Mommy “Mami” Makeover

By Dr. Jose Perez-Gurri, Director and Founder of Imagos

The combination of a tummy tuck and some type of breast procedure has become the most popular cosmetic surgical procedure sought after women following their pregnancies.

Many physical, hormonal, physiological, and emotional changes are rapidly occurring during pregnancy. The body undergoes tremendous stress which results in a physical transformation. Thus, hips become wider, localized fat becomes more prevalent particularly in the hips and flanks and stretch marks appear on the abdomen and breasts. The breasts lose volume due to their engorgement during pregnancy and indeed may simply sag. This leaves the woman wanting to regain her pre-baby body.

When undergoing an abdominoplasty or “tummy tuck,” specific issues need to be addressed during surgery  — the amount of fat to be removed and repairing of the underlying muscle. A surgical plan needs to be developed to address each individual’s needs. The skin/fat present from the umbilicus down to the pubic region will be removed. The incision pattern will vary according to the patient’s anatomy. After the removal of this tissue, assessment is made to see how far apart the rectus muscles have been left following the pregnancy. The rectus muscles are comprised of two muscle strips running from the breastbone/ribs down to the pubic region. Most, if not all, will require tightening of those muscles by suturing from the tip of the breastbone down to the pubic region, creating a corset. The tissue left above the belly button is then sutured and the belly button brought back out or re-surfaced. The belly button or umbilicus is what’s leftover of the umbilical cord. It is merely a piece of scar tissue with no apparent function. During a tummy tuck, for the most part, the plastic surgeon does not remove the belly button and make a new one but instead, once the excess overhang of tissue has been removed, the belly button attached to the abdominal wall is simply re-surface at a new position on the skin which should be exactly where it was prior since it is still attached to the abdominal wall (muscle layer).

The order in which a mommy makeover is carried out, tummy first-breast second or vice versa, is dependent on the plastic surgeon. Surgical planning and design are key to a successful outcome.

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