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The Mommy Makeover: Plastic Surgery After Pregnancy

Empowering or Repressive?

By

Updated July 05, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

"Mommy" and "makeover” are two words that, on their own, attract no particular attention. However, as the phrase "mommy makeover," those two words can stir up quite the controversy.

First off, what is a "mommy makeover?" A "mommy makeover" is the undertaking of multiple plastic surgery procedures to reverse the effects of pregnancy. Specifically, a mommy makeover is the combination of breast surgery, abdominoplasty (also known as a tummy tuck), and usually some form of liposuction.

The Controversy

The changes that occur with pregnancy are normal. Some refer to them as the "phenomena" or "sequelae" of pregnancy. There are some who believe that these changes to the body are "badges of honor," signs that a woman carried life. To them, it is offensive that some women feel a need to undo these signs of pregnancy. They see it as a step back in the feminist movement.

Others possess a completely opposite view. Some view these bodily changes due to pregnancy as a stigma, something to be rid of as soon as possible. They feel that if a woman so chooses, she has every right to improve her physique in the way she wants. And others may not view these changes as a stigma, but feel that it is in favor of the feminist movement for a woman to be able to regain her pre-pregnancy shape if she so desires.

Changes That Occur With Pregnancy

  • Breast Changes with Pregnancy

    During pregnancy, the breasts prepare to feed the impending newborn. The milk sacs begin to fill with milk, the breast ducts dilate, and the overall breast enlarges in size. Sometimes, this enlargement comes so rapidly that stretch marks form. When breastfeeding had ended and milk has dried up, the breasts more or less return to their original state. Other times, the breasts become smaller than before pregnancy. Additionally, because the breast growth due to lactation can be so rapid and extensive, once the breast has returned to its pre-pregnancy size, they may begin to sag or have what is referred to as ptosis.

    Reversal of Breast Changes

    Depending on what changes have happened to the breast, it may take more than one procedure to get breasts back to their pre-pregnancy state (or better!). Breasts that have ptosis (sagging) can be improved with a breast lift, also known as a mastopexy. If a woman has lost breast volume or size, breast augmentation with implants or with fat can be performed to enhance or enlarge the breasts. If both a post-pregnancy decrease in size and sagging are issues, both a breast lift and a breast augmentation can be completed simultaneously.

  • Abdominal Changes with Pregnancy

    As the baby grows in the womb, so does the abdomen of the mother-to-be. To make room for a child, the abdominal wall muscles, the rectus abdominis muscles, and the skin of the abdomen stretches. After delivery, the abdominal muscles and skin shrink back down. For some women, they return to their pre-pregnancy appearance. For other women, this is not the case. Some women may have stretch marks, a combination of stretch marks and loose skin, or the trifecta -- stretch marks, loose skin, and permanent separation down the middle of the rectus abdominis muscles. This is known as a diastasis recti. The latter causes an outward bowing of the abdomen if the muscle separation is severe enough.

    Reversal of Abdominal Changes

    Improvement of the abdomen involves tightening the gap of the abdominal wall muscles if they are separated. This is done in a process known as plication. Once this is done, the excess loose skin and fat can be removed via an abdominoplasty.

  • Fat Deposition and Pregnancy

    Inevitably with pregnancy comes weight gain. There is the obvious weight gain that comes from the growing baby in the uterus, the placenta, and the amniotic fluid. How much additional weight is gained varies depending on diet, exercise, and fluid retention. Some women gain extra pockets of fat with pregnancy. The lower body, specifically the thighs and the buttocks, usually bear the brunt of the weight gain in terms of additional fat.

    Reversal of Fat Deposition

    “Eating for two” used to be the standard diet pregnant women followed. The current teaching is that only 200-300 extra calories per day is needed during pregnancy. A return to a woman’s pre-pregnancy weight may possibly be achieved with a return to the pre-pregnancy exercise regimen, a reasonable diet, and breastfeeding (if possible). Excess fat that does not go away after pregnancy can be treated with liposuction.

The Timing of Mommy Makeover Surgery

The timing of mommy makeover surgery is quite important. Don’t be fooled by the celebrity moms who seem to bounce back within days of giving birth. For one thing, they are under intense pressure to return to their pre-pregnancy shape because their livelihoods depend on it. They have nutritionists, personal trainers, nannies, and others to help make their evolution that much easier and faster. Even at that, some of them will admit that it is indeed hard work to regain their pre-pregnancy shape. And secondly, you only see them at their best in magazines. They don’t show the transition, just the before and after.

It is important for the body to stabilize postpartum. This can take up to six months to one year. If a woman desires additional pregnancies in the short term (during next 3-5 years), she should probably hold off on any plastic surgery procedures until she’s done bearing children. It is indeed possible to have additional babies after a mommy makeover, but the financial, emotional, and physical recovery investment may be undone! Additionally, before any breast surgery, a woman should be at least six months out from breastfeeding. Milk can persist in the ducts after the stoppage of breastfeeding for even up to one year. Finally, a woman’s weight should have stabilized before considering any procedures.

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