Mommy Makeover

By: Jean-Pierre Riou, MD, FACS

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Child bearing is extremely difficult on the female body. Even if everything is done right—such as eating well, staying active, and limiting weight gain to 27 pounds—the abdominal wall still gets irreversibly damaged from the forward stretch of the uterus. This typically causes a “diastasis recti” where fascia between the two sit-up muscles gets attenuated, causing the postpartum abdomen to look several months pregnant even at normal weight and despite sit-ups and core training.

In addition, the breasts become engorged in preparation for breast feeding, stretching the supportive cooper ligaments and causing a saggy appearance. This is compounded by the loss of volume after the spikes in prolactin hormones have subsided, leading to “involutionary mammary hypoplasia” where the breasts are typically a cup size or more smaller than the pre-childbearing breasts.

A “mommy makeover” is the surgical correction of these bodily changes and restores the body to a more youthful appearance. This requires a combination of procedures under the same anesthesia, including abdominoplasty (tummy tuck), breast augmentation (with or without breast lift), and liposuction.

The abdominoplasty corrects all three components of the tummy problems: Liposuction for the surface fat, skin excision between the bellybutton and pubis for the “muffin-top,” and a “corset” suturing of the space between the two sit-up muscles for the abdominal wall weakness.

The breast augmentation component involves restoring fullness to the breast that has been lost—typically under the muscle with saline implants if there is still sufficient breast tissue or “form stable” silicone gel implants if there is not. If the nipples are very low, or the skin stretch is significant, a breast lift may be added, which involves repositioning the nipple and tightening the skin through minimal scars (Donut or Lollipop lifts), or more extensive scars if the breast skin has been massively stretched during breast feeding.

Recovery is difficult after a mommy makeover and should not be taken lightly. Narcotics are given but expect to be housebound for at least 10 days. Our patients must be normal weight, tobacco-free, and in good health for us to consider proceeding with this operation.

This combined approach to plastic surgery has several advantages. There is a significant cost savings since only one anesthesia is required. Additionally, it only requires one recovery, so downtime is less. Finally, the risks are no greater than single-procedure operations since we can limit total time in the operating room to less than four hours.

The loss of youthfulness of the female body after childbearing can cause significant distress and negative body image. Women get discouraged when proper diet and regular exercise fail to restore the appearance they desire. Surgical correction is often the only solution even in the fittest of women. Thankfully, in properly selected patients, the mommy makeover is a straight foreword operation that leads to consistently high satisfaction rates.

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Dr. Jean-Pierre Riou’s practice is dedicated exclusively to plastic and reconstructive surgery of the breast and body contouring (liposuction and tummy tucks). Riou Plastic Surgery Center is located at 19615 Liverpool Parkway in Cornelius, and they can be reached at 704.896.5806 or at www.riouplasticsurgery.com.