This story has been medically reviewed for accuracy by Brea, CA board-certified plastic surgeon Dr. Frederic H. Corbin on October 27, 2020.
Multitasking is a way of life for modern moms, especially in the COVID-19 era—just ask any Zooming-while-nursing-and-French-braiding ninja you know. So when the moment comes for a little surgical me time—a shot at reclaiming our pre-baby bodies—we’re usually looking to knock out several meaningful tweaks in one fell swoop. Plastic surgeons refer to this carefully choreographed, all-at-once overhaul of the female body as a mommy makeover.
How they manage to say it with a straight face, we’ll never know, but the term is an apt catchall for any combination of surgical procedures performed to restore a woman’s anatomy following pregnancy, childbirth, and nursing—forces that cause our tissues to stretch, scar, and sag. The most popular mommy makeover blueprint involves breast surgery (an augmentation, lift, or reduction), a tummy tuck, and liposuction—but moms will occasionally tack on other fixes too, like fat transfer to the breasts or butt (aka a BBL).
Googling any of these operations will yield crash courses galore, we’ve found, but they rarely delve into the practicalities surrounding the experience—all the nitty-gritty stuff women need to know before committing to surgery and taking themselves out of commission for a time.
When board-certified plastic surgeon Dr. Mary Gingrass meets with prospective mommy makeover patients at her Nashville clinic, “the conversation, more often than not, goes to the downtime and what kind of backup they’ll need to ensure their family is taken care of,” she says. Common concerns vary with a mom’s stage of life, she adds, since some choose to delay surgery until their kids are older while others aim to do it right after weaning their last child.
Wanting to tackle more than anesthesia and incisions, we asked plastic surgeons to address the real-life issues—from the pragmatic to the personal—on the minds of women mulling a mommy makeover. Doctors often have different takes on even standard subjects, it’s worth noting, so let their words be a general guide but always follow your surgeon’s unique-to-you instructions.
How long before a mommy makeover do I need to stop nursing?
Whether you’re having a breast augmentation with implants, a breast lift (with or without implants), or a breast reduction as part of your mommy makeover, plastic surgeons will typically ask that you stop breastfeeding three to six months prior to the operation, to allow milk to thoroughly dry up and “breast tissues to retract to their new baseline,” says Dr. Umbareen Mahmood, a board-certified plastic surgeon in New York City.
Doctors are especially strict about this rule when placing implants. On the heels of nursing, “the milk ducts are enlarged and there can be some bacteria lining those ducts—these are subclinical bacteria that we can’t see,” explains Dr. Gingrass. And bacteria in the company of breast implants raises the risk of complications, like capsular contracture. “If we’re just doing a reduction or a lift, timing is a little less critical, because we’re not worried about potentially seeding an implant,” she adds. Your surgeon may feel differently, however, and will likely share their specific timeline during consultation.
Can a tummy tuck incision be made over a C-section scar?
That’s a reasonable assumption, since the average C-section scar is about one-third the length of a tummy tuck incision, which spans from hip-to-hip in order to allow for maximum skin removal. The thing is, while “most C-section scars are pretty darn good, more often than not, they’re a little higher than you want,” notes Dr. Gingrass. So rather than repurposing and extending that onetime baby portal, surgeons will “usually go below it and eliminate it completely, aiming to keep the tummy tuck scar as low as we can without getting too close to the labial crease,” says Dr. Emily Kirby, a board-certified plastic surgeon in Fort Worth, Texas. This way, your old scar gets cut away and discarded along with your excess skin.
Can a tummy tuck help with #momproblems like lower back pain?
Indeed it can, because the operation typically corrects the abdominal muscle separation (or rectus diastasis) that occurs with pregnancy. “When the rectus abdominis muscles can’t stretch anymore, they widen and split—that nearly universally happens with almost every pregnancy—and they’re never quite the same again,” Dr. Kirby explains. The front of the core is left weak and the back winds up overcompensating.
During a tummy tuck, when surgeons realign those abdominal muscles and suture them together corset-style, strength and stability return to the abdomen and pelvic region. “The balance of the trunk feels more harmonious, and a lot of people notice their backs hurt less,” adds Dr. Gingrass.
A 2018 study investigating the phenomenon showed a major improvement in not only back pain but also urinary incontinence (which women commonly experience after giving birth) at six weeks and six months following abdominoplasty with muscle repair in 214 patients.
According to Dr. Mahmood, researchers have several theories to explain the improvement in continence: For starters, a tummy tuck removes excess weight from the front of the abdomen, relieving pressure on the pelvis. It also strengthens the abdominal wall, resulting in better bladder emptying. (“Incontinence is often due to not being able to completely empty the bladder,” she notes.) And finally, repairing the rectus muscles “tightens and elevates the fascia, which is a continuous sheet that connects to the urogenital tissue, and therefore helps lengthen the urethra and improve continence,” Dr. Mahmood explains.
Related: 3 Women Get Real About Their Mommy Makeover Experience
What should I tell my kids about my mommy makeover surgery?
Plastic surgeons routinely field this question from moms pondering plastic surgery. “Sometimes women express that they feel kind of guilty—like, ‘Should I really be doing this while I have kids at home?’” Dr. Gingrass tells us. “They have concerns about sending the wrong message,” especially to teenagers, who are navigating the complexities of body image. While all the doctors we interviewed advocate honesty, they say moms tend to feel most comfortable focusing on the restorative or reconstructive nature of the mommy makeover.
Dr. Gingrass suggests patients use language like, “After having babies, I had significant changes in my body, so we’re just tweaking it to get it back to what it was before babies.” Along the same lines, adds Dr. Kirby, “they might explain what happens to the tummy after pregnancy—how stretched out the skin gets—or focus on back-pain issues and say, ‘This surgery will pull my muscles together, to help me get stronger.’”
What recovery supplies should I buy in advance of a mommy makeover?
“I always tell people to invest in a whole bunch of pillows,” says Dr. Kirby—“it is all about the pillows after surgery.” She has patients build a “pillow throne” on their bed by stacking pillows behind their back, under their knees, and beneath their arms, to keep them comfortable during waking hours and prevent them from rolling over during the night.
“Patients often ask if they should purchase a recliner or a walker for use immediately after a tummy tuck,” notes Dr. Mahmood, “but I truly believe it’s best to keep things simple.” She too is a fan of using pillows to support the body in a “beach chair position.” As for things like walkers and canes? They can often hinder recovery, she notes.
In the spirit of simplicity, moms are reportedly grateful for two-piece PJs with tops that button down the front and a pair of cozy slippers to shuffle around in after surgery. Some doctors also recommend having a silicone scar cream on hand, to start using two to three weeks post-op.
How long before I can get back to work?
This depends somewhat on your precise medley of procedures, but since a tummy tuck is central to most mommy makeovers, it’s safe to assume the recovery won’t be a picnic.
“Trying to accurately predict downtime is one of the hardest parts of my job,” Dr. Gingrass says—particularly when it comes to the tummy tuck. “It has about the widest bell-shaped curve of any procedure, as far as recovery goes—people have a lot of different pain experiences.” It’s the muscle repair, not the skin excision, that makes the early post-op period so punishing.
Any accompanying breast surgery “just pales in comparison,” she adds. “With a breast augmentation or even a lift, honestly, it’s a long weekend. You’re sore, but you can function in most jobs unless you do manual labor.” But once you tack on a tummy tuck, “you’ll want to budget for two weeks off.”
Dr. Kirby pushes her mommy makeover patients to be completely selfish for those two weeks: “Don’t count on being responsible for any other human being on the planet—no social activities, no work events, no commitments of any kind.” During the pandemic, she notes, a lot of women assume they’ll be able to do their jobs from home while recovering. But Dr. Kirby finds these patients often wind up having a longer recovery because when working, even remotely, “they’re not focusing on themselves and what they’re supposed to be doing.”
Which is what, exactly? Surgeons want you up and moving on day one, to prevent blood clots from forming. “I encourage all patients to walk immediately and try to resume daily activities, except for vigorous physical activity or heavy lifting,” says Dr. Mahmood. You’ll be walking hunched over at first, due to the tension on your incision line, but your posture should improve within two weeks. “Patients will certainly be sore, they may have drains, and they’ll be wearing a postsurgical compression garment—but by showering 24 hours after surgery and walking around, they’ll have a quicker overall recovery,” she adds.
If you don’t have a partner, friend, or extended-family members who can care for the kids and house while you’re off duty, plan on hiring help for at least the first week, says Dr. Anthony Youn, a board-certified plastic surgeon in Detroit. And take care of as much as possible before surgery, suggests Dr. Kirby—get the house deep-cleaned; bring the dog to the groomer; arrange sitters and carpools for the kids; and relocate snacks and essentials to waist level, for easy access.
What kinds of drugs will I be on after my mommy makeover?
In an effort to help combat the opioid epidemic, surgeons have largely moved away from narcotic-focused pain-management protocols. “Working with my anesthesia team, we give various medications before and during surgery so that after surgery, the need for narcotics is as low as possible,” explains Dr. Kirby. Surgeons will often administer an ultrasound-guided TAP block during the abdominoplasty and some sort of regional anesthesia during breast surgery. Anti-inflammatories, muscle relaxants, and nerve pills are then prescribed, to keep post-op pain at bay. “On top of that, if [patients] still need the narcotic, they can take it, but those who do are usually on it for only a day or two,” she adds.
For how long will I need to wear compression garments?
Some surgeons say four weeks; others, six. But all insist that “as much as people don’t like the garments at first, they’re begging to keep wearing them by the end,” Dr. Kirby says. They find comfort in the supportive snugness and appreciate how the body shapers make their clothing fit. When they eventually peel them off, she says, “they tend to feel full and flabby and bloated—like they’re taking a step back—because the swelling is not gone by that point.”
Dr. Gingrass says that after four weeks, her patients are usually relieved to shed the garments at night, but many continue to lean on them while they’re ramping up their exercise routine.
What foods should I eat post-op, to help speed healing?
While bland foods, like crackers, bananas, and rice, may be your go-tos at first, once the anesthesia is out of your system and your appetite returns, you’ll want to prioritize protein and fiber. “High-protein foods can counteract the skeletal muscle breakdown that can occur after surgery,” says Dr. Youn. While “fiber and water are important, since constipation is common in the days following,” he also has patients stock up on lean meats, beans, pasteurized eggs, and colorful fruits and veggies. Pineapple is a favorite because it packs fiber, bruise-reducing bromelain, and healing vitamin C. Probiotic-rich fermented foods—yogurt, kefir, kombucha—and gut-friendly bone broth “can also be good when you’re on antibiotics,” Dr. Youn adds. Ask your doctor about introducing a multivitamin with iron too, if you’re not taking one already.
How many follow-ups will I need after mommy makeover surgery—and can I drive myself to these appointments?
The precise spacing of post-op visits varies from surgeon to surgeon, but generally speaking, you can plan on seeing your doc the day after surgery and then again around one week, two weeks, four to six weeks, six months, and one year (if you’re willing). On day one, “patients usually have tons of questions, because there’s so much about the garments and drains—it’s all so foreign,” says Dr. Kirby. More important, she adds, your surgeon will want to see that you’re able to walk into the appointment on your own and hear that you’re eating, drinking, and using the bathroom without issue. While you certainly won’t be driving the day after surgery, Dr. Kirby finds that most women are back behind the wheel by the end of week one—or as soon as “they feel like they can move quickly if they need to.”
Related: 10 Doctors Give Their Best Mommy Makeover Advice, in 10 Words or Less
How long before I can pick my kids up?
After having a tummy tuck, says Dr. Gingrass, “you’re not gonna whip a kid up and put him on your hip—it’s not going to be comfortable.” Still, few moms are able to resist holding their babies for weeks on end. “When I had my breast augmentation, I had a 3-year-old at home—and [based on that experience], I completely changed my post-op instructions,” she adds. “Now I tell patients, ‘Listen, I’m going to instruct you not to pick your kid up, and you’re going to pick him up anyway.’” So rather than setting firm timelines, she’ll show patients how to use their arms, shoulders, and legs—not their abs and back—when lifting little ones. Still, she says, “you want to be careful and keep it to a minimum.”
Dr. Mahmood advises patients to pull their kids into their laps while sitting (but urges them to wait three to four weeks before fully hoisting them up while standing). And Dr. Kirby will often encourage moms to transition their (age-appropriate) kids from cribs to toddler beds before having surgery, explaining that “one of the most physically taxing things you can do is reach into a crib and lift a child up and over.”
How long should I wait before having sex?
Three to four weeks is commonly quoted—six, if the makeover involved a labiaplasty. That said, the surgeons we spoke to weren’t exactly sticklers about this. While you don’t want to be bending and twisting your newly contoured torso or having anyone manhandle your freshly placed implants, the act of sex itself isn’t going to hurt you or compromise your results. In other words, says Dr. Gingrass: “Having an orgasm isn’t going to blow your stitches apart, but don’t just get lost in the throes of passion—you and your partner should exercise good judgement.”
What if—oops!—I get pregnant after my mommy makeover?
You wouldn’t be the first. While ideally, you’d have this surgery only once you’re done with babies and back to a stable weight that you can easily maintain, all the surgeons we spoke to have had patients unexpectedly get pregnant after investing in a mommy makeover. “Medically, you’ll be fine,” assures Dr. Kirby—your reconstructed abs can absolutely adapt to handle the physical changes. If you’re hoping to breastfeed, realize that “there’s always a risk of reduced ability after a lift or reduction,” says Dr. Mahmood. Still, Dr. Gingrass tells us that the “vast majority” of women who breastfed successfully before surgery are able to do so after.
Your skin and muscles will stretch again, of course. And some women do find themselves back at square one, looking utterly uncontoured. Others fare better, particularly if “they don’t gain any more weight than their OB-GYN tells them to,” notes Dr. Gingrass. Both she and Dr. Youn say they’ve had a handful of patients rebound beautifully after their surprise pregnancies. It’s not uncommon though for women to opt for an eventual touch-up, like an abdominal skin excision or a secondary lift, says Dr. Mahmood, to recoup their losses.
