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What is a Mommy Makeover?
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What is a Mommy Makeover?

Episode 9: What is a Mommy Makeover?

What is a mommy makeover? The simple answer is that a mommy makeover is a combination of procedures designed to bring your body back as close as possible to its form before you were pregnant and had children. And while that is a good definition, it doesn't really describe what a mommy makeover is because every patient's mommy make over is going to be different. And that's because pregnancy affects everyone's body in a unique way.

What areas are most frequently affected by pregnancy and breastfeeding?

Now, the breasts and the abdomen are the two areas that are most frequently affected by pregnancy, so those are the areas that are most frequently going to be addressed in a mommy makeover. It is, however, extremely common for other areas to be affected by pregnancy as well since pregnancy and breastfeeding affect tissue laxity and plasticity, as well as fat distribution throughout the entire body. So we'll address the breasts and the abdomen first, and then touch on some of the other areas that can be affected by pregnancy and breastfeeding. While almost everyone's breasts are affected by pregnancy, they are affected very differently from woman to woman. Essentially, the three possibilities for effects of childbearing and breastfeeding on the breasts is that the breasts could lose volume, they could become droopy or ptotic, or they could actually gain volume.

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What breast procedures are part of a mommy makeover?

The procedure that is indicated as part of a mommy makeover for a given person depends on what changes her breasts underwent. So for someone whose breasts lost volume as a result of pregnancy, a breast augmentation would be the procedure of choice. For someone whose breasts became more ptotic or ‘droopy” as a result of pregnancy and breastfeeding, a breast lift would be indicated. For someone whose breasts both lost volume and became ptotic, an augmentation mastopexy or breast lift with breast implants would be a good option. For someone who gained a lot of breast volume during pregnancy, a breast reduction might be the procedure of choice.

What is the role of abdominoplasty in a mommy makeover?

In terms of the abdomen, there is a predictable series of changes that occurs during pregnancy. As the uterus expands to make room for the growing fetus, it often pushes the rectus abdominis muscles, the six pack muscles, apart in the midline causing a weakening of the abdominal wall called a rectus diastasis. And the rectus diastasis is visible as a lower abdominal bulge. At the same time, there's often an increase in abdominal fat during pregnancy.

As the skin envelope expands to accommodate the growing uterus and additional abdominal fat, the overall skin surface area increases as well. After delivery when the volume of the uterus returns to normal and the abdomen begins to approach it's pre-pregnancy size, the skin envelope often isn't able to completely contract back to its pre-pregnancy volume. And it's this differential between the volume of the abdomen and the surface area of the skin that can lead to the characteristic rippling or skin laxity and skin access that can be seen in the postpartum period. At the same time, after pregnancy and after breastfeeding is completed, the volume of abdominal fat often returns to normal, but this occurs in varying degrees.

So essentially each patient needs to be evaluated on an individual basis to see the extent of change that occurred in each of these three treatable areas of the abdomen, namely the muscles of the abdominal wall, that's the rectus muscles that can become separated to form a rectus diastasis, the amount of fat in the abdomen and also the degree of skin laxity. And it is based on these changes that the best operation for that patient is chosen.

For example, in someone that has a severe rectus diastasis and significant skin laxity and also some remaining abdominal fat, a full tummy tuck would be the operation of choice. Alternatively, someone that doesn't have much of a rectus diastasis and has only mild or moderate skin laxity and only some remaining fat could potentially do very well with a liposuction procedure and some radiofrequency skin tightening. So from this discussion so far, we've shown that a mommy makeover usually consists of some kind of breast operation and some kind of abdominal operation and the exact combination depends on the needs of the individual.

What other procedures might be included in a mommy makeover?

Liposuction is also very frequently included in a mommy makeover to help take care of fat that has been redistributed in an unpleasing way as a result of the pregnancy. Frequent areas of concern include the mons, the waist, the lower back, and the thighs.

Pregnancy, and especially breastfeeding, can also take its toll on the shape and size of the nipples and areola themselves. So procedures like a nipple reduction or an areola reduction might be desired by a patient that wants to restore these areas to their pre-pregnancy appearance.

The labia may also become distorted from pregnancy and delivery. So labiaplasty may also be included as part of a mommy makeover. The overall tightness and configuration of the vaginal canal can also be altered as a result of giving birth. And one procedure we've seen great success with in this context is Emsella, which uses HIFEM, or highly focused electromagnetic energy, to essentially do the equivalent of 20,000 Kegel exercises in 30 minutes. And this procedure is completely noninvasive and can be performed while the patient is clothed.

Conclusion

So the moral of the story here is that pregnancy is a very complex process that affects everyone's body in a different way, and to design the perfect mommy makeover an in-depth consultation with a board certified plastic surgeon is a really good first step to explore what your goals are and the best strategies for achieving those goals. And while the definition of a mommy makeover, that is to restore your body to its pre-pregnancy form, is the same for everyone, the exact combination of procedures involved in a mommy makeover is different for each patient.

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  • Darren M. Smith MD
  • Darren M. Smith MD
  • Darren M. Smith MD

All photos are of models except before and after images.

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