The Mommy Makeover

Kids are a great blessing. They make us laugh, and watching your own children grow into successful adults is one of life’s greatest privileges. However, sometimes those cute little guys and gals do a number on their mothers’ bodies. There are times that, after having children, a mother’s abdomen and breasts have excess skin and laxity, causing these areas to appear older than the woman feels.

If a woman has also experienced any weight gain/loss throughout her life, these areas (breasts and abdomen) are likely even more affected after children. That’s why many of our patients opt for a mommy makeover here in our Austin, Texas office.

So what is a “mommy makeover?”

A mommy makeover is a term used to describe a surgery that revitalizes the abdomen and the breasts simultaneously. This typically involves an abdominoplasty (tummy tuck) for most of our Austin patients, with or without liposuction, and a breast lift.

Let’s first address the abdominoplasty:

The abdominoplasty is typically referred to as the “tummy tuck,” and it is a key component to the mommy makeover.

Patients needing an abdominoplasty typically have redundant skin below their belly button region. Sometimes there is also a C-section scar along the lower abdomen, or other areas of tethering that allow that extra skin to hang. This makes wearing certain clothes difficult, and it can make exercise and other physical activity more difficult or awkward. That’s where a tummy tuck can really help. Below is a common example of a patient who has had 2 children and has lost approximately 60 pounds over the last few years:

Notice that there is some “hooding” to the belly button, meaning that there is extra skin around the belly button that sort of hangs around it. In the lower abdomen, bellow the belly button, the skin tends to gather and fills the upper portion of the underwear. The skin bunches up, making it difficult to wear certain clothes. It can also hang over the upper thighs, making it difficult to keep this area dry during physical activity.

A standard tummy tuck will remove the skin between the belly button and the pubic bone, which is the typical problem area for mothers desiring a mommy makeover.

The diagram above demonstrates the skin that is removed in a tummy tuck (the red arrows). The green area shows the skin that is elevated off of the abdominal muscles. This skin is elevated so that it can be pulled downward to give the patient a flatter abdomen. A new spot for the belly button is then made in that downward pulled skin. The final scar is shown above in blue. This is a “hip to hip” scar that is typically buried in the underwear line. There is an incision around the new belly button, too.

Aside from removal of skin and the making of a new belly button, there is another major advantage to having a tummy tuck. During the procedure, we often tighten the abdominal muscles, which frequently separate due to pregnancy. Years of weight gain or loss can further stretch these abdominal muscles. The medical term for this is rectus diastasis. That is just a fancy term meaning that the abdominal or “ab”muscles (rectus) have separated (diastasis) in the midline:

The red area in the diagram above shows the splitting of the abdominal muscles. Those ab muscles should sit closely together in the midline of the abdomen. The only way to bring them back is to suture them back together. This requires the abdominal skin to be lifted to expose these muscles so that they can be repositioned.

Bringing the muscles back to the midline also has a corset effect on the waist. Bringing those muscles together essentially cinches the waist inward. This allows for removal of a little bit more abdominal skin and an overall better shape to the waist.

Liposuction

Sometimes liposuction is used during a tummy tuck to better shape the abdomen and hips. Extra skin is generally the issue over the lower abdomen, but often there is some excess fatty tissue on the flanks or “love handle” regions. This can be addressed with liposuction at the time of tummy tuck.

The following patient underwent tummy tuck with liposuction as part of her mommy makeover:

Breast Lift

The other component to the mommy makeover is a breast lift. This is a fairly generic term, since a “breast lift” can mean many things.

Let’s discuss the problem, and then we can talk about ways to address it.

After breastfeeding, the breasts are often smaller than they were prior to having children. Often, the nipples/areolas are sitting low and there is excess skin, causing the breasts to have a hanging appearance rather than a youthful, full appearance:

Notice in the above photo that there is a lack of volume to the upper regions of the breasts. These areas appear hollow. The nipples/areolas are sitting low, and the skin of the breasts is loose overall and tends to hang down. The left nipple/areola also sits a little lower than the right.

In order to “lift” the breasts, one of two things can be done.

• Add volume: One option is to add volume to the breasts. This will fill out the loose skin and can return the breasts to their pre-baby volume. This is done by adding breast implants.
• Remove skin: The other option is to remove the excess skin, so the current breast is lifted without adding volume.
• Add volume and remove skin: And finally, both methods can be combined (i.e., adding breast implants and simultaneously removing excess skin to make the breasts tighter).

Nipple/Areola Position: While volume of the breasts needs to be addressed, the location of the nipples/areolas needs to be addressed, too. Often, simply adding volume (via breast implants) will lift the nipples/areolas to a youthful position. In other cases, the nipples/areolas will need to be moved upward. This can be done along with the skin removal portion of a breast lift.

The best way to know what a “breast lift” will entail for a given patient is to have a consult with your plastic surgeon. He or she can guide you in achieving your breast goals.

The above patient underwent placement of silicone implants under the pectoral muscle, combined with skin removal and elevation of the nipples/areolas for her breast lift portion of the mommy makeover. Her overall transformation is below: