What Order Are the Procedures Performed in Operating Room for Mommy Makeover?

I am going in for a Mommy Makeover which involves full tummy tuck, trunk lipo (doc said that meant low back love handles), re-do on old BA from '95 (clean out some scar tissue & exchange saline implants for gel implants via aerola-old scar there, too), hernia repair most likely with muscle repair...what procedure does the doc start with and where from there? Thank you. I just will feel a bit better sort of knowing the flow of things to come.

Doctor Answers 17

Mommy makeover

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I usually perfrom the breast procedure first and apply sterile occlusive dressings if there are implants before proceeding to the body.  The two reasons I do it this way is to reduce implant infection by contamination from the groin and pubic region and I have to sit the patient up for the tummy tuck and part of the breast procedure is done easiest with the patient lying flat.

Breast First then Abdomen for Mommy Makeover

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Many considerations go into the decision concerning what order to do the procedures. Abdominoplasty results in the patient being in a somewhat flexed position, so if I have liposuction to do on the back, I will do that 1st before abdominoplasty. I like to do the breast augmentation surgery before doing the abdominoplasty since it decreases the risk of contamination and possible infection of the implants. I also like to place the implants before doing the breast lift to avoid contamination from the normal bacteria in the milk ducts. If I have a patient who is having liposuction of the back, breast augmentation, breast lift and abdominoplasty, my sequence would be to do the liposuction of the back in the facedown position, then do the breast augmentation, then the breast lift and finally the abdominoplasty.

John Squires, MD
Denver Plastic Surgeon
4.9 out of 5 stars 82 reviews

The order of operations in mommy makeover.

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Thank you for your question. 

The order of the surgeries that are performed in mommy makeover is mainly affected by the tummy tuck. When the tummy tuck is completed patients are usually sitting almost upright and kept in a bent position to take tension off the lower abdominal scar. Because of this final awkward position it is usually best to do do the other surgeries first.

For example: if I'm going to do a breast surgery with tummy tuck and posterior flank or other sites of liposuction, I usually do the liposuction first because it may involve turning the patient from side to side or flipping the patient over.

I usually performed the breast surgery next (unless we're placing breast implants through a tummy tuck) because of this point the patient can then be lying flat.

Usually the last step is the tummy tuck.

Each surgeon may have his or her own variation and the order is usual determined by how we best position our patients while they're asleep.

I hope that this answers your question.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 115 reviews

Sequencing for Mommy Makeover

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For significant liposuction of the flanks, I start with the patient prone and do the lower back/flank liposuction first. Next, you can be turned into the supine position and the rest of the procedures, redo breast augmentation and tummy tuck with hernia repair can be done.  Either order is fine for the procedures on the front; however, I like to start with the tummy tuck and do the breast procedures second.  I have done it both ways with equally good results. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Mommy Makeover

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Every surgeon has his preferences and they vary from one to the other. Ask your surgeon and he will be glad to go over that with you. It's important that you enter the procedure with confidence and if that knowledge helps, then by all means find out.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Dear Mountainmomma,

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yes, you will undergo a full mommy make over.

I think you will find most Board Certified Plastic Surgeons will give you a similar answer: I would start with the breast surgery, then progress with the liposuction and tummy tuck, including the hernia repair at the same time of course.

In my book, this is still a fair amount of surgery all at once, and you may consider staying overnight for pain management and monitoring in the Hospital if you have this option.

Your surgery should be performed by a Board Certified Plastic Surgeon, and you should feel all your questions and concerns were answered prior to the procedures.

Good luck,


Florence Mussat, MD

Florence Mussat, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 44 reviews

Steps to a Mommy Makeover

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Usually when I perform a mommy makeover I start with the Breast Augmentation or Breast Lift in your case implant exchange. The hernia and Tummy tuck with muscle repair are usually done at the same time. Lastly I would liposuction to abdomen and flanks.

Michael A. Fiorillo, MD
New York Plastic Surgeon
4.9 out of 5 stars 107 reviews

A mommy makeover is a breast augmentation/lift with a tummy tuck

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In my experience, I perform the breast augmentation and/or lift first followed by the tummy tuck portion of the case for a complete Mommy Makeover!

Surgeon's Preference for Procedure Order

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It really the surgeon's preference as to which procedure to perform first, but I can tell you what makes most sense for me.  If we are doing flank liposuction, I start with that first, as it is done in the prone (face down) position.  We then flip back to the supine (face up) position and re-prep / drape everything.  I next proceed with any breast surgery (augmentation, lift, reduction) before completing with the tummy tuck.


What Surgery Comes First In A Mommy Makeover?

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Basically, you are having hip liposuction, tummy tuck, and a breast augmentation.  Each surgeon has his or her own technique.  That being said, at the Mommy Makeover Institute of Hawaii, we do the liposuction of the hips first since you are lying prone on the table for this procedure.  We suture up all liposuction incisions, turn you over, and then do the breast surgery.  The breast surgery is done second because in a well done abdominoplasty, the patient is sat up at least at 30 degrees if not more, and this makes it very difficult to position the patient correctly for the breast surgery if it is done in the 3rd position.  The breasts are then dressed to decrease the chance of any infection, and also to lock in the desired position of the implants with ace wraps and bras.  Finally, the tummy tuck is done last because this surgery will determine which position the patient has to lie in for the next 3 days, and certainly how the patient has to be positioned in the recovery room. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.