38, female, 3 children, 140-145 lbs., 5’7”. What are my options - surgical and non-surgical? Mommy makeover? (Photos)

Thank you so much for sharing your story so openly, many women in your exact stage of life have very similar concerns, and the good news is that there are wonderful options to help you feel more confident again.
For your breasts, since your implants are 15 years old, an exchange is a natural next step. If you’re happy with your general size but simply want that youthful roundness back in the upper portion, a slightly larger or higher-profile implant can restore the fullness you miss. And if your skin has relaxed over time, combining the exchange with a lift can beautifully reshape and rejuvenate your breasts, giving you the perkier, elegant look you’re envisioning.
For your abdomen, you’ve already done so much by strengthening your core and improving your diastasis recti, that’s a big accomplishment. The remaining concerns of stretched skin and a softened belly button contour are incredibly common after pregnancies. Surgically, an abdominoplasty is the most effective way to smooth the skin, refine your waistline, and restore the belly button’s natural shape. This can be life-changing for many women who feel like their figure no longer matches how they feel inside.
Non-surgical tightening treatments, like radiofrequency or ultrasound-based options, can offer a subtle boost in skin quality, but they cannot match the dramatic improvement surgery provides when there is true laxity. They can, however, be lovely as a complement down the road.
You’ve done the hard part already, your family is complete, your weight is stable, and now it’s the perfect time to focus on you.

Hello, and thank you for your question about your surgical and non-surgical options and whether you need a mommy makeover. You describe yourself as a 38-year-old female weighing 140 to 145 pounds and having three children. Thank you for your history and pictures. Regarding your breasts, if you want to go with a larger breast implant, most plastic surgeons would suggest exchanging your implants for a larger implant. Most plastic surgeons don't think you will need a mastopexy or breast lift. I would suggest you continue with silicone implants as they have a lower capsular contracture rate than saline breast implants. I would also suggest you continue using the same breast implant pocket, specifically underneath the pectoralis major muscle.
Regarding your abdomen, you have excess skin and fat, mostly below the umbilicus or belly button. On profile view, you have some excess skin and fat above your belly button. You also have an umbilical hernia. If you only do abdominal liposuction, you will have loose hanging abdominal skin. This is due to your age, stretch marks, and history of having children. Therefore, I would suggest an abdominoplasty or tummy tuck. There were two types of tummy tucks you could undergo.
There is the low transverse abdominoplasty, where the incision is made low on the abdominal wall and primarily in a horizontal position. With this incision line, the tummy tuck scar is fairly well hidden when you wear reasonable, even low hip-hugger type jeans. Another alternative would be a high lateral tension abdominoplasty. In a high lateral tension abdominoplasty, the incision is placed low over the mons or pubic region. As the incision extends laterally, the incision towards the hips changes course by approximately 45° up towards your hips. This leads to a more hourglass shape. The downside of the high lateral tension abdominoplasty is that the scar is more visible, especially when wearing lower pants or jeans. When you undergo the abdominoplasty, it is important to have your hernia repaired. Most plastic surgeons can repair hernias at the same time. You could undergo your abdominoplasty and breast implant removal and replacement surgery at the same time. Procedure length varies, but an abdominoplasty procedure should take approximately three hours. Your implant exchange should take two to three hours. These procedures should be performed under general anesthesia with an anesthesiologist. These procedures are outpatient. Plan on a two-week recovery. Returning to physical exercise at about four to six weeks. Good luck. I hope I answered your question about your surgical and non-surgical options and whether you need a mommy makeover.
Sincerely, Dr. Katzen, MD, MBA. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

A tummy tuck would tighten the loose skin and remove excess fat in your mid-section, as well as repair abdominal muscle separation if necessary. At the same time, your belly button can be modified to achieve your desired appearance. Nonsurgical options would not achieve as predictable or dramatic results as surgery.

Based on what you’ve described, you could be an excellent candidate for a breast implant exchange to restore upper pole fullness, possibly combined with body contouring procedures to address the stretched skin and abdominal changes. Since your current implants were placed 15 years ago and you’ve experienced volume loss and skin laxity, a breast implant exchange with a slightly larger size could help restore fullness especially in the upper pole. Depending on your current breast position, your surgeon may also recommend a breast lift (mastopexy) during the same procedure to tighten and reposition the breast tissue for a more youthful shape.
After multiple pregnancies and breastfeeding, it’s common to experience loose abdominal skin, even with good postpartum recovery and pelvic floor therapy. The appearance of a stretched-out belly button and residual skin laxity could be addressed with:
Mini tummy tuck (if only lower abdomen is affected), Full tummy tuck (abdominoplasty), especially if there's still mild diastasis recti or excess skin above and below the navel
In some cases, liposuction or skin-tightening technologies like Renuvion or BodyTite can be used for more moderate laxity without large incisions
Non-Surgical Options (for mild cases): EmSculpt or Morpheus8 Body for toning and mild tighteningUltrasound or radiofrequency-based skin tightening However, these treatments may offer limited results when skin laxity is moderate to severe.

Your breast photographs are limited but you may benefit from explantation with lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. This will also pull up the upper abdominal skin. At the same time, a tummy tuck can be done. This will cut out the extra skin, fat and tighten the abdominal wall. If you have an umbilical hernia then this will be corrected as well.

Best Wishes,

Gary Horndeski, M.D.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello dear. Given your medical history—three births, breastfeeding, corrected diastasis, loose skin, and loss of fullness in the upper breast—the best recommendation would be liposuction to define your body contour and implant replacement with slightly larger ones, which will allow you to regain the upper projection and fullness you desire.

You are at an excellent stage for these procedures, as you have completed your pregnancy and are maintaining a stable weight.

You can contact us at 829-554-6062 to receive a personalized quote and schedule your evaluation. It will be a pleasure to help you achieve the results you are looking for!

You appear to be a good candidate for a Mommy Makeover. A standard tummy tuck with liposuction for contouring will remove excess fat and skin as well as correct abdominal wall laxity. You can have an implant exchange done at the same time to give you more of the look you are wanting. I've included a video I hope you find helpful.

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery in Frisco, TX:
Thank you for sharing your story and photos — they provide important insight into your goals and anatomy.
A mommy makeover is a wonderful way to restore and enhance your body after pregnancy, and it sounds like you’re a great candidate for a customized combination approach based on your needs.
For the breasts:
Since you already have silicone implants, but are looking for more upper pole fullness, there are a few options: • Implant exchange for a higher-profile implant or larger size can improve projection and fullness in the upper breast • Fat grafting can also be added to selectively enhance the upper pole and achieve a more natural, soft contour. • Depending on skin and implant position, a revision with a lift (mastopexy) may be recommended for optimal shape and symmetry; this with the same size implant or even a smaller will likely restore upper pole fullness.
For the abdomen:
Your photos show signs of diastasis recti (abdominal muscle separation) and skin laxity, which are very common after pregnancy. Combined with an umbilical hernia, this would be best treated with a: • Full tummy tuck (abdominoplasty) to tighten the abdominal muscles, remove excess skin, and reposition the belly button for a natural look. • Hernia repair, which can often be done at the same time — either by your plastic surgeon or in collaboration with a general surgeon, depending on the severity.
This comprehensive approach not only improves the aesthetics of your abdomen but can also restore core strength and comfort.
At Lone Star Plastic Surgery, I tailor every mommy makeover to the individual — combining breast and body procedures in a safe, coordinated way to restore confidence and contour.
As always, be sure to choose a board-certified plastic surgeon who regularly performs combination procedures like yours and is experienced in both primary and revision breast surgery.
Warmly,Dr. Sean HillBoard-Certified Plastic SurgeonLone Star Plastic Surgery – Frisco, TX

Based on your post photos, the recommendation would be implant exchange to a larger size high profile implant with possible upper pole fat transfer under ultrasound. Full tummy tuck with muscle repair and unliable repair. Liposuction waste. Fee range $12,000-$25,000. Best of virtual consult with.