“Mommy Makeover” Explained

A growing operation within plastic surgery is the “Mommy Makeover”.  This term can be quite confusing because it is not clear what it is exactly. In fact, there really isn’t a single procedure that is a “Mommy Makeover”.  It is a made-up term, to describe the combination of multiple procedures into a single operation. This means, that each “Mommy Makeover” is different and customized for each person.

 

What procedures are common during a Mommy Makeover?

 

As stated above, each Mommy Makeover is unique and customized for each person. This means that your Mommy Makeover will consist of what you need. Since a Mommy Makeover is intended to reverse the common affects of pregnancy, there are some procedures that are most popular. These include:

  • Tummy Tuck
  • Breast Surgery
  • Liposuction
  • Brazilian Butt Lift

 

 

Tummy Tuck

 

Pregnancy causes many changes in the abdomen. The growing baby and hormonal changes of pregnancy cause stretching of the skin and separation of the abdominal muscles. After birth, many of these changes improve over time, but it can be variable.  Diet and exercise cannot completely reverse these either. Multiple pregnancies and large weight gain during pregnancy can also result in more significant abdominal changes that are even harder to improve without surgery. A tummy tuck, or abdominoplasty, is a surgical procedure designed to target the extra skin, extra fat, and separated muscles.  This is the most common procedure requested by moms, and is often the cornerstone of a Mommy Makeover.  The incision is kept low beneath the underwear or bikini line.

 

 

 

 

Breast Surgery

 

Breasts often change with pregnancy. They may deflate, droop, grow, or a combination of any of these. Your breast procedure will depend on what your complaints are about your breasts. If they have deflated, placement of a breast implant (breast augmentation) would be appropriate. A breast augmentation would involve placing a saline or silicone breast implant under the breast to increase the volume.  If they are drooping, which is common after breast feeding, then a breast lift would be what you need. In this case, the breast tissue would be lifted into a perkier position. Sometimes breasts grow with pregnancy and aging, and the treatment would be to have a breast reduction. During a breast reduction, the breasts are made smaller and also lifted. Many times, there is a combination of things you may be unhappy with. Maybe you feel your breasts are drooping AND deflated. In that case, you would be a candidate for a breast lift AND augmentation.

 

 

Liposuction

 

Excess fat accumulates after pregnancy and aging. This excess fat can be anywhere on the body, including the abdomen, flanks, back, thighs, arms, and even the neck. Liposuction is the surgical removal of the fat using suction. During this procedure, a small cannula is inserted and the fat is removed form the area using suction. Liposuction can be performed virtually anywhere on the body. It is best considered a “shaping” procedure and not a weight loss procedure. Liposuction is commonly combined with breast or abdominal surgery, and it a very common component of a Mommy Makeover.

 

Brazilian Butt Lift

 

A Brazilian Butt Lift is a procedure in which fat is removed using liposuction and then re-injected into another area of the body such as the butt and hips. Basically, fat is removed from the places you don’t want it, and added to the places you do want it. By adding fat to these areas, it is possible to fill a deflated butt, fill hip dips, and give the appearance of a butt lift. The results will depend on how much fat is injected. The more fat that is injected, the more dramatic curves. However, in many cases, a small amount of fat is injected for a subtle reshaping that works together with the tummy tuck to improve the overall appearance. 

 

 

Why have Mommy Makeovers become more popular?

 

 

  • Improved Techniques and Safety:

There are a few reasons why Mommy Makeovers have increased in popularity. First, there have been safety improvements that now allow for combined surgeries to be performed more safely. In the past, combining multiple procedures resulted in long surgeries with increased risk of surgical complications, However, anesthesia and surgical techniques have improved, leading to shorter surgeries, shorter anesthesia times, and less risk of bleeding or blood clots.

 

 

  • Desire for a single recovery:

Many people prefer to recovery only once from a surgery, even if it means that the recovery will be longer and harder. If you separate a surgery into multiple procedures, the recovery for each will certainly be easier and shorter. However, you would need to do that multiple times, and each recovery requiring time off from work and family.  If you combine your procedures into a single Mommy Makeover, you only have to do that once, which is more desirable to many people.

 

  • Decreased Cost:

The cost of your surgical procedure will be a combination of the surgeon fee, the facility fee, the materials fee, and the anesthesiologist fee.  These costs will vary depending on the complexity and length of your procedure. Commonly, discounted rates are offered when surgeries are combined. This is because there is usually a cost savings on the anesthesiologist and facility, since a Mommy Makeover is considered a single operation.  While you should never base your decision to have a certain procedure solely on cost, you are likely to find that the total cost of a Mommy Makeover is less than the costs of each individual procedure done separately.

 

  • Improved results:

Many times, combining procedures will give a better result than if done separately.  This is because many procedures compliment each other and performing them at the same time, allows the surgeon to make necessary adjustments to maximize the results. For example, performing liposuction of the back with a fat transfer to the hips (Brazilian Butt Lift), will improve the results of a standard tummy tuck. Or, breast augmentation at the same time as a tummy tuck will improve the total appearance of your torso.  Of course, these can be done separately, but doing them separately may require that you have a revision of the previous procedure to make things work better together.

 

 

Who is a candidate for a Mommy Makeover?

 

Anyone who desires multiple procedures is technically a candidate for a Mommy Makeover. Contrary to the name, you don’t even have to be a “mommy” since weight changes, aging, and genetics can cause the same changes in your body as pregnancy. Because a Mommy Makeover combines multiple procedures, the surgeries will be longer. This means that you need to be in optimal health. You will be required to undergo full pre-operative medical testing to make sure you are healthy for this longer surgery. If there are any issues, such as anemia, your surgeon may recommend splitting the procedures into separate operations, or not operating at all.  You also want to be sure that you have made appropriate arrangements for post-operative help and time off from work or away from your family.

 

 

How to select your surgeon?

 

Since your Mommy Makeover will involve several different procedures, you want to be sure to select a surgeon experienced in ALL the procedures you are having done. You should select a Board Certified Plastic Surgeon. You also want to review before and after photos to be sure you are comfortable with the results that he or she can provide you. If your surgeon is an expert at tummy tucks, but not at breast surgery, you may want to reconsider choosing them if your Mommy Makeover involves both. Be sure to find out if your surgeon is experienced in combining multiple procedures into a single operation. You should also find out where your surgery will be performed. Will it be in an appropriate facility such as a hospital or accredited ambulatory center? Will you be required to stay in the facility overnight or will you be allowed to go home right after? These are the types of questions that you should be asking your Board Certified Plastic Surgeon.

 

If you would like to learn more about a Mommy Makeover and if you are a candidate, contact New York City Board Certified Plastic Surgeon, Dr. Matthew Schulman. During your consultation, you can find out if a Mommy Makeover is right for you.

Traveling for Your Surgery

As the popularity of plastic surgery procedures increases, so does your options for surgeons. Ideally, you would select a surgeon in your local area since it would be most convenient for your surgery and all the necessary pre-op and post-op appointments. However, the best surgeon for you is often not right down the street. This means, that more and more people are electing to travel to the surgeon of their choice. Oftentimes, the surgeon in far enough away that it requires a very long car ride or even a plane trip. Many people are selecting surgeons that are in different states and even different countries.  This is not necessarily a bad thing, but does require some additional considerations and planning. 

 

 

Why choose a far-away surgeon?

 

The easy answer is that you think it is more important to select the best surgeon for your procedure, and their location does not make a difference to you.  With the rise of the internet and social media, potential patients have exposure to surgeons from around the globe. Gone are the days where you picked your surgeon because your primary doctor recommended him or her, or your friend had gone to them.  Now, there are so many internet resources to help you choose your own surgeon. This may be based on reviews or before and after photos.  Your internet research will likely lead you to a surgeon that is many many miles away from you, especially if you are looking for an expert in a very specific procedure such as a Brazilian Butt Lift or Mommy Makeover. Sometimes people choose a surgeon based on cost, and if you happen to live in an area with a vey high cost of living, you may elect to travel to s surgeon in a region with lower prices.

 

There are many things to consider, when choosing to have your surgery far from your home, and it will certainly require additional planning.  Continue reading to learn about these considerations.

 

 

 

How will you have your consultation?

                                                                             

If you choose a surgeon who is far away, you need to think about how you even start the process of the consultation. Will the consultation be done virtually?  If it is done virtually, who will be doing the consultation?  Will it be with the doctor themselves or will it be with a nurse or assistant? Or will you be making a specific trip for an in-person consultation?

 

It is true for any consultation – in-person or virtual – that the consultation MUST be with the actual surgeon who will be performing your procedure. Only that specific surgeon is in a position to appropriately discuss the surgical plan and any risks of the procedure. If your consultation is not with the surgeon, I would strongly recommend re-evaluating your choice. If your consultation will be virtual, you want to make sure that there is a designated time to be examined in-person by the surgeon prior to surgery. This means that you should be examined the day before the surgery, and not 5 minutes before the procedure. This will have given the appropriate time for any changes in the surgical plan to be made safely. 

 

 

How will your travel for the surgery?

 

Will the distance require you take an airplane? If it does, you want to make sure that it will be safe for you to travel home in the same manner. Some surgeons will request that you avoid flying for a certain amount of time after a procedure. Also, some procedures may make airplane travel very uncomfortable.  Also be aware that there are often traveling delays and you need to account for this possibility. Your flight may be delayed due to weather or other situations. You may hit unanticipated road traffic.  Make sure you allow extra time, and this usually means, planning to arrive to the area a few days BEFORE your surgery.

 

 

Where will you stay after the surgery and for how long?

 

Your surgeon will recommend the appropriate amount of time that you should stay in the area after your surgery. This may be anywhere from a few days to a few weeks, depending on the complexity of the procedure. You may have sutures that need to come out or drains that need to be removed, and this may require that you stay even longer. You need to make the appropriate arrangements for wherever you are staying – hotel, friends/family, airBnB, recovery house.  Your surgeon will examine you and give you the clearance to return home when you are ready. But you need to also be prepared for the possibility that he or she may require you to stay longer if there are concerns or complications that need to be monitored.

 

 

Who will be accompanying you during your surgery?

 

As is the case with any surgery, you will need someone to help take care of you afterwards. When you are traveling for surgery, this will also mean that someone else will need to travel with you. You will need to find a family member or friend that is willing to make the trip and stay for as long as they are needed.

 

 

Who will you contact if there are concerns after you go home?

 

You want to make sure that you have the contact information of your surgeon. Certainly, there will be questions about your recovery and you need to make sure that someone will be available to answer those questions. Your surgeon should be available to you even if you are now 1000 miles away. 

 

 

Does your surgeon have a colleague in your area who can assist in your care if needed?

 

In the event that you have a problem and need to be evaluated, your surgeon should be able to call a colleague in your area.  Any reputable board certified plastic surgeon should be able to pick up the phone and call a colleague in an emergency. This is another reason why you should choose a respected Board Certified Plastic Surgeon. Unless it is a true medical emergency, your surgeon should not be instructing you to go the nearest emergency room for care that can be provided in a profession setting with a plastic surgery colleague.

 

 

Where will your post-operative care be done?

 

There is a lot of post-operative care that is required for any plastic surgery procedure. This includes routine check-ups, suture removal, drain removal, scar treatments, etc.  If you choose to travel to a surgeon in another area, you should be prepared to travel back to that surgeon for this routine post-operative care, unless he or she has made pre-arrangements with a local surgeon.

 

 

Cost Considerations

 

The main benefit to traveling for your surgery, is that you are able to select a true expert. In fact, about 35% of my patients come to me from distances over 500 miles away. However, you need to be aware of the additional arrangements and planning required. These also come with additional expenses, since you need to consider the cost of travel, cost of accommodations, and the costs associated with returning to that surgeon for routine (or non-routine) care. Keep this in mind if your main motivation for traveling to have your surgery is the reduced cost, since when you factor in the additional costs, the savings may not be as much as you had thought.

 

Dr. Schulman welcomes patients from all over the world. To start the process of your Virtual Consultation with New York City plastic surgeon, Dr. Matthew Schulman, visit our website.

Male Chest Reduction Explained

A procedure that is growing in popularity is the male chest reduction. Many men are self-conscious of their chests. They feel like their chests are too big and resemble small breasts. This can be a significant source of anxiety for them, especially if they are young men or teens.  It is not uncommon for men who suffer with enlarged chests to avoid taking their shirts off in public. This causes them to avoid situations like going to the beach or pools, or changing in a locker room.  Men you suffer from enlarges chests often wear baggy shirts, or even multiple layers of shirts to cover themselves up. 

 

 

 

 

What is Gynecomastia?

 

Gynecomastia, is the enlargement or swelling of breast tissue in males. It can occur in one side or both.  Both males and females have breast tissue. Females, obviously have more, but in some males, the breast tissue can grow and can give the appearance of small breasts. In fact, reports indicate that it can be seen in up to 80% of young adolescent boys. This is likely the result of some hormonal changes and most of the time, the breast tissue shrinks as hormones continue to change during puberty and male hormones like testosterone increase. 

 

 

Causes for Gynecomastia:

 

There are several causes for the enlargement of a male chest.  The vast majority of cases are just simply normal hormonal changes of development and pose no physical danger. These hormonal changes are common during three phases of a male’s life: just after birth, during puberty, and later in life.  Early in life, as a baby, there are high amounts of female hormones (estrogen) in the body, and this is from the mother. This is why newborn male babies often have puffy breast tissue. This shrinks as the mother’s estrogen is naturally removed from the body.  Again, male chest enlargement can occur during puberty as the normal hormones are changing and regulating themselves. As males age, testosterone levels tend to drop. So men between the ages of 50-80 also commonly experience chest enlargement.

 

Normal hormonal changes are by far the most common reason for male chest enlargement, but some other less common causes include:

 

  • obesity
  • liver or kidney disease
  • tumors (testicular cancer, breast cancer)
  • prescription medications (for hair loss, anxiety, depression, bipolar disorder, acid reflux)
  • alcohol
  • marijuana

 

 

What to do if you have Gynecomastia:

 

If you suffer with gynecomastia, the first thing you should do is visit your doctor. He or she will examine you and take a detailed history.  They will also likely do some routine blood tests. This will help them determine the cause for your gynecomastia and help develop a treatment plan.

 

 

Treatment for Gynecomastia:

 

The treatment for your male chest enlargement will depend on what the cause is. If the cause is a medication or drug, then the treatment is to stop the offending thing and see what happens with your chest.  If the cause is an underlying medical problem, then that problem should be addressed. If the cause is a hormonal issue, the treatment would be to adjust your hormone levels so that your testosterone increases and your estrogen decreases. 

 

However, since the majority of cases of gynecomastia have no identifiable cause, the treatment would be surgical correction of the chest enlargement. This would also be true if the cause of the chest enlargement was treated, but the enlargement still remained.

 

Surgical Correction of Gynecomastia:

 

The first step is an evaluation by a Board Certified Plastic Surgeon, experienced in a male chest reduction procedure. During your evaluation, your surgeon will take your medical history and perform a physical examination. He or she will specifically examine your chest, looking carefully at the amount of excess skin, the quality of that skin, underlying breast tissue, and signs of asymmetry.  Your surgeon will also review your medical evaluation to make sure there is no underlying cause that should be addressed before surgery.  Your surgeon will also discuss the required incisions and resulting scars for your chest reduction. These incisions will depend on exactly what needs to be done for you and whether you require only breast tissue removal or also some skin removal. In general, if you are young, you likely only require removal of the underlying breast tissue that has enlarged. If you are older, or obese, you may also require some extra skin removal which would require additional incisions and scarring. Your plastic surgeon will be able to discuss with you which surgical approach is best.

 

 

·         Breast Tissue Removal:

 

The removal of breast tissue can be done either using liposuction or making a small incision and directly removing the densest part of the breast gland.  When liposuction is performed, it can be done through tiny hidden punctures on the chest. These puncture holes are very tiny and often require no more than a single stitch. This is a good technique for removing the majority of breast tissue. However, breast tissue can be very dense, especially directly under the nipple. This is why is is common to also make a small incision around the areola to directly pluck out the thick gland.  If this incision needs to be made, it is small and well-hidden around the edge of the areola.

 

·         Skin Removal:

 

In cases of excess skin, the skin would need to be removed as well, in order to get the best results. This is most common if you are overweight or have lost a lot of weight, or if you are older and have normal skin laxity that comes with aging. Sometimes the skin can be removed from just around the areola. Other times, more incisions need to be made down the chest or in the breast fold. 

 

 

 

 

Where is the Procedure Performed?

 

A chest reduction is a surgical procedure that needs to be performed in an accredited surgery center or hospital. These are regulated facilities with the appropriate safety standards and appropriately trained staff.  The procedure is usually performed using intravenous sedation or general anesthesia. It is usually an out-patient procedure, meaning you are able to go home the same day. In situations where other procedures are being done at the same time, you may be required to stay overnight for monitoring.

 

 

 

 

Recovery

 

After a few hours in the recovery room, you will be discharged home. You will have pain medication and antibiotics. This procedure is very well tolerated and the pain is significantly less than with other procedures like a tummy tuck. You will wear a chest compression garment.   After about a week, most people feel pretty good and you will be cleared to return to normal activities, including work and school.  You will be restricted from heavy exercise for about 3-4 weeks while you are healing. It may take several months for swelling to go away and your appearance will improve during this time.

 

 

Recurrence of your chest enlargement

 

In general, this surgical procedure will permanently correct your chest enlargement. However, if your chest enlargement is due to things like recreational drug use or prescription medications, and you continue to use those things, then certainly your chest enlargement may recur.  In some cases, chest enlargement may come back, simply because it is just way your body is programmed.

 

If you would like to learn more about reducing your male chest and correcting your gynecomastia, contact New York City Board Certified Plastic Surgeon, Dr. Matthew Schulman. During your consultation, you can find out if a male chest reduction is right for your and specifically which surgical technique is most appropriate.