‘Mommy makeover’ or not, combination cosmetic procedures illuminate the path to rediscovering your curves of youth.

Words Sara Fiedelholtz

Youth and beauty go hand-in-hand. Then we grow up, and sacrifice said youth and beauty to the demands of family, career—often both. What’s a lack of sleep, stress, and endless thankless tasks give us? Misplacement of once-voluptuous curves, something many of us are all-too familiar with.

It’s no surprise, then, that industry experts report a rising interest in the area of body contouring. But it’s not just about “contouring”—these days the trend is to combine procedures to get optimal results.

The Cosmetic Combo

“A lot more women are coming in after pregnancy and undergoing breast lift with implants. There’s [also] been a sharp increase in abdominoplasty,” says Howard Tobin, MD, FACS. That combination, of breast and abdomen procedures, is what today’s moms are choosing.

Mommy Makeover—you’ve heard the phrase and you probably have a good idea of what it is. According to cosmetic surgeon Michael Kluska, DO, FAACS, the typical “mommy makeover” patient is in her mid-30s to mid-40s, and undergoes breast augmentation with a lift and/or implants, and a tummy tuck with multi-site liposuction.

It is this multiplex of procedures that defines the makeover, getting all of it done at once in a single operating session. It is, consequently, a fairly long operation, but when you’re done, well, you’re done—and this is what makes it so popular.

“A breast lift with implants and tummy tuck plus or minus liposuction for most women is three to three-and-a-half hours on an out-patient basis, with full recovery within three to four weeks,” says Dr. Kluska.

It is also a less risky operation than it was in the past, thanks to advancing techniques. Dr. Kluska, for example, uses local anesthesia and sedation (via tumescent solution and an IV tube) as opposed to general anesthesia. “We’ve learned a lot about the body and how it responds to local vs general aesthetic,” he says. “Patients don’t need general anesthetic and seem to recover more quickly…it’s easier on the patient, and it’s safer.”

Still, because the procedures are so comprehensive, and so invasive, recovery requires some immediate downtime, and then several weeks of rest and restricted activity. “When you start doing liposuction, breast implants…it’s a major assault on the body,” says Dr. Tobin.

For the first four to five days, advises Kluska, “You’ll need help at home—a good support structure, someone to help with the kids, meals, shopping, all the little things that moms do.”

The good news? There’s not a lot of bruising with today’s combo body surgery. The tumescent solution helps constrict blood vessels, which decreases the bruising—as well as increasing safety “because it limits blood loss,” says Dr. Tobin. And there is usually a marked reduction in both pain and bruising within 24 hours. Still, expect it to take about four to six weeks to be fully functional.

As for long-term recovery, “scars are for the most part standard across the board,” says Dr. Kluska, though scarring can be minimized with the application of topical cream such as Mederma or steroid cream.

Not For ‘Moms’ Only

While the combo contour is called a mommy makeover, to limit the idea of combination procedures that include the breast, abdominal region and overall body area to moms only is short sighted, says Dr. Tobin. “To suggest these procedures are just for someone who goes through pregnancy is trivializing,” he says. “We should treat every person individually.”

According to Maurice Sherman, MD, FACS, the so-called “mommy makeover” really just is a marketing term used to describe the combination of simultaneous procedures.

Dr. Tobin concurs: “We’ve seen an increase in combining breast augmentation and abdominoplasty—the ‘mommy makeover’—but in that sense, we are seeing more interest [overall] in combined procedures. I think it’s just a reflection of the increasing interest in body contouring [which] is more common today than it was 15 to 20 years ago.”

The rise in demand for multiple, simultaneous treatments, including the mommy makeover, is due to several factors. One of the big reasons is that procedures today are more standardized than they were
15 years ago, making time in surgery more efficient.

Take breast augmentation. A combined breast augmentation and lift used to be done separately. “The old traditional, conservative way was not to do this together. It used to be with older techniques to do lifting first and then six months later come back [for the implants],” says Dr. Sherman.

Today the trend is to combine the two procedures into one, thanks to advancing techniques that enable surgeons to create a strong enough pocket during the lift to support the implants at the same time.

The one thing that will not bend to improved technology is surgical time limits. For all the improvements in the cosmetic surgery field, experts agree that there is a limit to how much time you should spend in the OR.

“We have a strong feeling that elective surgery should be limited to four hours because studies have shown for four hours surgical risk is steady,” says Dr. Tobin. “We can do a tummy tuck and breast lift within four hours. I would offer a caveat—it can be a dangerous trend to combine procedures when extending operating time into a longer period. I don’t think that is acceptable in cosmetic surgery.”

“You don’t want to be under for more than 4 hours,” says Dr. Kluska. “Under 4 hours, in my opinion, is very safe.”

Road to Results

In the end, as with any invasive procedure, the patient has to be, well, patient. Even without complications, the healing takes a while. “There’s a healing process to go through, with swelling, bruising, and numbness,” says Chasby Sacks, MD, FAACS.

And then there are the psychological aspects of recovery. “About two weeks after surgery patients may undergo a bit of depression,” says Dr. Sacks. “Why did I go through this? Bruised, swollen scars,
still red.”

Dr. Kluska agrees that there can be psychological challenges for cosmetic surgery patients to face, especially during the first week after surgery. “It’s buyer’s remorse. Patients spend lots of money and expect to see immediate results,” he says. “The biggest challenge is getting them through the first week, then you start to see results.”

As Dr. Sacks aptly puts it, a key aspect of having realistic expectations is “to think about…the road to the results.”