WHAT IS A Mommy Makeover®?
Mommy Makeover® is an American expression that encompasses the combination of procedures that women may require after giving birth, and is specifically aimed at two areas of the body: the breasts and the abdomen.
Often, after childbirth, women are not pleased with the changes to their bodies. Because of the weight increase, breast volume increase and breastfeeding, there may be significant changes in the breasts that do not fade as weight goes back down – excess skin that gives the breast a sagging look, or atrophy of the mammary gland. In the abdomen, women are bothered by flaccidity and excess skin, stretch marks, an overall bulging look, and changes in the shape of the navel..
CHARACTERISTICS OF THE IDEAL CANDIDATES FOR A MOMMY MAKEOVER®?
Saggy breasts, without volume or larger than desired;
Excess skin and fat in the abdomen and diastasis recti;
Changes in the genital area;
Delivery was more than 6 months before;
Not breastfeeding for at least 6 months;
Not considering future pregnancies that could compromise the result;
With realistic expectations.
BEFORE AND AFTER CASES OF Mommy Makeover® Postpartum
WHAT RESULTS CAN I EXPECT
AFTER A MOMMY MAKEOVER®?
Fuller and natural breasts
With an augmentation mammoplasty, a mastopexy or a reduction mammoplasty, you will achieve fuller and rounder breasts, proportional to the rest of the body.
A flat and firm abdomen
With a lipoabdominoplasty, you will achieve a flat abdomen, with no sagging skin and a toned appearance. You can also get rid of some stretch marks on the lower abdomen.
Better self-esteem and quality of life
Mommy Makeover® has a very positive impact on a woman’s quality of life, self-esteem and the way she relates to her body.
YOUR MOMMY MAKEOVER® MEDICAL APPOINTMENT
The first step of your Mommy Makeover® medical appointment is a careful assessment of your body, health and lifestyle. This will allow us to design a customized plan for your case.
Simulation with Vectra 3D
With Vectra 3D we are able to simulate the results of surgeries such as liposuction, abdominoplasty, augmentation mammoplasty, mastopexy, reduction mammoplasty, etc.
During the your Mommy Makeover® medical appointment, a treatment plan will be presented to you, and the risks of surgery, pre- and post-operative care and the results you can expect will also be explained.
After the medical appointment, you will be presented with an exact price for your surgery, according to the combination of procedures.
Any surgical intervention involves scarring and Mommy Makeover® is no exception. The scars will depend on the initial state of the body and on the procedures to be performed. The plastic surgeon will make sure the scars are as small as possible. As time goes by, scars get ligther and closer to their final appearance. Good healing will also depend on the post-operative care and the patient’s genetic characteristics.
- Augmentation Mammoplasty: inframammary or periareolar scar;
- Mastopexy: periareolar scar, vertical or inverted T;
- Reduction mammoplasty: vertical scar or inverted T;
- Abdominoplasty: the scar is on the bikini line and its size will depend on the amount of skin to be removed;
- Liposuction: the scars are very small, only a few millimeters wide, just enough for the thin cannulas to be inserted. Whenever possible, these are made in hidden areas or natural folds of the body.
TYPE OF ANESTHESIA
Mommy Makeover® is usually performed with sedation and local anesthesia or epidural. The type of anesthesia is defined according to the combination of procedures to be performed. Sedation is administered intravenously by the anesthesiologist so that the patient is asleep and unaware of anything during the entire surgery. With the patient already asleep, local anesthetics are administered in the areas to be treated. The anesthesiologist will be present throughout the whole surgery for greater comfort and safety.
WHAT ARE THE MOST COMMON PROCEDURES
There is no fixed rule that establishes the combination of procedures that Mommy Makeover® includes. Everything will depend on the initial state of the woman’s body and the desired results. These surgeries will focus on body parts that have undergone the most striking changes due to pregnancy. The most common surgeries are:
After pregnancy and breastfeeding, it is very common to have a decrease in the volume of the breasts – they look empty and withered. The volume decreases both as a result of the milk drying up and the normal weight loss after pregnancy. Thus, breast augmentation is performed on women who wish to regain or increase their breast volume, improve its contour and projection, and improve its harmony with the rest of the body. If the breasts are slightly sagging, a periareolar augmentation mammoplasty can be performed to eliminate the excess skin around the areola.
Mastopexy is a surgery that aims to correct sagging breasts (breast ptosis). Also known as breast lift, mastopexy consists in lifting the sagging breasts that drooped as a result of pregnancy, breastfeeding and weight changes. This can be done with or without breast implants, depending on the initial size of the breasts and the woman’s desire to increase or not her size.
During the period of pregnancy and breastfeeding, there is an increase in breast volume not only due to the production of milk, but also due to the fat that the woman may have accumulated over the 9 months. If the woman has gained a lot of weight during pregnancy and is unable to lose all it all, the breast may not return to its original size and cause discomfort and dissatisfaction. In these cases, a reduction mammaplasty can be performed to reduce the size of the breasts. Most women who have a breast reduction have a sagging breast and areolas are enlarged, so breast lifting and areola remodeling are also usual parts of the procedure.
Removing fat deposits accumulated in specific areas to improve body contour is the goal of liposuction. However, it is important that the skin of the treated area has a good elasticity and allows an adequate retraction to avoid sagging. Liposuction can be combined with an abdominoplasty or performed alone in various areas of the body, such as the abdomen, flanks, back, thighs, “bra fat”, “jowls”, “mons of Venus”, etc.
Alongside the breasts, the abdomen is, of course, the part of the body most affected by motherhood. Therefore, the goal of abdominoplasty is to eliminate excess skin, reduce excess abdominal fat and correct the rectus muscle that was separated and weakened. Abdominoplasty can be performed without liposuction, but most women who resort to this procedure have accumulated fat and as such, perform a lipoabdominoplasty.
This surgery aims to “tighten” the vaginal canal after the relaxation caused by vaginal delivery. In other words, the goal is to make the vaginal wall muscles return to their normal activity and benefit the couple’s quality of life and intimacy.
The hormonal changes inherent to pregnancy are responsible for causing hypertrophy of the vaginal lips in some women and that is characterized by excess skin and flaccidity in the small lips of the vagina. This problem causes physical and emotional constraints in women due to the prominence of the lips. This can be corrected by labiaplasty.
Always aiming at improving the body contour, there are other procedures that can considered. A buttock lipofilling is an example. It is a process that uses the body’s own fat to achieve a natural and long-lasting result, with a very low complication rate, because of the usage of autologous fat.
3D SIMULATION OF MOMMY MAKEOVER®
In your Mommy Makeover® medical appointment, photographs and body measurements will be taken, which will be introduced in Vectra 3D to create a three-dimensional image of the result you can achieve with procedures such as liposuction, abdominoplasty, augmentation mammoplasty, mastopexy, and others. Vectra is an innovative system that allows you to manage expectations and helps you take more conscious decisions.
MAKEOVER® SURGERY STEP BY STEP
MARKING PATIENTS WHILE STANDING
The markings are made with the patient standing so that we can correctly visualize the areas to be treated.
The sedative is administered intravenously by the anesthesiologist who will be present throughout the surgery.
DISINFECTION AND DELIMITATION OF OPERATING FIELDS
The areas to be treated are cleaned and disinfected to reduce the risk of infection. Operative fields are placed to isolate the area to be treated from the external environment.
The local anesthetic or epidural is injected with the patient already asleep. The anesthetic will prevent you from feeling any pain during the entire surgery.
Incisions are made in the abdomen and breasts according to previously planned techniques.
CLOSING OF INCISIONS
The incisions are closed using absorbable suture threads. The result and symmetry are then checked.
The glue is applied over the scars and seals the skin, isolating the scar from the external environment. It does not require dressings and falls off gradually after 15 days.
Before being transported to a recovery room, a post-surgical bra and an abdominal binder are worn, and they must then be used for 30 to 45 days. The patient is awakened by the anesthesiologist and is then transported to the recovery room where she remains under observation for 24 to 48 hours before getting discharged.
PREPARING FOR MOMMY MAKEOVER®
- Do not take aspirin or other anticoagulant medications as they may increase the risk of bleeding and interfere with anesthesia. You should inform the medical team of any medication you are on or a medical condition you suffer from.
- Do not smoke two weeks before the surgery and as long as healing is taking place, as the consumption of nicotine harms the healing process.
- If you get a cold or feel ill in any way in the days prior to the surgery, the medical team should immediately be informed.
- Carefully read all the documentation that was given to you before the surgery, as there may be some doubts.
- If you have small children, organize your routines in advance. You should have help at home, especially during the first two weeks.
- If you have any doubts regarding the Mommy Makeover ©'s surgery, preparation or post-operative care, do not wait for the day of surgery; ask all your questions beforehand.
- The day before surgery you should have light meals only, in order to avoid indigestion. You should be fasting for 8 hours before the surgery - do not eat or drink any liquids including water.
- Shower with the prescribed antiseptic shower gel the day before and the day of surgery. Do not wear any accessories, makeup or nail varnish.
- Do not wear any accessories, makeup or nail varnish.
- Bring comfortable clothes to wear when you are discharged - preferably with buttons or a zip.
- After discharge, you can neither drive nor go home unaccompanied. If you have no one to take you home and help you at home during the first few days, you must inform us before the day of the surgery.
- The recovery period depends on the length of the procedures and the number of surgeries performed, but in general it takes between 1 and 3 weeks.
- Rest, especially during the first week and gradually return to your routine. For 4 weeks you should not make any physical effort. Family help at home is therefore extremely important.
- Have a balanced and healthy diet and maintain good hydration drinking plenty of liquids.
- Follow all instructions given by the medical team regarding medication and/or other needed care, such as lymphatic drainage and the use of the compression belt/bra.
BENEFITS OF PERFORMING A Mommy Makeover®
Since a Mommy Makeover® involves more than one surgery, there are several advantages associated with this concept:
- Several surgeries in one single intervention;
- One single anesthesia;
- Just one recovery period;
- Lower financial burden;
- More “dramatic” body transformation;
- Better body contour;
- Flatter and smoother abdomen;
- Cleavage effect;
- Possibility of eliminating some stretch marks;
- Improvement of self-esteem and quality of life.
WOMAN TO WOMAN
“The fact that we too are women and we too have children, makes it easier for us to relate to our patients’ complaints. We are able to better understand what bothers them and the impact that these bodily changes have on their lives. We know that the goal of those looking for these interventions is to improve the body’s appearance and self-esteem, and we encourage all women to invest in physical and emotional well-being. Surgery is often the starting point for a healthier and more balanced life. Performing physical exercise, following a balanced diet and taking care of the body, contribute to maintaining the results in the long run, and provide the emotional balance needed in our day-to-day ”.
Dr. Alice Varanda Pereira / Plastic Surgery
Member of The Portuguese Medical Association, Nr. 47051
Graduated by the Faculty of Medicine of the University of Lisbon, she completed her master’s degree in human sexuality and is currently developing her PhD at this same institution.
She joined the University faculty academic staff in 2008 as a lecturer of the Institute of Anatomy. It is in this unit that she produces most of her research projects, mainly in the area of surgical anatomy, whilst also supervising master’s thesis for undergraduate students.
Dr. Marta Gouveia Duarte / Plastic Surgery
Licenciada em Medicina pela Escola de Ciências da Saúde da Universidade do Minho, onde concluiu a sua tese de Mestrado em Envelhecimento Humano.
Concluiu a especialidade em Cirurgia Plástica Reconstrutiva e Estética, no Centro Hospitalar de Lisboa Central – Hospital de São José.
Colabora em vários projetos de investigação na NOVA Medical School.
Dr. Mariana da Rocha Martins / Plastic Surgery
Member of The Portuguese Medical Association – Nr. 55124
Graduated by the Abel Salazar Institute of Biomedical Sciences at the University of Porto and specialized in reconstructive and aesthetic plastic surgery at Hospital de São José, in Lisbon.
Throughout her specific training in plastic surgery, she worked in internationally renowned institutions such as Institut Kaplan (Barcelona), La Clinic (Montreux) and Great Ormond Street Hospital (London).
Mommy Makeover® Postpartum
IS IT SAFE TO PERFORM VARIOUS PROCEDURES AT THE SAME TIME?
Yes, more than being safe, it is actually more convenient, as it only requires one recovery period. However, to ensure patient safety, the surgery should not take more than 6 hours. It is also important that the combination of procedures does not compromise the patient’s comfort and mobility.
HOW MUCH DOES A MOMMY MAKEOVER® COST IN LISBON?
The price of a Mommy Makeover® depends on the initial state of the body and the combination of procedures required. After the diagnostic during your medical appointment, you will be presented with a treatment plan as well as the exact price for the surgery.
WHICH PROCEDURE SUITS ME THE MOST, LIPOSUCTION OR ABDOMINOPLASTY?
Liposuction is indicated to treat localized fat. If, in addition to fat, you have flaccidity, excess skin and diastasis recti, liposuction will not be enough to achieve a flat and firm abdomen. In this case, an abdominoplasty or lipoabdominoplasty will be necessary.
HOW LONG AFTER DELIVERY CAN I PERFORM THE SURGERY?
You must wait as long as necessary for the organism to recover. This is different for every woman, but on average, it is between 6 and 12 months. It is also important that you are no longer breastfeeding.
ARE THE RESULTS DEFINITIVE?
Mommy Makeover® does not guarantee lifelong results as the body is not immune to changes resulting from the natural aging process, weight fluctuations and future pregnancies. To ensure long lasting results, it is important to follow a healthy lifestyle – a balanced diet, and regular exercise.
CAN I GET PREGNANT AGAIN?
Ideally, these procedures should be performed when no further pregnancy is planned; not because there is some incompatibility with a pregnancy, but so that the body does not go through the same changes, compromising the results of the surgery.
DO SCARS DISAPPEAR?
The scars are permanent, but over time, they become thinner and lighter. The final appearance of scars is different for every person and is usually determined by the genetic characteristics of each patient and post-operative care. The final result is expected 12 to 18 months after the surgery.
WILL I NEED DRAINS?
The use of drains is extremely important as they help to eliminate the liquids that accumulate after surgery. They are placed whenever necessary and are usually removed after 24/48 hours.
HOW PAINFUL IS THE RECOVERY?
Recovery from breast surgeries and liposuction is usually well tolerated. Regarding abdominoplasty, discomfort is variable and may require complete rest for the first two days. The prescribed painkillers will contribute to a more comfortable recovery.
WHEN CAN I RESUME PHYSICAL ACTIVITY?
You should not perform physical activity or any physical effort during the first month, and then make a gradual comeback. You must be extremely careful at this stage, as this not only warrants a quicker recovery, as it also contributes to obtaining better results.
IS THE RESULT IMMEDIATELY VISIBLE AFTER THE SURGERY?
The result is usually visible soon after surgery. However, for some time, you will be swollen and bruised, which may distort the result. The final result is usually visible 6 to 12 months after surgery.