Mommy Makeover.....what's that?? Well, the definition changes for different parts of the country, but here in Oklahoma it usually means a breast lift (with or without augmentation) and a tummy tuck (with or without liposuction).
As most women know, after having children, the ole body has a tendency to change a bit. The hormones of pregnancy cause skin to stretch and in many cases, it never returns to the pre pregnancy tightness. The connective tissue under the skin also stretches, leading to the end of that flat tummy. We all see the movie stars that have babies and shortly after...LOOK GREAT!! Unfortunately, most of us have to work for a living and cannot spend our days at the gym or in a spa pampering our skin and re-toning our musculature. Even if we could do that, in many cases, our genetics make it impossible to shake the effects...in many ways, it's the luck of the draw.
To get back on point, after babies and breast feeding, the breast, which enlarged during milk production, shrinks and in many cases sags. The nipple position that used to be perky now points in a more Southern position and can lose volume.
Here is a picture that shows the different degrees of ptosis or droop. A or "normal" is perky, high and tight. After children, all bets are off as to where you will end up. My experience is that if you start off with little or no breast tissue, the post pregnancy changes are less dramatic than if you start off with a large amount of breast tissue.
Other issues can also occur with shape and in some instances breast abnormalities that have been present since birth. As you can see in the pictures below, chest wall shape, breast size, breast development, and nipple shape can all play a roll.
With all of this in mind, we try to help you return to your pre-pregnancy state if possible. This may or may not include implants, but what it does do is re-position the nipple and lift the breast tissue that is hanging. Some of this tissue may get removed if it is well below the fold where the breast hangs over the chest wall. My personal experience is that most women desire implants to increase the fullness in the upper pole of the breast. The incisions can differ depending on how far the nipple needs to move but usually they are in the form of an anchor or "lolly pop".
The nipple is not "removed", it is rotated into its new spot conserving the nervous innervation and blood supply. These incisions have a tendency to heal very well and after 6-12 months they turn into little white lines. Implants, saline or silicone, are placed through the same incisions and usually under the muscle so they stay in place over time.
Now for the tummy..... We see stretch marks, sagging skin, bad c. section scars, bulging, hernias...you name it. The way to remedy all of these things is with the tummy tuck.
A tummy tuck is done through an incision in the lower abdomen a few centimeters above the labia. The incision goes from hip bone to hip bone and also around the stalk of the belly button. The skin is raised off of the underlying connective tissue and muscle up to the ribs. Once this is done, the loose muscle and underlying connective tissue is tightened back up to make the abdomen flat. The skin is then pulled down and the extra is removed. A new opening for the belly button is created. The smooth, non stretch marked skin from above the belly button is pulled down and stretch marked tissue, scars, etc. are removed. The incisions are closed and within 6-12 months they become thin white lines. 
Some can get away with a mini tummy tuck which removes a small amount of sagging skin (below the belly button) only.
Liposuction can be added to either procedure to remove problem areas in the hips, under the arms, thighs and saddle bags.
The great thing is this.....at Total Body Surgical, we can do both procedures at the same time, saving time and money.....one anesthetic, one recovery time. How can we do this?? Because we have two fellowship trained Cosmetic Surgeons that work very well together. We can do both procedures in under three hours and usually as an out patient.
Get your pre baby body back....come see us today!!
Call 918-786-7780 for a complimentary consultation!
We have special spring pricing to help you get back in shape for summer!
This young lady is a good example to discuss. For women who have never had children have tighter skin than those who have not...in most cases. This makes sense in that their breasts have not enlarged gradually over nine months, then shrunk down after. When the skin is tight and implants are placed, it takes a little bit of time for the skin to stretch to accomidate them, in some cases, up to three months or so. The other thing to consider is the distance between the nipple and the fold under the breast. If you look at this picture, in the 45 degree view, you can see the natural fold under the breast that delineates the breast from the chest wall. This is the nipple to fold distance. In women with small breasts, who have not had children, this distance is usually very short. If you can imagine placing an implant in this breast, the implant will ride high until this skin stretches to accomidate the new and extra thickness of the implant. After the skin stretches, the implant drops into place giving the more natural look that most women want.
As you can see in this picture, the nipple to fold distance in the first photo is essentially non-existant, in the after photo, 3 months later, the implant has settled, the skin has stretched, giving a nice result. Again, 3 months later!!
The stretch marks in this photo would indicate to me that a tummy tuck would be a better choice for her...why? Her skin will have less of a chance of contracting after the fat is removed because of the poor starting skin quality. It will be more likely than not that her skin will not contract. This does not rule out liposuction for her but she must understand that, in clothes, she will look better and more sculpted, but in a swimming suit, the skin will still look bad and possibly more saggy. If her skin were smooth, she would be a much better candidate.
Gynecomastia during adolescence is made of fatty tissue with a bud of breast tissue under the nipple. By the early 20's it should be gone, if not, it may become a real problem. The problems it causes are not generally physical but psychological. Wearing normal clothing becomes an uncomfortable situation for a guy that has breast tissue and makes one very self conscious. Working out to develop pectoral muscles can often times only make things worse...so what's a guy to do??
First of all, be patient. It is hard to do but fortunately, in a majority of cases the problem resolves after hormone changes settle down. In cases that don't resolve, we can take care of the problem. Usually, in the normal case, I will liposuction the chest and remove the "bud" of breast tissue. I do this through a small incision in the arm pit to liposuction the chest of excess fatty tissue. I then make an incision through the nipple to remove the small bud of breast tissue. We do this in the office procedure room using some IV sedation and tumescent local. It takes less than an hour and can be life changing. We have you wear a compression shirt for about 3 weeks and from that point on, normal clothes can be worn without the worry of those two little reminders poking through. The incisions heal very well and go unnoticed after a healing time of a few months.
We can lift the breast in this instance but it will not make the upper part of the chest full. Once the nipple has been repositioned into a more appropriate spot, we have all the skin left below it. This skin must be removed and the skin envelope tightened. We now have a breast that is much perkier with a nipple position that is elevated. 
As you can see, there is a great improvement in shape and nipple position. However, from this 45 degree view, the upper aspect of the breast is very sloped. Many women don't mind this and that is fine but if upper breast fullness is desired an augmentation is required with an implant. That's where the problem comes in. The second problem is this; now that we have a tighter breast skin envelope we are now going to place an implant that will stretch what we have now tightened. This can easily be done and since we have lifted the nipple we put the implant below the muscle. What this does is fill in the upper pole of the breast and helps you regain that youthful breast that was lost.
As you can see from the picture, on the lateral view and 45 degree view the upper pole is now full with good cleavage...nice result.
Although rippling can happen with silicone, it occurs less frequently. Silicone is a lower pressure implant and that is why. Because of this lower pressure, the upper pole is not quite as full as with saline and can look less like an implant.
Let's talk about eyelids for a bit. As the old Yiddish proberb says, "the eyes are the mirror of the soul"....eyes are very important. When we meet someone, where is the first place most people look??? the eyes. Therefore, if we have prematurely aging eyes, they can make us look older, more tired, and cover one of the most beautiful attributes we all have. Eyelids, though small, can change even the way we think about ourselves. We look in the mirror and even though we don't feel tired because of the "tiredness" we see in our eyes we begin to reflect it in our actions.
Youthful eyes are wide and inviting. The upper lid is full with few wrinkles and no excess skin present. The lower lids are smooth with skin color that is pink. There are no bulges, folds, or "bags" to draw our attention from the color of the iris or the pupil. We see well as there is no abstructing skin in the way. We look and feel great.
Why is this? When did it happen? How did the first picture become the second?? Well, let's get some answers. The eyelid skin is some of the thinnest skin on the body. It also moves more than the other skin and it is constantly exposed to the damaging UV rays of the sun. The other thing that happens is a loss of fatty tissue in the face. This exposes underlying connective tissue where it is tethered to bone. Lines and bulges that are normally window shaded by ample fat pads begin showing up when those fat pads diminish. Fine lines and wrinkles develope from sun damaged skin, motion, and sagging of the muscle around the eye. The process is unrelenting and over time, the sagging skin can even decrease vision.
What we see here is a large amount of extra skin on the upper lid obstructing vision and the fat pad below the eye is protruding with severe skin changes. Regardless of actual age, these changes can create the image of a very old person and the view of the eye is just a slit...not a very good view of the soul.