What nonsurgical procedures would be best as an alternative to a mommy makeover and how much improvement is achievable? (Photo)

Question

I'm 31yo, 5'2 125lbs. Have quite a bit of stretch marks which are completely pale now, but my skin is pretty lax and thin.I don't feel there's MUCH excess hanging/folding skin on my abdomen, only a small bulge just above my pelvic area.Want to remain as natural as possible.Pretty noticeable breast asymmetry, about a full cup size, which id like to correct with fat grafts from elsewhere(thighs or flanks), and to restore fullness.DO NOT want the scars from TT and breast surgeries, nor implants.

Daniel Barrett, MD · Answer

Dear MegSweets,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from a tummy tuck and probably breast lift. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Caner Kacmaz, MD · Answer

Thank you for your questions and photo. 
you are a great Candidate for your requested procedures. 
As mommy makeover operation is a combined surgery, it would be better to see your pictures to give a better consultation and quotation. We generally combine tummy tuck, liposuction and breast operations for mommy makeover but first, we need to understand your needs.

Kenneth Hughes, MD · Answer

Breast fat transfer is a great tool to balance breasts, improve symmetry, and gain up to one cup size in volume. In general, 200 cc per breast is typically the upper limit of fat injection recommended by most plastic surgeons. It is not that more cannot be injected; but on average, this has been determined to be the most that can be expected to live during one transfer. Multiple transfers would be required for additional cc's. In general, the abdomen and thighs are preferred donor sites but fat from other areas can be used. The fat must be injected through multiple planes in small amounts to the tissue through one tiny incision under each breast. About 50% of the fat obtains permanence. Thinner patients are outstanding candidates in my opinion, because the fat transferred is extremely resistant. Results are largely dependent upon the skill of the surgeon, his/her ability to remove fat without creating contour deformities, and your expectations. 
You may be able to avoid the TT, but this will depend upon your exam and the precision with which the liposuction is performed. How flat the abdomen will be will depend upon how much fat is removed from the area as well as how you heal; however, the lipo will not repair the diastasis recti.  The great thing about having lipo and TT after pregnancy is that the transformation that occurs in a couple of hours in the operating room trumps any period of time in the gym.

Gary M. Horndeski, MD · Answer

You do not need a mommy makeover. If your breasts are slightly asymmetrical then fat transfers can be performed. You will need a small amount. At size 32 or 34, each 100 cc of fat corresponds to 1 cup size change. At size 3 6 or 38, each 200 cc of fat corresponds to 1 cup size change. In terms of your abdomen, it looks very good. You may benefit from a circular umbilical revision. The scar will be continued around the umbilicus and take care of the excess skin and hooding that you have.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Robert M. Tornambe, MD · Answer

Meg
I appreciate your concerns about maintaining your natural appearance, and for that reason you should seriously consider doing nothing other than maintaining whatever diet and exercise regimen you have been following because your figure looks pretty darn good!
 It does not appear that you have enough fat to make any sort of a difference with regard to lifting or filling out your breasts, and their shape in your photos is more than reasonable. It appears that you have only modest abdominal wall laxity however muscle tone appears to be excellent, however physical examination would be needed to confirm this. You have little or no redundant skin or fat within your abdominal region. Stay away from so-called noninvasive skin tightening procedures, as they provide little positive results, and nothing works for cellulite. Save your money for now and reassess your situation after you are finished all future pregnancies. Best of luck!

Abraham Pathak, MD · Answer

From your photos you have some mild breast asymmetry and abdominal lipodystrophy, more focal to the anterior abdomen, typically definitively treated with surgery- tummy tuck with breast lift/augmentation. But based on your endorsed aversion to TT and Breast surgery scars, you still have a few options. In regards to your abdomen/flanks employing liposuction with an energy adjunct (ultrasound assisted VASER or Radiofrequency modalities such as BodyTite) to not only address the moderate adiposity but also promote skin tightening may best suit you. As for your breasts, fat grafting would be a reasonable procedure to render improved symmetry, but ultimately requires that you have enough fat harvested for transfer. I would recommend you visit a board certified plastic surgeon in your area who specializes in such procedures and can best determine your candidacy with an in-person exam. 
'This answer has been solicited without seeing this patient and cannot be held as  true medical advice, but only opinion. Seek in-person treatment/evaluation with a trained medical professional  for appropriate care.'

Camille Cash, MD · Answer

From your photos you have mild breast asymmetry.  You can consider breast transfer to help improve this as long as you have adequate fat for transfer.   BodyTite combined with Morpheus8 may be an option for skin tightening of up to 40%.  I encourage you to visit with a board certified plastic surgeon near you to discuss these procedures and determine if you are a good candidate.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Based on your photos, you are an ideal candidate for VASER Liposuction. The Gold Standard for superior liposuction results requires use of the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I perform full body liposuction cases every week. VASER liposuction has been the only modality that has consistently resulted in outstanding liposuction outcomes. VASER liposuction ensures a smooth contour regardless of degree of excess fat by virtue of being able to remove any and all remaining fat comprehensively and uniformly. If skin redundancy is observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

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