A Tummy Tuck or a Breast Augmentation First?

Question

I had a consultation already with a plastic surgeon in my area this summer. I went in for a consultation about a tummy tuck and a breast augmenatation. He was very helpful and is a great surgeon. However, I am 23 years old and have 2 boys. I plan on having no more children, but my problem is that right now, I can only afford one surgery. I really want both. My stomach is full of stretch marks from the pregnancies, and my breast have them too, as well as loss of volume. Which would be recommended to do first?

Young R. Cho, MD, PhD · Answer

The mommy makeover is a very popular procedure and is usually more cost-effective as there are overall cheaper hospital, anesthesia and surgery fees.  I would definitely choose the one that bothers you most, as there is no medical/surgical reason to prefer one over the other.  If budget is a concern, then augmentations are usually more affordable than tummy tucks.  Also consider the recovery process as the tummy tuck has a longer recovery process than the breast augmentation.

	Good luck with your decision.

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. To provide a valid medical opinion I will need to see pictures of you body from different angles. I would suggest to be treated by board certified plastic surgeon with experience in this procedure, to get the best desired results.
Respectfully,Dr. Emmanuel Mallol Cotes.-

Jed H. Horowitz, MD, FACS · Answer

The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.  #Combined operations are often performed with our #Gynecology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries included with a #MommyMakeover. If you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your physician and board-certified plastic surgeon. Also, combining these #procedures may decrease anesthetics, costs, and recovery time.In addition to a one-on-one consultations with a board certified Plastic Surgeon, patients always need to be seen by their primary care doctor prior to such procedures.  We screen every patient and their medical records for risks of blood clots (DVT) and then take appropriate measures.  MWL (massive weight loss patients of  75 lbs or more) tend to have poor skin elasticity and will frequently need additional tightening even afte 6 -12 months regardless of who or how their surgery is performed. This is simply the nature of such body tissues and the ability to heal with the lack or limited elasticity. Your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question! These procedures can be effectively and safely performed in one setting. The breasts and tummy tuck are commonly performed together, often referred to as the "mommy makeover". If you are healthy and your surgeon decides that a/he could perform the procedures in a safe time for you, these procedures certainly can be done in one stage. Staging the procedures to have them performed at various times will likely not have any cost benefit for you. When you combine procedures, there is often a discount that is provided by the surgeon for multiple procedures. Also, when having multiple procedures performed at the same time, you save on anesthesia and facility fees, which otherwise are paid for with each individual procedure. In addition, you may benefit by the single recovery time. It is your decision as to whether you have your procedures performed in one or multiple stages, but your surgeon will give his/her recommendations.  Which to do first will be your decision as to which one you'd like to have done first or which bothers you more. I would consult with a plastic surgeon well-versed in these procedures and discuss your concerns with your surgeon and see what your options are as well as have an examination.  Your safety is ultimately the most important factor and is always on the mind of your surgeon when making such decisions. Hope that this helps! Best wishes for a wonderful result!

Jerome Edelstein, MD · Answer

Both procedures can be performed at the same time, and if you have money for one, you can consider getting financing. Pay as much as you can and the rest can be financed.This would probably be more efficient as you wouldn't have to undergo two surgical experiences and the related downtime. In addition, it will probably cost less as well since you don't have to pay for some surgical costs twice (anesthesia fee, facility fee, etc.)

Larry S. Nichter, MD, MS, FACS · Answer

I would recommend that you wait until you have enough funds then do both procedures at once for a few reasons: It will be less expensive as only one anesthesia and recovery room charge, and  you only have one recovery. Your breast augmentation procedure in the right hands can be safely done through your tummy tuck incision so there are no scars on the breast - this is my favorite approach over the past 25 years when both are done at the same time.

Andrew Turk, MD, FACS · Answer

I believe in listening to the patient as to which part of the mommy makeover is most important to her. That will help determine if her breasts or tummy is most bothersome.
It is safe to perform a breast augmentation with a tummy tuck in a young healthy patient.
But since only one procedure can be done, the breast augmentation is often preferred.  It is less invasive and has a shorter recovery time. Being this may be your first cosmetic surgery, filling the volume with an implant is a surgery that takes less time to perform than a tummy tuck.

Steven M. Lynch, MD · Answer

Hi,

	  You are the typical mom that wants to do something for herself since she has done everything for her family.

	  Combination procedures are done in over 95% of my practice and this is in many thousands of cosmetic procedures.  The combination of breast surgery and body contouring is one of the most common of the combination procedures.

	  There is a significant cost savings in doing both together.  This would pertain to the surgery fees and the hospital/anes/facility fees.

	  My suggestion is to go to the plastic surgeon and get the opinions and costs of the procedures if they are done together or if they are done individually.  Then, go home and figure out what course of action you want to take.  If you decide on one only, then go after the one that bothers you the most. 

	   I personally feel that if both bother you, then wait.  Do not do one only if during the next few months you are looking at the new contours and then saying to yourself "darn, I should have done both". 

	  Get the information and think it over.  This combination certainly makes mommy's happy and so are their families.

	  Good luck with it all,

	              Steven M. Lynch, M.D.

Sugene Kim, MD, FACS · Answer

A lot of moms undergo "mommy makeover' which is a combination surgery of both tummy and breasts. Combination surgery is beneficial because it allows one recovery time and overall cheaper anesthesia and OR fees. However, if you can afford only one procedure at this time, choose the area that bothers you the most. Also, consider the recovery time in your decision making. Tummy tuck has a longer recovery time (about 2-3 weeks of pain and 6 weeks till full recovery) than breast which has about 3 weeks till the full recovery.

Tom J. Pousti, MD · Answer

This decision is and should be based on your preference. Many patients do choose to do the full mommy makeover at the same time if they are a good candidate for the surgery. However, I would advice you to choose going with which ever area bothers you most. Also, consider the recovery time you will need to heal from the surgery you choose. Either way, you will be very happy with the change and improvement.

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