weaned over the first few days following surgery.  It is recommended to avoid exercise and heavy lifting for 6 weeks post-operatively to lower risk of bleeding, further swelling, and healing complications, particularly relating to the muscle repair.  Given that patients undergoing mommy makeover procedures often have young children at home, you may need to arrange help with childcare and housework during this time period.  Patients may wish to defer surgery until their children reach an age when they no longer require routine lifting.  It is generally possible to return to office-based work within a week or two of surgery.  If physical requirements are more strenuous in the workplace, it is important to discuss your concerns with Dr. Power pre-operatively for specific recommendations.

How much should I weigh before considering a Mommy Makeover?

It is recommended to achieve a stable and healthy BMI pre-operatively.  A body mass index of less than 30, ideally closer to 25, is recommended before surgery.  A mommy makeover is not an effective technique for weight loss.  It is a body contouring procedure that may remove loose skin and soft tissues of the abdomen that stretched during pregnancy.  It may also improve breast contour by correcting ptosis and restoring volume after breastfeeding.

How long should my weight be stable before a Mommy Makeover?

It is recommended for weight to be stable for approximately 6 months before proceeding with a mommy makeover.  If weight loss is planned, it is recommended to achieve before surgery.  If further weight is lost after a mommy makeover, loose abdominal skin may recur and additional volume may be lost from the breasts.  Surgical results will be more stable and predictable if weight has stabilized before undergoing surgery.

When can I exercise after surgery?

Exercise should be avoided for 6 weeks following surgery.  Patients commonly ask whether exercise may be resumed sooner if the surgical site is protected.  For example, would it be acceptable to lift weights or run on a treadmill after a mommy makeover if crunches and core abdominal work-outs are avoided?  Unfortunately any form of exercise that elevates heart rate and blood pressure may increase risk of bleeding during early recovery and should be avoided until 6 weeks post-operatively.

How painful is a Mommy Makeover?

Patients generally report that the tummy tuck is the most uncomfortable site following this procedure.  The muscle repair is often sore during early recovery.  Local anesthetic is infiltrated within the rectus sheath, which provides pain relief over the first 6-8 hours post-operatively.  Wearing the abdominal binder may reduce discomfort by supporting and splinting the abdomen.  Slighting flexing the waist when walking over the first day or so may also reduce discomfort by decreasing tension on the incisions.  Discomfort of the chest varies between patients based on pain tolerance and technique of cosmetic breast enhancement.  If breast implants are placed below the pectoralis muscle – which is recommended in thin patients to mask the implant and to enhance the aesthetic result – tightness or localized discomfort is also common during early healing.  Prescription pain medication may generally be discontinued within a few days following a mommy makeover.

Are there any special considerations for patients considering a Mommy Makeover?

New mothers have many responsibilities relating to child care, housework, and work outside the home.  It is important for patients to arrange help as needed to ensure that adequate time may be dedicated to recovery during early healing.  It is recommended to avoid lifting over 5 lbs. for 6 weeks post-operatively.  Patients may need to arrange help with young children if lifting is still required during bath time and other day-to-day activities.  Preparing meals in advance to carry over the first week post-operatively may also be helpful.  Groceries should be picked up in advance.  Dr. Power will provide your prescription during your pre-operative visit, which should be filled in advance of surgery.  Preparation is the key to a smooth recovery.

When should I have this type of surgery if considering more pregnancies?

Although a patient may still carry a healthy full-term pregnancy following a mommy makeover, the aesthetic benefits of surgery would likely be compromised.  It is recommended to defer surgery until childbearing has been completed.  If pregnancy occurs following a mommy makeover, revision surgery may be required.

How long are drains in place after a Mommy Makeover?

Drains are removed when output has achieved a low amount over a 24 hour period.  Your overnight nurses will perform patient education to ensure you are comfortable performing daily drain care and recording measurements prior to discharge home.  Generally one drain is removed during the first post-op visit and the second one shortly thereafter based on output.

How long should I wear the abdominal binder?

The abdominal binder is recommended for 6 weeks full-time except when showering.  It provides support to the abdominal muscles during early healing, reduces swelling, and may lower the risk of developing a seroma (fluid collection) at the surgical site.  Many patients report that the abdominal binder also reduces discomfort over the first few weeks after a tummy tuck.

Are the effects of a Mommy Makeover long-lasting?

Results following surgery should be long-lasting as long as one maintains a stable and healthy body weight and there are no future pregnancies.  Redundant skin and soft tissue may recur if weight fluctuations occur.

What are potential complications of a Mommy Makeover?

Risks of surgery will be discussed in detail during pre-operative assessment.  Surgery is generally well-tolerated in appropriately selected candidates.  It is important for patients to be non-smokers (or commit to smoking cessation for at least one month pre- and post-operatively) to lower risk of infection and healing complications.  It is also important to understand a patient’s motivation and surgical goals to assess the likelihood of achieving high patient satisfaction from a mommy makeover.

Risks of a mommy makeover include local and systemic complications.  Local complications of tummy tuck include bleeding, hematoma, infection, seroma, delayed wound healing, hypertrophic scarring, skin flap or umbilical necrosis, asymmetry, and dehiscence of the muscle repair.  Risks of cosmetic breast enhancement include similar risks of bleeding, infection, and delayed healing, in addition to implant complications, asymmetry, altered nipple sensation, and skin flap or nipple necrosis.

 

Systemic complications of a mommy makeover include DVT and pulmonary embolism, as well as anesthetic complications.  Risk factors for developing venous thromboembolism are assessed pre-operatively.  Compression devices are placed on the lower legs to enhance circulation during surgery.  Early mobilization is also recommended to lower risk of developing blood clots.  If additional risk factors are identified, further management may be indicated or elective surgery may not be recommended.

 

If considering a Mommy Makeover in the Toronto area, please contact female plastic surgeon, Dr. Stephanie Power, to schedule a consultation!