Breast Surgery plus Tummy Tuck (Mommy Makeover)
Many women who have had children have stretched abdominal wall muscles (diastasis recti), loose skin, unsightly stretch marks, as well as changes in their breasts after pregnancy and breast feeding. Despite working hard after delivery to restore their bodies to pre-pregnancy condition, some women fail to achieve their goals. Plus, they find that one cannot “exercise” loose skin, and that any lost skin tone, laxity, or stretch marks remain in their abdomen even after the “baby weight” comes off. Abdominoplasty (tummy tuck) is the only way to remove the loose skin, stretch marks, and flatten that protruding “mommy pouch” via muscle repair!
As with abdominal skin, breasts also undergo changes with pregnancy, and these can be even more dramatic after breast feeding. Loose skin (to varying degrees) as well as loss of breast volume (size) may require breast augmentation, breast lift plus implants, or in cases where breast size is equal to or greater than the patient’s aesthetic goals, breast lift or breast reduction. Aesthetic surgery of the breasts is needed to lift, rejuvenate, and restore youthful, perky, and shaplier breasts. But now this totals two operations to restore youthfulness to the post-pregnancy body!
Combining breast surgery (whichever variety) with tummy tuck is the only one-step answer that deals with both the stretched belly tissues AND the post-pregnancy breast changes! This single “two in one” operation is often called a “Mommy Makeover.”
Since every patient and every pregnancy is different, and since localized areas of stubborn diet-resistant fat may remain after weight loss and exercise, many mommy makeovers include liposuction of one or more areas, such as the hips or thighs.
At Minneapolis Plastic Surgery, breast augmentation is our most commonly-requested procedure—our American Board of Plastic Surgery certified plastic surgeons perform several hundred breast surgeries each year, and tummy tucks are done in significant numbers as well. Many patients choose to combine these two operations into one surgical procedure to save time, money, and reduce time off work or social activities. Some choose to add liposuction of one or several areas at the same time, thus making their “mommy makeover” individual to their specific needs and goals, but different from another woman who has also completed her family.
Others worry that this may be “too much” surgery at one setting, and this usually is derived from concerns about “too painful,” “too risky,” or “too costly.” Let’s address these concerns.
How much surgery at one time is “too much?”
As long as outpatient surgery is kept to less than 6 or 7 hours, and appropriate safety measures are in place along with state-of-the-art anesthesia practices, all of these procedures can be safely combined into one operation. This also means less time off work or social activities, one set of risks (however low the risks, two operations double the risks), and one recovery. And significant cost savings!
At Minneapolis Plastic Surgery, we keep the patient warm via Bair Hugger warm air blowers and heated pads, warmed IV fluids, and carefully-observed room temperature control. So even with long procedures, core heat loss is minimal. Intravenous fluids are carefully administered with every operation, and are tailored to the individual patient and the procedures performed so that fluid overload or dehydration do not occur. Urinary output is also monitored in the operating room by use of a bladder catheter (small soft rubber tube inserted after you are asleep, and usually removed before you awaken in the recovery room. In some cases it will be left in for patient comfort so that she will not have to “get up” and go to the restroom the first night after surgery.) Careful and precise surgical technique is part of our everyday surgical regimen, and meticulous hemostasis (precise cautery control of bleeding vessels intra-operatively) means that even long surgeries will not cause post-operative anemia from excessive blood loss. Even chronically anemic patients (usually from menstrual losses) can safely undergo multiple procedures since additional blood loss is just not an issue.
Thus, temperature loss, fluid loss, and blood loss are minimized as concerns about “long” operations.
Other legitimate concerns involve pooling of venous blood in the immobile lower extremities during long operations, increasing the risk of venous thromboembolism (blood clots that can travel to the heart or lungs, abbreviated VTE). This is a rare but serious risk that can lead to pulmonary embolism or death, so we take precautions to minimize these risks with EVERY operation, not just longer ones. Each patient undergoing any operation at Minneapolis Plastic Surgery has active anti-VTE devices used during their operation. These are inflatable booties that are placed on each patient’s feet after they are comfortably positioned on the operating table. These devices sequentially inflate and deflate multiple times each minute, actively “pumping” blood in the leg veins as if the patient was walking or actively flexing their feet as advised during long car rides or air flights. These devices decrease venous stasis (pooling) that can lead to clots and VTE.
In other higher-risk cases, low molecular weight dextran, low-dose heparin, or Lovenox (a blood thinner) may be utilized to further decrease blood clot risks, while minimizing potential increased risks for bleeding.
Pressure irritation on the patient’s head, buttocks, heels, and elbows can also become an issue with prolonged periods of immobility. We use special pads, lambswool protectors, and gel pads in our practice for each and every operation.
Is a “mommy makeover” right for you?
If your family is complete, and you have post-pregnancy changes in your breasts and abdomen you wish to have addressed with one operation, a “mommy makeover” is perfect for you. Areas or localized excess fatty tissue that did not come off with post-pregnancy weight loss can also be addressed—each operation is tailored to every woman’s anatomy.
Some women want only to restore breast volume (breast augmentation), but others may require breast lift, breast lift plus implants, and a few request breast reduction, all of which are designed to rejuvenate and improve breast appearance, symmetry, and perkiness.
Likewise, the abdominal wall after pregnancy undergoes stretching between the rectus (“6-pack”) muscles, and while these muscles can be exercised to “abs of steel,” the stretched fascia surrounding these muscles cannot be tightened via exercise, and requires surgical tightening in most cases. Umbilical hernias or other hernias can usually be repaired at the same tummy tuck operation, since both Dr. Richard H. Tholen and Dr. Douglas L. Gervais completed full General Surgery residencies before their subsequent plastic surgery fellowships. Both were certified by the American Board of Surgery, and maintain active certification by the American Board of Plastic Surgery.
In certain cases of excessively-weak abdominal musculature, recurrent hernias, or prior repairs that have failed, mesh reinforcement of the abdominal wall can be included to improve patient outcomes or prevent future problems.
Of course, the main goal of tummy tuck (abdominoplasty) surgery is the removal of stretched, loose abdominal skin that cannot be “exercised” to its former pre-pregnancy (or pre-weight loss) state of youthful tautness. Striae (stretch marks) can also be removed or reduced. Wrinkled or unsightly belly buttons can be restored to a more youthful appearance, and the scars can be hidden to reduce the “bullseye” scar seen in some tummy tuck patients. Muscle (fascia) repair is part of virtually every tummy tuck, so not only the skin, but also the underlying abdominal wall is tightened and made flatter.
Liposuction, ultrasonic liposuction, or other body contouring can be included as part of any patient’s individualized “mommy makeover.” Each “mommy makeover” is performed under a light general anesthetic (TIVA) as an outpatient operation in our nationally accredited (AAAASF) on-site surgical facility. No overnight stay is necessary.
Costs for “Mommy Makeover”
Since “mommy makeover” is a generic term for tummy tuck (or extended tummy tuck) plus breast surgery of various options (breast implants, breast lift, breast lift plus implants, or breast reduction), exact costs will depend on the specific surgical options best for you. Individual cost ranges for the individual options are available by clicking on the links below, but combining these together in one operation will save not only hundreds to a thousand dollars or more, but also time off work, social activities, and the need for two (or more) recoveries. For example, the cost for breast augmentation (cohesive silicone gel implants) alone is about $6950, and for a tummy tuck alone (including muscle repair and no additional liposuction) the cost is about $9850.
Together, these two operations as a single “mommy makeover” procedure will cost about $15500, or a savings of $1300, plus the savings of a single time off work or social activities rather than two “vacations” or sick leave. Exact cost quotes are available at the time of complimentary consultation with our American Board of Plastic Surgery-certified plastic surgeons. Cash discounts and financing options are also available.
For more information about each of the parts of “mommy makeovers” please click on the links below, or contact Minneapolis Plastic Surgery, Ltd. for a complimentary consultation with our American Board of Plastic Surgery-certified plastic surgeons: