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

The order of procedures may vary from doc to doc but I start wih implants as these are the most sterile part, ie it's best to exchange implants first and then close them up safe and sound before moving to the abdomen. I would the start with lipo of the flanks, the raise the abdominoplasty flap, repair the hernia and tighten the muscles and then close the tummy tuck. Hope that helps, Dr K

Thank you for your question.

For a precise answer,  you will need to ask your plastic surgeon what his/her plans are.

For the "mommy makeover" procedure  in my practice, the order of procedures would be as follows;

If I am working on the back/flank area for a patient, I will start with the patient prone (laying on her stomach) to do the work on the back area.  This may involve liposuction and or lipectomy surgery. Sterile dressings are applied.  

After that, the patient is placed in the supine position (laying on her back)  and positioned carefully. Fresh gloves / instruments etc are used to work on the breasts.  I leave the incisions of the breasts open so that I can adjust things, if needed, after the tummy tuck procedure.  After performing the tummy tuck procedure (and pulling down and removing the excess skin), it may be necessary to adjust the breast pockets one more time before closing the breast incisions. Again, this is done with fresh gloves.

After the tummy tuck portion of the procedure,  the patient is kept in the flexed position.  The appearance of the breasts are checked in the upright position several times during the procedure.  The patient is usually  extubated in  the operating room and transferred to the recovery bed, again in the flexed position.

Again, this is my routine and may differ from your plastic surgeons'.

Given that you are about to go major surgery some additional words of advice may be helpful to you:

1. Make sure you are doing the procedure for the right reasons (for yourself)  and that you have realistic expectations.  Be aware that an improvement in the “problem area” may not translate to an overall improvement in your life   situation.  You are bound to be disappointed with results of the procedure if your motivation for doing the surgery is not internally driven.

2. Time your surgery carefully; generally, it is not a good idea to have surgery done during or immediately after a stressful period in life (for example divorce or death of a loved one). The additional stress of surgery will undoubtedly be  more challenging to deal with if a patient's emotional reserves our already exhausted. Remember, that an improvement in your physical appearance will not translate to an improvement in your life situation.

3. If possible speak to patients who have undergone similar procedures and query them about the toughest times of their recovery period. Any practical hints previous patients can provide may be very helpful.

4. Make sure you are aware of potential complications that may arise how to reach your surgeon if necessary.

5. Make sure you have a strong and patient support system (several people if possible) in place who have time/patience to take care of you. Arrange for professional nursing if any doubt exists regarding the availability and/or stamina  of your caretakers.

6. Be patient with the healing process, understanding that it will take several weeks to months to feel “normal” again. It may also take many months/year to see the end results of your surgery.

7. Be prepared to distract your mind with things of interest such as books, magazines, and movies.

8. Expect less of yourself; do not go back to work, school or chores too early and let others take care of you (for a change).

9. Pick your surgeon carefully (a well experienced board-certified plastic surgeon) and trust in his/her advice. Keep in close communication with your surgeon and do not hesitate to communicate questions/concerns and the   emotional swings that you may experience.

10. Resume all medications that you were using preoperatively when cleared by your plastic surgeon and stop the use of narcotics and sedatives as soon as feasible after surgery.

11. Keep in mind the end results as you go through the tougher emotional times after your surgery. 

Best wishes with your upcoming surgery.

 

 

Hi there-

To some extent, the order the procedures are performed will depend on your anatomy, the details of your particular procedure, and your surgeon's preferences, so your best bet is to ask your surgeon what his plans are.

Generally speaking, if all other things are equal, I prefer to complete the breast enhancement procedure first, then follow with the tummy.