Mommy Makeover
March 16th, 2009
Many plastic surgeons are advertising the “mommy makeover.” This is a marketing combination of breast surgery (enlargement, reduction,lift) and body sculpting (tummy tuck, liposuction). The goal of the surgery is to restore the natural feminine shape after a pregnancy. Often women will tell me that they are disappointed that their breasts have changed with pregnancy. This may include changes in size as well as shape. The most frequent complaint I hear is, “My breasts are smaller than they were.” However, some women will experience an increase in breast size.
Changes in breast shape are frequently interpreted as breast sagging or loss of perkiness. If your nipples are above the cease below your breast, the loss of fullness above your nipples is the problem. This is best corrected with breast enlargement, provided you are comfortable with larger breasts. Breast lift surgery is necessary if nipples are below the crease. Breast enlargement or reduction can be combined with breast lift surgery.
The other area of a woman’s body which changes is her abdomen. The skin and muscles are stretched by the growing baby. The extra skin can sag while the stretched muscles can reveal a protruding tummy. Tummy tuck surgery is perfect to correct these changes. Liposuction may be considered if localized fat collections persist afer weight loss. The timing of a “mommy makeover” is critical. I recommend waiting six months to a year after delivery before considering surgery. This allows your body to recover from the pregnancy. If breast-feeding, three months must pass before breast surgery. Recovery is also easier when the baby is older. I do not recommend combining tummy tuck or liposuction with breast surgery. I believe it increases the severity of the recovery, because when combining surgeries, the risk of problems after surgery is increased.
Hiding Scars
March 12th, 2009
Visible scars are inevitable after any surgery. Emergency surgery unfortunately will leave scars which are obvious as a trade for saving a life. Elective surgery does allow for planning. This planning allows for design of scar placement and the application of technologies which reduce scar length. Most notable in general surgery are the recent advancements in endoscopic surgery and its application in “natural orifice surgery.”
Arguably the first natural orifice surgery is rhinoplasty or cosmetic nose surgery. This operation developed at the end of the 19th century is done through multiple incisions within the nostrils. The supporting structure of the nose is resculpted by addition and/or subtraction of tissue and implants to give a more aesthetically pleasing nose shape.
More recently, the advent of liposuction has allowed the safe removal of fat through multiple tiny carefully placed inconspicuous incisions. In fact, once healed many of these scars are hard to find! Prior to liposuction, long unsightly incisions were used in an effort to remove excess fat and sometimes skin.
The planning of all cosmetic surgery centers around the final anticipated scar. The direction, location, and length are the keystones of design. Scar direction as it relates to normal skin creases and wrinkles is critical. Generally, scars which parallel these lines heal better and are less apparent. Minimizing scar length obviously reduces scar size. This is a constant battle in cosmetic surgery. As a surgeon I need access to the treatment area to complete dissection, sculpting and control bleeding. Finally, we want to place any visible scars such that they are either easily covered by the smallest bathing suit you want to wear or easily concealed with make up and/or hair style. Elegant surgical design is possible only when all these things are taken into consideration.
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