My Mommy Makeover conversation with the Southern Marin Mothers Club continues below.

(Click here to read Part 1 of the Mommy Makeover article)

Feeling Good and Looking Good: Part 2
Mommy Makeover Surgery:  A conversation with plastic surgeon, Dr. Carolyn Chang

Can you describe the procedures that most women are including in a mommy makeover?

• Tummy Tuck (abdominoplasty)
  The tummy tuck, or abdominoplasty, is the mainstay of the mommy makeover.  This procedure is designed to tighten the abdominal wall by repairing and realigning the abdominal muscles and removing any excess skin and fat that may have persisted after pregnancy.  The scar that is created for this procedure most often extends hip to hip.  This scar can be customized in its position, so it can easily be hidden under most bikini bottoms.  Patients are often worried that this type of surgery is especially hard to recover from.  I find that using a temporary implantable pain pump really helps to minimize the discomfort after surgery.

What’s important about this procedure is my patients not only look better afterwards, but they often feel better as well, because the abdominal muscles are realigned, the back is stabilized and straightened, thereby relieving the lower back pain that a lot of mothers feel.

• Liposuction
  The general rule of thumb is that the places where your body collected fat before you had children will be the places where it will continue to deposit afterwards — and often to an even larger degree.  A common request among moms is to reduce the love handles, also called the flanks, through liposuction in conjunction with a tummy tuck.  In this way, the entire torso area can be slimmed and sculpted.  Other common areas that respond well to liposuction include the outer and inner thighs and the upper arms.
• Breast Augmentation
  During pregnancy, the breasts engorge due to hormonal changes in preparation for breast feeding.  Afterwards, as the milk production diminishes, many women actually notice that their breasts become even smaller than they were pre-pregnancy.  This is because the breast tissue actually shrinks.  Breast augmentation is a procedure that uses silicone or saline breast implants to enlarge the breast tissue again and restore that youthful fullness.
• Breast Lift (mastopexy)
  For some women, the swelling of the breasts results in overstretching of the skin, and afterwards, sagging breasts.  Implants can help in some of these cases. But in the most severe, the nipple position is so low on the chest that an implant alone cannot fix the problem.  For these mothers a breast lift, or mastopexy, is the answer.  A mastopexy re-centers the nipple on the breast mound and ‘lifts” the entire breast so that it is rounder in shape again.  A mastopexy can be performed alone or with an augmentation.

There are many ways to perform a mastopexy, and unfortunately, all result in some external scarring.  To minimize this, my preferred technique is that of a shorter lollipop scar.

• Breast Reduction
  For those mothers whose breast tissue actually got larger after pregnancy, a breast reduction is available to relieve the weight and reshape the breasts to a more youthful contour.  Like the mastopexy, my preferred method when possible is through the shorter lollipop type scar, as opposed to the old-fashioned anchor type scar.  Not only is the scar shorter with the lollipop technique, but the shape tends to be rounder and perkier.

Beyond questions specific to surgery, what are the most common questions that mothers ask you about a mommy makeover?

How much time will I need for recovery?
Depending upon the selected procedures, recovery generally takes about a week or two.  I insist that my mothers get reliable help for their children during this time period.  I want them to take the time to rest and recover.  Mothers can feel guilty about taking time away from their children, but they shouldn’t lose sight of the importance of doing something for themselves as well.

How do I explain this to my children?
Mothers with young children are afraid of frightening them, and mothers with older children, particularly girls, are afraid of encouraging unhealthy body image issues.  In general, I have found that reassurance without going into too much detail works well with the younger children, and a frank conversation works with the older children.  A mommy makeover is reconstructive in nature, so it is not difficult to explain the motivations to have it done to a teenager.

When is the right time to have surgery?
My response is always the same, “It’s when you’re ready.”  Which means you have worked as hard as you can to get your body back into shape naturally. It also means that you are mentally ready and 100 percent committed to having a procedure.  You should have planned this carefully with your family to insure that they are onboard.  And finally you should do your homework to seek referrals to plastic surgeons from your doctor and word of mouth referrals from family and friends, and select a board- certified plastic surgeon with whom you are confident.

A little trepidation is normal, however being prepared will insure that you will have a successful result and recovery, and a more satisfying overall experience.

For more information on the Southern Marin Mothers’ Club visit: www.southernmarinmoms.com

Dr. Carolyn Chang, San Francisco Plastic Surgeon