I recently had a consulation with a plastic surgeon. He recommend three different surgeries. One would be the tummy tuck, another breast lift and last breast augmentation. I understand the longer the procedure the greater the risk. But is this a routine thing? He suggested to wait 3 months between the breast procedures. He said the breast would have time to relax and have less likely to have double lumps (one being natural breast tissue the other the implant) Would this give best results?
Is It Recommended to Have a Mommy Makeover in 3 Separate Surgeries?
Doctor Answers (34)
Mommy Makeover in 3 Surgeries?
Assuming you are in good health and there are no extenuating circumstances, it is "possible" and many times desirable to perform these surgeries in one setting. I frequently and safely perform "mommy makeovers" in an outpatient setting using one anesthetic. This allows mom to undergo one time off of work/child care, one anesthetic and certainly less costs. However, not all patients fit this description and not all surgeons are comfortable with this approach. Ask your surgeon for patients that you may contact to discuss their experience.
One Step Mommy Makeover
In my own practice, we routinely perform mommy makeovers on a single day. Unless there is something unusual about your medical history or you have an extreme of body weight this should not be a problem.
There are occasions where I prefer not to perform a breast lift on the same day as an implant, because I believe the healing will be superior and that the final result will be improved. We routinely do breast lifts in our office surgical suite with light oral sedation and a local anesthetic.
Mommy Makeover in 3 Stages: Get second opinion because this is NOT a Mommy Makeover.
The entire premise of a mommy makeover is that is corrects the effects of child bearing with one operation so that down time is limited and you can return to your family. A 3 stage procedure is not a mommy makeover at all! The procedures you describe can be dome in one stage by an experienced mommy makeover surgeon. Let me know if you have questions.
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Mommy makeover- staging procedures vs one single procedure
If the patient is healthy, these procedures are usually performed at one setting. The risk is quite low in published studies, and there is only one recovery time instead of three.
With all combined procedures, there is a theoretical risk that exceeds the risk for the procedures performed individually, at least that is what we typically tell patients.
However with experienced surgeons performing the procedures expediently in accredited surgical centers, I believe this risk is very low.
For that reason, we would perform typical mommy makeovers at one surgical setting.
3 separate surgeries for mommy makeover is ridiculous!
Not only will this result in three operations, three times the (minimal) risks, and three time the recovery, it will cost you LOTS more. I hope that greed is not the motivation of your surgeon, but let's assume it's not. Why would a surgeon with proper training, board-certification (American Board of Plastic Surgery), experience, and skill recommend three separate operations when one can be safely performed with one set of risks and one time off work for recovery?
Depending on your size, a tummy tuck should take no more than 3 hours, perhaps less. This includes umbilical transposition, entire breast bone to pubic bone muscle plication, and layered closure with dissolving sutures beneath the skin (no staples or external sutures to leave marks). A full Wise pattern breast lift with similar closure technique should take no more than 3 hours, and implant placement adds another 45 minutes. With proper OR table padding, urinary catheter (removed before you wake up in the recovery room), Bair Hugger warming in the OR, and pneumatic boots to keep the blood moving in your legs (decreases the risk of blood clots), you are at extremely low risk for any operative-time-related complications. Three operations simply triples these same risks! I routinely do 6,7, and occasionally up to 8 hour-long operations as OUTPATIENT procedures, but this requires expert anesthesia and use of IV general anesthesia rather than inhalation gas anesthesia. It also requires enough surgical skill, experience, and celerity (speed) to do all of these operations expertly with minimal blood loss
Some plastic surgeons are uncomfortable doing full breast lifts AND implant augmentation at the same time. If his justification for doing the breast surgery in two operations is to decrease the risk of double bubble formation, perhaps this betrays a history of bad outcomes that stimulate this way of thinking. I accept nothing less than the best outcomes possible, and I must say that MOST plastic surgeons are not only capable, but prefer doing both parts of breast lift plus augmentation surgery at the SAME operation. (There IS a way to minimize double bubble formation, but this technique is not the way most of us were trained to do this (lift + implants) operation). I would be happy to discuss this technique with anyone interested--it's not magic, just good planning and technique.
In short, I sense extreme conservatism in your doctor, perhaps because of speed (slowness) of operating, lack of experience with one or more of these procedures, difficulty with anesthesia management for longer operations (sometimes out of the surgeon's control unless he/she own their own surgical facility as I do), or perhaps restrictions of the operating facility (some outpatient surgicenters require shorter procedures, or restrict the surgeon to specific "block times"). If your surgeon operates out of a hospital, perhaps he's trying to reduce the possibility of overnight admission, which increases the costs substantially (and makes the patient angry at the surgeon). Perhaps it's simply greed (the charges for three separate operations are invariably MORE than one combined operation). Perhaps it's truly a fear for your safety if there are complicating health issues, such as Factor V Leiden, diabetes, or cardiac issues.
My best advice: get at least one more opinion (two is better yet) from well-trained, experienced, board-certified (American Board of Plastic Surgery) plastic surgeons, and ask them about multiple procedures at the same time. Virtually all of us do things that way because it is safe, effective, and best for the patient overall.
Mommy Makeover is Meant To Be Accomplished in One Surgery
The mommy makeover is one of the most popular operations performed by plastic surgeons. The procedure is a combination of cosmetic breast surgery, liposuction and abdominoplasty. It has been designed to correct changes that occur normally with pregnancy.
There are multiple advantages in performing these procedures in combination. These include an improved overall result, lowered cost and a single recovery. Patients typically report increased self-esteem, self image and an overall improvement in the quality of their lives. For these reasons, the mommy makeover is one of the most popular operations that is currently performed in plastic surgery.
If you are in good health otherwise, there is no reason to stage the procedures. This will ultimately result in more expense and more downtime. Safety should be everyones priority. If the procedure is done in an accredited facility, with a board certified anesthesiologist and plastic surgeon the risk should be low.
Every patient is unique and there may be other factors that have impacted the decision to stage your procedure. If you have questions, don’t be afraid to get a second opinion.
How Many Procedures In A Mommy Makeover
As much as possible and within the bounds of safety it is preferable to complete the mommy makeover at one time so the mommy can get back to taking care of her job and family. But safety is the key issue. Some surgeons work more quickly than others and time under anesthesia is of some concern. Another issue is breast implants at the same time as a lift. My personal preference if we are doing a major anchor style lift is to do the implants 3 months later for reasons of circulatory problems in the breast and also not all patients will want implants after they see how good the lift looks. When we separate the procedures we make sure it is at the same cost as it would have been if they were all done at once to avoid the impression we are upselling.
Mommy Makeover in Stages
Thank you for your question.
Different surgeon's have different preferences. Personally, I think 3 operations are not necessary. In my practice, I would generally suggest a single or 2 stage approach depending on the patient's specific situation. It never hurts to get additional information / opinions.
Please make sure you are working with a well experienced, board certified plastic surgeon.
Mommy makeover is best done in one stage.
If you haven't already had your surgery, go elsewhere. This is not sophisticated.
1) It is much better for the result to do the breast lift and the breast augmentation together.
2) If you are healthy, there is no reason why the breast surgery (both) and the tummy tuck should not be done together.
Safe method for Mommy Makeover
I whole heartily agree with you surgeon. He is being conservative and cares for you safety. To perform three big operations under one sitting increases the risk of anesthesia and surgery related complications, such as:
- pulmonary complications,
- blood clots.
Blood clots are the most dread of all complications, by forming in your legs or pelvis they can travel to your lungs and be life threatening. This is especially true if you are a larger size person in which case each surgery will take longer to complete.
As far as breast augmentation is concerned, I personally wait 6 months after a lift operation.
At 3 months the lift wound are not healed completely and an added weight of the implants may cause large and unsightly scars or even deformity.