Steven H. Warnock, MD

A Mommy Makeover can vary from patient to patient and include different procedures.  The Mommy Makeover addresses both breasts and abdomen after childbirth, however not every patient needs the same exact thing.  Some women require a breast lift while others may only need a breast augmentation and then there are those that need both.  The same thing can be true with a tummy tuck where some women may need a full versus a mini and occasionally some liposuction of the flanks or hips to help the waist contour.I offer special pricing for the Mommy Makeover as I am sure other surgeons do as well.  I think it is always best to consult with a board certified plastic surgeon to find out exactly what procedures are needed in your specific case.  Pricing will vary by regions, just be sure and ask questions and make sure that there are no hidden fees associated with the surgery that you will be responsible for.

Pregnancy can definitely take it's toll on your body.  The same things happen with or without implants.  If your breasts increase in size with pregnancy and/or you breast feed then it is very possible that you can have sagging after.  However, although not the best scenario there are ways to fix this after pregnancy.  A breast lift could be done to help tighten the breast tissue and reduce the sagging.  The procedure can be done without affecting the implants.  You do not even have to remove or replace the implants at the same time.  If you are unhappy with the way they look after I would suggest seeing your plastic surgeon for possible options.

Recovery is a very important thing.  After undergoing surgery, especially cosmetic, you need to make sure you follow instructions to give you the best possible end result.  That being said, breast implants are a pretty easy recovery.  Usually the first 3 days are the worst because of swelling.  By day 5 I find that most of my patients are back to normal daily activities.   To answer your specific question, I think that 1 week off work is generally good.  However, there are lifting and exercise restrictions that you would still need to abide by.  I suggest no cardiovascular activity for 3 weeks after surgery and no lifting over 25 lbs for 6 weeks.  It is always best to make sure you follow your surgeons advise.

I find that this question is probably the most common one among women.  Most people want to have a more natural look and not have implants that are too noticably "fake".  Choosing a size can be a hard thing for a lot of women and most over think the volume or ccs.  For example, a 400 cc implant will look totally different on you versus your friend.  Each body is so different. I typically suggest a range of sizes for my patients based on their breast diameter.  You don't want one that is too narrow or too wide for your chest.  I then allow them to spend some time trying on sizes to get a feel for what they will look like once surgery is complete.  I find that once the patient focuses more on the look than the size or cc it makes them feel more comfortable about their choice.

It is not uncommon when doing a tummy tuck for me to find a small hernia that the patient does not even realize they had.  These are easily repaired during an abdominoplasty procedure.  It does not add increased risk or recovery after surgery.  I would definitely have the conversation with your surgeon.

It is possible with your saline implants to have your surgeon rupture the implants a few weeks before surgery to get an idea of how much breast tissue you currently have and whether a lift would be needed.  However, if you currently have 700cc implants you most likely will lose 2 cup sizes and will feel deflated without a lift. If you are not able to deflate your implants before surgery, you can always just have them removed and do a lift at a later date.  There are benefits of doing these procedures separately and letting the breast heal for 3-6 months before doing the lift.  I definitely would have another conversation with your surgeon about the pros and cons.

Unfortunately, it is fairly common to get sick after a surgical procedure.  When your body is trying to heal it can lower your immune system, therefore making you susceptible to pick up the flu or common cold. It may slow down your healing time, but should not affect your final results.  Of course, you should continue to follow post op instructions from your surgeon.  If you are not feeling better soon, it would be a good idea to see your primary care physician.

That is a very good question.  Swelling can cause numbness in the area.  It can take up to 6 months for all the swelling to subside from a major surgery such as a tummy tuck.  I am assuming perhaps you are in a compression girdle or binder.  Wherever there is no compression the swelling will travel.  I suggest that my patients wear some spanx or tight underwear to give the mons area some compression also.  It is hard to be patient, but give it some more time.  I would also discuss this with your surgeon and follow up with any concerns.

I do not believe that there is one right answer to your question and many options out there.  However, I find it better to be on the safe side.  If you have an open wound then there is always the possibility of infection if you are in dirty water (i.e., pool, Jacuzzi, lake, etc.)  Showering and letting clean water run over the area should cause no problems.  You definitely should follow up with your surgeon regularly for wound check to make sure things are healing properly.

Those are some very good questions.  I approach and remove breast implants the same whether they are above or below the muscle.  Depending on how old the implant is the integrity of the shell may be more compromised and could possibly rupture, however the possibility of this happening is not very likely.  A small incision can be created because the skin and tissue will stretch out enough to allow for the removal of the implant.  There are different grades of capsular contracture.  Depending on how severe the contracture is can determine whether the implant and capsule will be removed as one (such as an en bloc procedure) or separately.  The risk of bleeding would be the same whether they are above or below the muscle.  I would suggest a consultation with a Board Certified Plastic Surgeon to discuss the best plan for your specific case.