Dr. Joseph M. Perlman Advanced Plastic Surgery Centre

Mommy Makeovers have gotten to be a popular term in the last few years. The most common definition refers to cosmetic surgery that involves a combination of breast enhancement as well as abdominal contouring.

Many women, who have children notice significant changes in their breasts, particularly if they have breastfed. In addition, women will gain an average of 26 pounds during pregnancy, but I’ve had patients who gained and lost as much as 90 pounds. Needless to say, that wreaks havoc on the belly. The laxity of skin and muscle tone can be more pronounced after a cesarean section. Women tend to be in their 30s or early 40s, and once the childbearing days are done, want to spend a little more time feeling better about themselves, and that includes improving their self-esteem with cosmetic surgery.

When I was a resident in the 1980s, these procedures were called the “Divorcee Special”. They were combination procedures, done on women who were in the process of getting divorced and wanted to make themselves more attractive. I think some of the women wanted their ex-husbands to know how good they could look, but for most women, it was because they were going back out on the “market” and wanted to look their best.

After childbearing, many patients lose volume in their breasts. In addition, the breasts start to sag and even though they may fill the same cup brassiere as previously, they’re not perky. The abdominal skin as well as breast skin may have significant stretch marks indicating permanent damage to the skin. Patients will get back into active exercise programs and keep their weight at a good level, hoping that the skin will tighten up. Unfortunately, this rarely happens to any significant degree.

When I see patients, I explain to them, that lifting the breasts will probably cause a loss of volume of 1/2 cup to one full cup size and most patients will want a small breast augmentation, in order to get back to the size they were before, while they are undergoing a breast lift. As far as the abdomen is concerned, I will perform liposuction all the way around including the lower back. This decreases the volume and allows them to develop more of a waistline. I then proceed with the tummy tuck or abdominoplasty. The extent of the incision varies, depending on the amount of skin that overhangs when the patient is sitting on the examination table. Patients with relatively flat tummies and not much excess skin undergo what is known as a mini tuck or mini abdominoplasty.

Other patients can have so much excess skin the incision may extend all the way around to the back. The mini tuck can be done as an outpatient procedure but the more extensive procedures require an overnight stay. The results are quite dramatic. These patients are very happy and are only too glad to refer their friends to me.