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  • By Wendy Lewis, Editor in Chief 

    Celebrity moms seem to bounce back to their size zero pre-pregnancy shapes impossibly quick.  But what about moms in the real world whose bodies fluctuate after childbirth and breastfeeding? Fortunately, there is a lot they do to get their bodies back into great shape.  “Good nutrition, a healthy diet and rigorous exercise can make a positive impact, but in many cases the only way to reverse the signs of aging and childbirth is through surgical means,” explains Dr. Tracy Pfeifer, a New York City plastic surgeon.

    Mommy Makeovers, the surgical trifecta of body contouring, breast lifts (with or without breast implants), and skin tightening aims to reduce women’s main concerns about loose skin, sagging breasts, loss of breast fullness, protruding abdomen, and fatty bulges. “A Mommy Makeover usually involves a combination of procedures that address the shape of the breasts in addition to other areas of the body such as the waist, hips, abdomen, buttocks and thighs. It is fairly common to have a breast lift and tummy tuck performed simultaneously,” Dr. Pfeifer said.

    BREAST ENHANCEMENT

    We all know how childbirth and breastfeeding can negatively affect the shape of the breasts. To correct sagging breasts and reposition the nipple, New York City plastic surgeon Dr. Z. Paul Lorenc offers these solutions “Breast lifts require an incision placed around the nipple, either partial or circumferential. A vertical incision is also necessary in some cases, especially for larger breasts where there is more tissue to be removed and elevated. I will then remove excess skin and glandular tissue to achieve a better breast position and shape, which is what most women need after pregnancies and breastfeeding.”

    Implants are also an option for women with smaller breasts who have seen a loss in cup size after pregnancy. Most plastic surgeons agree that silicone gel is their ‘go to’ implant in most cases. “I can report that silicone is my first choice for most patients. I have experience with it from both a clinical and a surgical perspective, and I am fully comfortable with the safety aspects.” Dr. Pfeifer said. Dr. Lorenc agrees that the modern silicone implant design offers a stronger shell and better quality, firmer silicone gel than those from previous generations.

    Of course, there is no single best type of implant and approach for every breast augmentation. Dr. Bryan G. Forley, a board-certified plastic surgeon based in Manhattan, believes a talk with your plastic surgeon to discuss preferences regarding breast size, incision location, and how you would like your breasts to look is the first crucial step.

    Women now have three brands of silicone gel implants to choose from that have been cleared by the U.S. F.D.A.  Silicone gel-filled breast implants have a silicone outer shell that is filled with silicone gel. They can have either smooth or textured shells. Silicone gel-filled breast implants are approved for breast augmentation in women age 22 or older and for breast reconstruction in women of any age. Allergan Natrelle and Mentor MemoryGel were the first two brands to gain a nod from the F.D.A.  Most recently, Sientra’s Silicone Gel Breast Implants were also cleared for marketing in the U.S.  

     

    TUMMY TUCKS

    For some women, no amount of crunches can eliminate a protruding abdomen. Weight fluctuations can leave women with fat deposits in certain areas that won’t respond to diet or exercise. Dr. Pfeifer suggests that women with severely sagging excess skin with stretch marks and/or loose muscles that have accumulated around the midsection, consider a full or partial abominoplasty as only a tummy tuck procedure can produce a flatter and firmer stomach.

    As for the position and curvature of the scar from the tummy tuck procedure, Dr. Lorenc specializes in using techniques to minimize scarring. “Women want the smallest possible scar. We often ask patients to bring in a bathing suit or panties to position the scar so that it can be easily concealed with clothing,” says Dr. Lorenc.

    However, if your muscles are taut, your skin has retained good elasticity, and your tummy bulge is only below the navel, Dr. Lorenc suggests bypassing the traditional tummy tucks for a less invasive procedure, called a mini tummy tuck or partial abdominoplasty. For an even better contour, tummy tucks may be combined with liposuction of the hips, waist, thighs, and back.

    TIMING IS EVERYTHING

    Post-pregnancy women’s bodies continue to change for 6 – 12 months, particularly if they are breastfeeding. Dr. Forley recommends waiting at least three to six months after new mothers have finished breastfeeding to accurately determine their post-pregnancy size and shape. It is usually recommended that women wait until they have finished having children to consider this surgical makeover as these procedures involve skin excision and are usually done only once.

    Just like every mom is unique, no single approach to a Mommy Makeover is right for every woman. Dr. Pfeifer tailors each makeover to meet the need of each individual patient. “A Mommy Makeover is a once in a lifetime procedure and you must be confident and satisfied with the proposed plan,” she said. She often recommends having your breasts and lower body reshaped in one stage to cut down on recovery time, especially if you have small children to care for.

    Opting for breast surgery with a tummy tuck of liposuction can be very beneficial. The cumulative effects offer a real “wow factor” to the patient.  “The final outcome of a breast lift or augmentation with a tummy tuck can make a dramatic difference that women love. They can get their bodies back into shape and feel good about themselves again,” said Dr. Lorenc. “If you are planning future pregnancies, it may be best to delay your abdominoplasty, as the vertical muscles in the abdomen that are fused during the surgery will tend to separate again during pregnancy.”

    When you are ready to go for a mommy makeover, consult several board-certified plastic surgeons who will be able to customize the safest and most effective program for your needs and goals. Visit http://www.surgery.org or http://www.plasticsurgery.org to locate a board certified plastic surgeon near you.


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