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Birmingham, Alabama Plastic & Reconstructive Surgery

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Mommy Makeover

"Dr. Moor has always been very courteous friendly but remains professional at the same time. I have had Dr. Moor perform several different procedures on me and I have always been pleased with his work. He strives to make you happy with your procedure. He always answers your questions and gives you the suggestions of what he thinks would be most beneficial. His office workers are friendly and attempt to get you in to see Dr. Moor as soon as possible. They are also courteous and professional. I could not imagine having anyone else perform my procedures/needs." - patient testimonial

 

A Mommy Makeover at ALABAMA PLASTIC SURGERY focuses on the breasts, the abdomen, localized fat reduction, and changes in skin pigmentation.

Becoming a mother doesn’t mean you cannot look as good, or better than before pregnancy.  Pregnancy and motherhood is a happy time.  However, the physical change of pregnancy can be disheartening.  Some women are lucky and can bounce back to their original figure, others cannot.  Plastic surgery can help you regain your pre-pregnancy form and say good-bye to your post-partum figure.  Dr. Gene Moor at ALABAMA PLASTIC SURGERY in Mountain Brook Alabama 35223 does most of these procedures on an outpatient basis and you can return to your busy life relatively soon. 

The ‘Mommy Makeover’ is designed for women who have had children recently and usually don’t plan to have any more children.  Plastic surgery is becoming more and more popular and accepted.  There is no reason not to consider plastic surgery to improve that post-partum figure.

During pregnancy skin is stretched and weight is gained.  There is a persistence of localized fat, even after a large amount of weight has been lost.  There is a limit on how much the post-partum skin can return to the pre-pregnancy state.  When you look in the mirror you may be unhappy with the hanging, deflated breasts, the abdominal apron, localized fat pockets, as well as changes in skin.                   

 

Your breasts during pregnancy swell, and the milk glands may replace the fatty tissues.  After child birth, the breast size usually decreases with the remaining breast in a larger envelope of skin.  The envelope can be filled with an implant and return the breast to a more youthful look.  It is unlikely that breast enlargement will interfere with subsequent breast feeding and subsequent pregnancy. 

In some rare instances  after child birth, the breasts stay large or even continue to enlarge. Once the breasts are a stable size and the patient feels that her breasts are uncomfortably large, a Breast Reduction can be performed. Excessively large breasts may be detrimental to self-esteem and unfortunately can lead to back and neck pain, shoulder pain, as well as poor posture because of the extra weight.

Excessively large breasts may limit the level of activity: bending forward or stooping becomes difficult and may be interfering with work.  The ability to do certain physical exercises and post-partum activities may also be impaired.

Another common scenario for women to experience is upper pole breast flattening, and gaining a few pounds after child birth. These women tend to have a large breast size before pregnancy, with upper pole fullness and minor sagging.  While definitely not interested in a breast reduction before pregnancy because these women liked their larger breasts, things may change after pregnancy: sagging, upper pole breast flattening (atrophy), may be relieved with a breast reduction. The patient seeks a breast reduction to help relieve her chronic symptoms related to the weight of large breasts and to make her breasts more proportionate to her body as well as have a more youthful look.

Correction of sagging breasts:

In addition to the swelling of breast tissue, the skin can be stretched, contributing to the sag. The surgical procedure that addresses the excess breast skin is called a Mastopexy or Breast Lift. The goal of a Mastopexy is to establish the appropriate relationship of the breast mound (the body of the breast itself) and the nipple to the infra mammary fold on the chest wall.  Pregnancy with its sudden weight gain, and subsequent weight loss, can contribute to saggy breasts. 

The degrees of Ptosis (sagging, droopy breasts)

Pseudoptosis means that with the deflated breast,  the nipple is above the infra mammary fold with loose, saggy skin and atrophy of the breast tissue. This means that the nipple is still in place above the fold under the breast, as opposed to being lower than the fold. This is not considered a true sagging or ptosis.

Ptosis is measured in degrees: 1,2,3 degree ptosis, depending upon the nipple relationship to the infra-mammary fold.

Pseudoptosis and Grade One Ptosis both, may be treated with a Breast Augmentation only. 

For a more severe degree of ptosis, a skin excision of the breast with nipple reposition is necessary. This is the case when the woman is not satisfied with her breast shape.

With the patient who desires to correct her sag and wants to be larger as well, a second cosmetic procedure, a Breast Augmentation with implants can be added to the Mastopexy breast lift.

If the patient has severe sagging, with a lot of excess skin, an implant is added to give upper pole fullness, not necessarily to make the breast larger.  A 200-300cc implant may be inserted. The Mastopexy and the Augmentation are both cosmetic procedures.

These cosmetic procedures can also be staged.  The Augmentation can be done first, see if the patient likes it, if she still has too much of a residual sag, a Mastopexy can be performed at a later time as a second cosmetic procedure.   

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Tummy Tuck after pregnancy:

With pregnancy the abdomen changes in many ways: there may be an ‘apron’ of skin hanging down, local fat deposits, loss of the flat stomach due to the loss of muscle tone and loss of fascial support below the umbilical area. With pregnancy you may have accumulated excess fat in the abdomen, waist, hips, and thighs. You may have lost your hour glass shape. 

If you are not planning another pregnancy, the post-partum belly deformity is the most common reason for an Abdominoplasty to address the lower abdominal fullness. This fullness is worse in the standing position and does not respond to dieting and exercise.  On physical exam there is excess skin and laxity of the abdominal wall. The severity of the deformity determines which operation is desirable: Mini Tummy Tuck or Tummy Tuck.

Liposuction after pregnancy:

If you don’t have excess skin or laxity in the abdominal wall, then liposuction is all that is needed.  A small incision about half an inch long is made in a strategic location to allow access to the fat pocket. 

Dr. Moor uses the advanced Vaser ultrasound and traditional liposuction techniques combined.  This requires a more superior skill in liposuction. The Vaser ultrasound melts the fat which I then suction out with traditional liposuction.  The fatty tissue in some areas of the body is more fibrous and responds better to the combination of ultrasound assisted-traditional liposuction than the traditional liposuction technique alone.

Liposuction of the abdomen is a useful technique when you only have excess fat with normal abdominal muscle tone and no excess skin.  Liposuction will not treat the bulge in the lower abdomen.  Liposuction may make the condition less objectionable by removing the fat but the laxity will still be present.

The stomach pooch or pouch after pregnancy:

The post-partum pooch is best treated with a Mini-Abdominoplasty or Mini Tummy Tuck which consists of liposuction of the abdomen, making a  small, low incision about the length and location of a ‘C- section’ scar.  The fascia muscle is sutured together from the umbilicus on down to the incision and the excess skin is excised. 

The amount of excess skin, in other words the ‘apron’ determines the length of the incision. The amount of loose skin and laxity above the umbilicus determine wether the full Abdominoplasty is needed.

“I like to do an abdominoplasty in combination with a liposuction of the waist, which gives an overall refined, sculptured appearance.”

Can an abdominoplasty and breast surgery be performed at the same time?

Yes.