Thank you for your question. Interestingly, women in your age group who have had children and share your concerns are the largest group of patients seeking Breast Augmentation in my Boston Plastic Surgery Practice, and have been for many years. The use of the name “mommy makeover” has brought a great deal of attention to the combination of breast and abdominal or tummy rejuvenation following pregnancy, usually a combination of a tummy tuck or abdominoplasty and a breast lift or dermal mastopexy with or without breast augmentation or breast enlargement. Many women complain of small breasts, sagging breasts and a loose tummy or sagging tummy skin after pregnancy.

Most commonly in my practice a “mommy makeover” consists of a tummy tuck and a combination of the breast lift and breast augmentation. Recent studies have reported that the combination of these procedures is safe if performed properly on a healthy patient.

Above-Before and After Bikini Tummy Tuck

Below-Before and After Breast Lift and Breast Augmentation

My own opinion is that the mommy makeover, that is the combination of a tummy tuck, breast lift and breast augmentation or breast enlargement can be done safely under the following circumstances:

1. The patient is healthy-a Class 1 Anesthesia Risk-that is a person with no significant medical disease such as diabetes, high blood pressure, significant obesity, history of blood clots, and many other potential medical complicating conditions.
2. The board certified plastic surgeon is skilled and experienced at doing multiple procedures
3. The procedure can be accomplished in less than 4 hours ( this is my personal opinion, longer surgeries increase risk )

The mommy makeover requires a healthy patient and an experienced and skilled plastic surgeon that can expeditiously perform the combination of a tummy tuck, breast lift and breast augmentation. Your choice of a surgeon is critical and you need to ask specific questions about the doctor’s experience and the time it will take for the operation.

Not every patient who wants a mommy makeover requires all three operations, that is a breast augmentation, breast lift and tummy tuck. Many women only need a breast augmentation if they have small breasts after pregnancy but not sagging breasts. Other women who have adequate breast tissue but sagging breasts will only require a breast lift or dermal mastopexy. In my practice a mommy makeover which requires only a minor tummy tuck and a breast augmentation can be achieved in less than 2 hours.

If a combination breast augmentation, breast lift, and a major abdominoplasty are required the procedure can take as much as 3 hours.

The decision as to what type of mommy makeover is required depends on your particular anatomy. You can read more about how decisions about breast augmentation, breast lift, and tummy tuck are made by reading my previous blogs on this topic.

The mommy makeover, that is the combination of a tummy tuck and breast lift and or breast augmentation, in my experience, produces excellent results and produces some of my happiest patients. The improvement in the self esteem of my patients has been remarkable. Many patients say “I can’t believe it”, “I love my breasts and my new shape” and other happy comments.

The most important thing for you is to make certain you are healthy and you must find an experienced plastic surgeon who can safely and in a reasonable operative time accomplish a good cosmetic result.

If you would like to see results of plastic surgery visit my clinical website drseckel.com.

If you would like to learn more about how to choose a plastic surgeon read Save Your Face. If you would like more information contact me.

Dr Seckel

978-369-4499

Concord, Massachusetts

Boston, Massachusetts

Your question is one of the most common situations I see in my plastic surgery practice. Most women who have had children notice lax abdominal skin or a sagging tummy and experience laxity of the breasts or sagging breasts and no amount of hard work can completely firm these areas back to the way they were before pregnancy.

The tummy tuck and breast augmentation or breast lift are frequently done together. A minor tummy tuck involves only an incision down low in the abdomen which can be designed to be hidden under today’s brief bikini’s so that the scar is not visible at the beach. A major tummy tuck, called an abdominoplasty, done when there is a great deal of abdominal skin laxity and excess abdominal skin and stretch marks, require an incision around the “belly button” or umbilicus, and thus creates a visible scar. Most women in your age group only need a minor tummy tuck.

Many women who only have a small amount of sagging of the breast, called glandular ptosis, can restore their breast shape and firmness with only a breast augmentation or breast enlargement with a breast implant. The implant can be a saline breast implant or a silicone gel breast implant which has a more natural feel.

For women who have more severe breast sagging, called breast ptosis, a breast lift or dermal mastopexy is required. This decision is made based on your breast anatomy. Generally if the nipple is below the inframammary crease (IMC) the diagnosis of mammary ptosis is made and a breast lift or dermal mastopexy is required.

Most women do not want to have the breast lift, called a dermal mastopexy, done because the dermal mastopexy or breast lift creates visible scars on the breasts. However the breast lift or dermal mastopexy can create a beautiful youthful breast shape and many women choose this procedure and accept the scars which are much less noticeable with time.

The lollipop lift or lollipop breast lift is a procedure designed to minimize the scars associated with the breast lift or dermal mastopexy. The lollipop breast lift involves a circular scar around the areola and a vertical scar running straight down the breast beneath the areola so it looks like a lollipop when viewed from the front.

My recommendation is that you consult 2 surgeons who are certified by the American Board of Plastic Surgery and get their opinions as to the best options for you.

Thank you for your question.

For more information on plastic surgery and non-surgical facial rejuvenation read Save Your Face or contact me.

Dr Seckel

978-369-4499

Concord, Massachusetts

Boston, Massachusetts

Thank you very much for your email. As a Plastic Surgeon I do many breast operations and welcome your important question,

By far the greatest number of women seeking breast augmentation and or lift are women just like you who have had their children and are unhappy with what has happened to their breasts after having children. During pregnancy the breast is full and very feminine looking. After childbirth the actual breast gland atrophies, gets smaller, and the skin that has been stretched during pregnancy sags and allows the breast to drop.

What bothers my patients most is the lack of fullness and cleavage. They just want to be able to fill out their bathing suit and look good in today’s fashions.

There are many wonderful techniques available today to restore the breast to a beautiful full youthful feminine appearance. Depending on how much the breast has sagged some people may need the dermal mastopexy or breast lift, which as you point out does leave noticeable scars.

But for most people the breast augmentation procedure can correct the post pregnancy breast appearance without the need for a lift or mastopexy.

The key issue in making this decision is the position of the nipple. Check the crease in the skin below your breast. This is called the inframammary crease. If the nipple is above this crease then chances are a breast augmentation can be done without a breast lift and restore your breast to a full youthful appearance.

Another technique I use to avoid scars and lift the breast is called the Transareolar Breast Augmentation. Using this technique I make a very small incision in the areola—the round pink part surrounding the nipple. I then modify the breast gland so that it falls nicely over the implant.

Using the Transareolar approach does push the nipple up and places the volume of the implant under the nipple and which is where the volume of the normal breast was during pregnancy.

The other benefit is that the areolar scar is almost invisible. Scars tend to be pink, the areola is pink, and so the scar is not as noticeable as it is when placed under the breast or in the armpit. Also in my experience there is no increase in risk to the sensation or feeling of the nipple it nearly always remains the same as it does with other breast augmentation techniques.

The implant can be placed either under the breast or under the chest muscle using this technique, but when a breast lift is needed the implant is usually placed beneath the chest muscle directly under the breast gland.

Obviously I would have to examine you to see exactly which procedure will give you the result that you will be happy with.

However most women I see who complain of small sagging breasts after having their children can get a beautiful result with the Transareolar Breast Augmentation and avoid the scars associated with the breast lift or Dermal Mastopexy Procedure. I have hundreds of very happy patients who came to me with exactly your problem.

Thank you for your very important question.

To read more about plastic surgery read Save Your Face or contact me.

Dr Seckel

978-369-4499

Concord, Massachusetts

Boston, Massachusetts