More women are expressing interest in plastic surgery to restore a more youthful figure after having children. An update on combined procedures for postpartum body contouring — addressing the abdomen, breasts, and other problem areas — is presented in the August issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Sometimes called the “mommy makeover,” postpartum body contouring combines a “tummy tuck” (abdominoplasty) with breast liftsurgery (mastopexy) and other procedures to address the “multiple body areas affected by pregnancy that may enhance the patient’s overall appearance,” according to ASPS Member Surgeon Dr Alan Matarasso of Manhattan Ear, Eye, and Throat Hospital and Dr. Darren M. Smith of University of Pittsburgh Medical Center. They write, “In the appropriate context, multiple procedures can be safely and effectively combined to address the various regions affected by postpartum changes.”
Postpartum Body Contouring — Goals, Methods and Outcomes
The growing interest in “mommy makeovers” reflects the increase in pregnancies at later ages and increased multiple births, in a generation of women with “a keen interest in nutrition, fitness, and a continued desire to retain a youthful figure,” Drs. Matarasso and Smith believe. In a review of 40 consecutive women undergoing abdominoplasty, the researchers found that half of the patients were between 35 and 44 years old. Women seeking abdominoplasty between age 35 and 54 had 50 percent more pregnancies than younger patients.
Women seeking postpartum body contouring want to regain a more youthful appearance, improving all areas of the body affected by pregnancy, with the least conspicuous scarring and the least amount of discomfort and recovery time. While the focus is usually on a “firmer, flatter abdomen” and more youthful-looking breasts, women may have concerns about pregnancy- and age-related changes in other areas as well.
Drs. Matarasso and Smith highlight the need for clear communication in understanding and meeting the patient’s aesthetic goals. “The postpartum patient often uses her pre-pregnancy appearance as a barometer for her post-pregnancy goals,” they write.
For postpartum women concerned that they have “lost their waistline,” abdominoplasty can provide a firmer, trimmer abdomen. Liposuction is added to address specific problem areas. Ideally, abdominoplasty is postponed the woman has completed planned childbearing. However, recent studies suggest a “positive outlook” for women with unplanned pregnancies occurring after abdominoplasty.
Breast lift surgery can restore a more youthful appearance of the breasts. Additional procedures can be performed to address issues in adjacent areas such as the pelvic area, back, hips, flanks, or legs. For plastic surgeons, performing multiple aesthetic procedures in combination entails some challenges and risks. While a number of different factors can affect the risk of complications, Drs. Matarasso and Smith try to minimize risk by keeping the total surgical time under four hours.
Plastic surgeons also need to address patient concerns regarding “drains, pain, and scars” afterabdominoplasty. Experience suggests that most women will accept some abdominal scarring as the necessary tradeoff for achieving the desired improvement in body contour, the researchers note. They also emphasize the importance of evaluating the patient’s psychological status — especially during the emotionally vulnerable first postpartum year.
With advances in surgical techniques and patient care, combination procedures as part of postpartum body contouring can meet women’s desires for maximal cosmetic results, while minimizing downtime and controlling costs, Drs. Matarasso and Smith believe. They conclude, “In the appropriate patient and context, multiple procedures can be safely and effectively combined to address the multiple regions affected by postpartum changes and thus deliver a synergistic improvement in postpartum body contour.”
With the increase in “mommy makeovers,” some plastic surgeons are even noticing an increased demand for body contouring by men in the same age group. “The trend in women may be motivating spouses to do their own ‘Daddy Do-Overs,’” Dr. Matarasso adds. “Men typically target the chest and abdomen area, which includes those troublesome ‘love handles’”