Are There Complications that Come with a Mommy Makeover?

The mommy makeover is one of the most popular operations performed by plastic surgeons. The procedure is a combination of cosmetic breast surgery, liposuction, and abdominoplasty. It has been designed to correct changes that occur normally with pregnancy.

Although the procedure is considered to be extremely safe, complications may occasionally occur. These include bleeding, hematoma formation, loss of tissue, wound breakdown, excess scarring, infection, asymmetry and numbness.

Several steps can be taken to minimize complications. These include utilizing an accredited outpatient surgical facility, a board-certified plastic surgeon and a board-certified anesthesiologist. Although, these steps won’t totally eliminate complications, they will hopefully decrease the incidents. 

Pain Management Following Mommy Makeover Surgery

The mommy makeover is one of the largest procedures performed in cosmetic surgery. This procedure has several components. These include breast augmentation, breast lift, abdominoplasty, and liposuction of the hips and thighs. The exact procedure performed in any particular case is dependent upon the specific needs of the individual patient.

Pain tolerance varies from patient to patient and is dependent upon a variety of factors. The vast majority of patients who have mommy makeover surgery describe their pain

as moderate. This pain is especially noticeable in the first 24 hours following surgery, but improves rapidly over the next week.

Patients are given narcotic pain relievers in the immediate postoperative period and switched to Tylenol 5 to 7 days postoperatively. It’s not unusual for patients to have pain, which is related to muscle spasm following this procedure. When this situation arises, muscle relaxants are extremely helpful as well.

If you’re concerned about postoperative pain management, it’s important to discuss this issue with your plastic surgeon. Your surgeon should be able to develop a plan that addresses your concerns. 

Chest Wall Tightness after Breast Augmentation

It’s not unusual for patients to complain of tightness of the chest following breast augmentation surgery. This tightness is related to spasm of the chest wall muscles and swelling of the adjacent soft tissue. It’s more common when implants are placed beneath the muscles, but can occur with sub glandular placement as well.

In an effort to minimize these symptoms, a variety of strategies have been utilized. Swelling is managed with compression devices and support bras. Although swelling can be significant in the early post-operative period, it tends to resolve rapidly.

Chest wall tightness can also result from spasm of the chest wall muscles. When this occurs, muscle relaxants and massage are helpful. Massage of the back helps relax the anterior chest wall muscles. These muscles are connected by layers of fibrous tissue and for this reason; massage of the back can help alleviate spasm in the frontal muscles which cover the breast implants.

With time, these symptoms improve and patients are ultimately happy. If you have tightness following breast augmentation, make sure you discuss the issue with your plastic surgeon.

Breast Fullness Following Breast Reduction

Some of the most satisfied patients seen in our practice have had breast reduction surgery. These patients note significant improvement in their symptoms as well as improved breast aesthetics. The procedure simultaneously reduces the breast volume, reduces areola size, lifts the breast into proper position, and creates upper breast fullness.  

This is accomplished by leaving attached underlying breast tissue, which supports the blood supply to the nipple areola complex and wrapping it in a tightened skin envelope. Results are usually excellent in the immediate postoperative period. Unfortunately with time, gravity causes the breast tissue to drift downward stretching the skin, creating recurrent sag.

This phenomenon is known as bottoming out of the breast and not only results in sag, but loss of the upper breast fullness as well. This phenomenon is more likely to occur if the patient has thin skin. The amount of sag that the patient has preoperatively and how much breast tissue is left behind are also factors. 

In an effort to minimize the development of recurrent sag and loss of upper breast fullness, surgeons have utilized various maneuvers. Positioning of the breast pedicle to a more superior location has been found to be helpful. Internal suture techniques have been utilized as well. Despite modifications in surgical technique, loss of upper breast fullness may still occur. Despite your surgeon’s best efforts, it’s important to realize that gravity is an unrelenting force.

Swelling Following Breast Augmentation

Patients undergoing breast augmentation can anticipate significant swelling in the immediate postoperative period. This swelling resolves quickly with the vast majority being gone in about three weeks. Almost all of the visible swelling is gone in four to six weeks, but small amounts of residual swelling may be present for up to three to four months following surgery.

Compression bras and dressings are frequently used following breast augmentation to minimize swelling. Swelling can add to a patient’s postoperative discomfort. It can also increase anxiety regarding breast size immediately after surgery.
 
For these reasons, we feel it’s important for the patient and the surgeon to have good communication regarding this topic immediately following surgery. In this situation, a little reassurance can go a long way towards making this a more comfortable experience.

Fight Aging and Extend the Life of Your Breast Lift Procedure With Proper Recovery

This is a commonly asked question in our practice and it’s hard to answer because of the large number of variables that are present. It’s safe to say that because of the constant force of gravity, we can set the clock back but never stop it from ticking.  Women who do not have breast lifts experience progressive sag and women who have had breast lifts can expect some recurrent sag as well.
 
Factors that are associated with the development of recurrent sag include thin skin, large breasts, fluctuations in weight, pregnancy, failure to use a bra for support, certain types of disease that involve the connective tissue, and cigarette smoking.

Surgical technique is important as well, but less important than the patient’s wound-healing and soft tissue characteristics. Most breast lift procedures utilize the skin to create an envelope, which supports the breast tissue. Recently, techniques have been developed that utilize internal sutures to provide additional support. If breast implants are used to add volume or create additional upper breast volume they should always be placed under the muscle and should not be of excessive size.
 
In my experience, breast lifts are associated with high satisfaction rates and in many cases last between 10-15 years. It’s important to realize that gravity goes to work immediately and as time marches on, recurrent sag is inevitable to some degree.

Know Your Options for a Smooth & Happy Breast Augmentation Procedure

Several questions need to be answered before proceeding with breast augmentation surgery.  These pertain to the following issues: 1) Implant size, 2) Implant type, 3) Incision location, 4) Under or the over muscle, and 5) With or without a breast lift.
 
Depending upon the answers to these questions, a large variety of treatment options potentially exist. Each patient should be considered individually since no two patients are the same. Patients may have unique anatomic findings and specific aesthetic goals that impact their treatment plan.

In general terms, data shows that the majority of implants are placed under the muscle through an inframammary approach. There is a greater tendency to use silicone gel implants than saline implants, but saline implants are still frequently used.

When breast sag is present, most surgeons perform a breast lift, but occasionally plastic surgeons place the implants on top of the muscle to avoid scarring.

There’s no best breast implant. It’s important that each patient be carefully evaluated by a board-certified plastic surgeon who has experience with breast augmentation. It’s essential that he or she listens to you and understands your aesthetic goals.

It’s also important that you listen to your plastic surgeon; he or she may recognize anatomic limitations that might prevent you from accomplishing your aesthetic goals. These discussions need to occur before surgery, not after. This results in less confusion and patients who are ultimately happy with their breast augmentation.

Is There An Age Limit for Breast Augmentation?

We frequently see women in their fifties and sixties who request breast augmentation. In the vast majority of these patients, breast augmentation can be performed without any difficulty.

It’s important to realize that as we get older, changes occur in our bodies.  These changes are often related to multiple pregnancies.  In many cases, they have developed loss of breast volume and associated breast sag.  For these reasons, many of these patients will need breast lifts at the time of their breast augmentation.

Breast Implants: Silicone vs. Saline

The type of breast implant used is one of the most important decisions facing patients undergoing breast augmentation. Silicone and saline implants both offer significant advantages for breast augmentation and are both associated with high satisfaction rates.

Although it’s hard to tell the difference between saline and silicone when looking at patients, there is a significant difference in how they feel. This difference is especially noticeable in women who have minimal amounts of breast tissue.

Silicone implants offer several advantages over saline implants. The most important advantage is how they feel. There is no doubt that they feel more natural than saline implants especially when there is minimal breast tissue present. In addition, silicone implants are less likely to cause rippling than saline implants.

Implant Massage After Breast Augmentation

Not every plastic surgeon recommends implant massage following breast augmentation, but the vast majority of surgeons believe it’s extremely important. Implant massage is also known as implant displacement and is designed to stretch the implant pocket to avoid the development of capsular contracture.

Implant massage starts following surgery and is typically performed approximately three times per day. The implant is displaced superiorly, inferiorly, medially, and laterally. This is done for at least one year following surgery.

Can I Have a Breast Reduction if I’m Overweight?

For many patients, breast reduction surgery is a life-changing experience. Symptoms such as back, neck, and shoulder pain seem to improve almost overnight. Patients note that clothes fit better and over time, their self-esteem and self-image improve as well.

Patients who are overweight don’t differ from other patients in this regard. They note similar improvement in quality of life and significant improvement in symptoms.

When patients who are overweight undergo breast reduction surgery, they often experience additional benefits. They often note increased exercise tolerance and subsequently become more physically active as they adopt a healthier lifestyle. In many cases, this results in significant amounts of weight loss.

Liposuction for Men

Liposuction is one of the most commonly performed cosmetic surgical procedures in men. The flanks, abdomen, chest, and neck appear to be the most commonly treated areas. This procedure is
associated with high satisfaction rates when patients are near their ideal body weight.

Liposuction in men has limitations because the fat tends to be more fibrous. In addition, a large amount of the abdominal fat is located within the abdominal cavity where it can’t be reached by a liposuction canula. These characteristics can limit the amount of fat that can be removed with this procedure. Men generally have thicker skin than women and as a result, skin sag is less likely to occur in this group.In some cases, ultrasonic liposuction has been found to be helpful when performing liposuction on men. In theory, this procedure results in skin tightening as well.

Capsular Contracture Following Breast Augmentation

It’s normal for your body to react to a foreign material such as a breast implant by forming a scar. This scar surrounds the breast implant and is known as a capsule. Capsule formation occurs in every patient to some degree following breast augmentation. In most cases, this represents a normal response to a foreign material being placed inside your body.

Without capsule formation, implants don’t stay in one place. When this happens, implants migrate and secondary pocket revision may be necessary. In some cases, capsule formation occurs in an aggressive form, which results in a capsular contracture. In severe cases of capsular contracture, the breast implants become hard, distorted, displaced, and painful. The majority of capsular contractures develop within six months of surgery, but they can develop at any time.

There’s no laboratory or radiology test that makes the diagnosis. The diagnosis is entirely based on physical examination.

Teen Breast Reduction

When younger patients have significant breast enlargement with associated symptoms, we don’t feel that they should be denied the benefits of this procedure because of an arbitrary age cutoff. Before proceeding, there are several unique considerations in this group that must be considered.

One of these is the issue of breast growth. We would prefer stabilization of breast growth for at least six months prior to proceeding with surgery. Another issue is the age of consent. Because of this, parents should be involved in every step of the decision- making process.

Will Pregnancy Ruin My Breast Implants?

Breast implants are not impacted by pregnancy and breast-feeding, but the surrounding breast tissue can be significantly impacted. These changes vary from patient to patient following breast augmentation and pregnancy. Some patients are minimally impacted, while others note sag of their native breast tissue, loss of breast volume, and stretch marks. These changes are probably not related to breast implants, but are instead related to the natural biologic tendencies of the breast tissue. In other words, loss of breast volume, sag, and stretch marks would occur even if breast implants weren't present.

Exercise Following Breast Augmentation

Recovery times following breast augmentation surgery vary from patient to patient. These times are significantly impacted by the nature of the procedure, the patient’s employment, and the patient’s social situation. It’s important to realize that even though breast augmentation is a cosmetic procedure, it’s still a significant operation with associated risk. For this reason, premature return to normal activity can result in an increased incidence of complications.
  
We generally recommend light activity for the first week following the procedure. After one week, patients are allowed to gradually resume normal non- strenuous activities. Strenuous activities and heavy lifting are not allowed for at least six weeks in most cases. At six weeks, most patients are able to resume all of their normal activities.

Insurance Coverage for Blepharoplasty?

When redundant upper eyelid skin results in obstruction of vision, it’s more than a cosmetic issue.  Patients often have excess skin, which obstructs vision superiorly and laterally.  Under these circumstances, excess upper eyelid skin can actually cause significant functional problems.  For instance, this can create problems when driving a motor vehicle and this can be potentially dangerous.  When this happens insurance carriers will occasionally view upper lid blepharoplasty as
medically necessary and cover its expense.

Before insurance carriers cover the expense of blepharoplasty they require that certain criteria be met.  These include documentation of symptoms and physical findings associated with visual field obstruction.  In addition, visual field studies that demonstrate visual field obstruction are critical to insurance approval.

Visual field studies are typically performed by an ophthalmologist or optometrist. The study is performed by measuring the patient’s response to a series of flashing lights. The patient’s responses are recorded and a computer- generated report is made. This report will demonstrate any visual field defects that the patient may have. The initial study is followed by a secondary study in which the upper eyelids are taped in an upward direction.  Improvements in the results of visual field studies with the upper lids taped as opposed to untaped would indicate that blepharoplasty would benefit the patient.

Should I Get Breast Implants If I Plan On Getting Pregnant Later?

The results of breast augmentation surgery are never permanent. Changes in weight, normal aging, pregnancy, and breast-feeding can all be expected to change the breasts. Each patient who is considering breast augmentation and possibly pregnancy should be considered individually based on their personal situation. As a rule, if a patient is planning pregnancy within a year of surgery, we generally recommend postponing surgery until after the pregnancy. Most patients who present for breast augmentation don't have plans for pregnancy in the short term, but realize that it's probably in their future. It's important for this group of patients to realize that pregnancy may impact their final result.

The impact of pregnancy on breast augmentation varies from patient to patient. Some patients are minimally impacted, while others note sag of their native breast tissue, volume loss, and stretch marks. This often results in the need for secondary procedures, such as implant exchange and breast lift.

Surgical Correction for Patients with Breast Asymmetry

Often unrecognized, the vast majority of women have mild to moderate asymmetry of their breasts. Caused by genetics or hormonal fluctuations, asymmetry occurs during adolescence or pregnancy. Depending on the degree of breast asymmetry, you have options to correct your condition.

Women with a large size difference in breast size find appropriate clothing and bra fitting extremely difficult. Some women may also feel self-conscious or embarrassed about their condition which affects their sense of body image. Cosmetic surgery may be a viable solution to their problem. Surgical options include breast augmentation, breast lift or breast reduction – or a combination of any two or all three.

Mommy Makeover

Most women, today, take pride in their appearance. They work hard to maintain a proper lifestyle by eating mostly healthy foods, exercising, and keeping fit. When motherhood occurs, however, everything changes. Pregnancy, childbirth, and breast feeding all take their toll on every part of the body. Before a woman knows it, a lifetime of her efforts have been undone.