Which Procedure(s) Is/are Best?

Age: 45 yrs, 64 inches tall, 200 lbs, good health. I carry my weight in my tummy and hips. I would like to see my navel or lift tummy from my lap and increase my breast size from B to D cup for a more symetrical appearance. Which procedures are best.

Doctor Answers 7

About a Mommy Makeover and Tummy Tuck

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.  #MummyTummy is a term given to modified tummy tucks which can use liposuction and skin tightening with radiofrequency such Vanquish, Vela3, thermage, thermiRF and others.  The actual fat contouring can be done non-surgically as well with #UltraShape or Cool-Sculpting. 

#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.

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.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Abdominoplasty with Liposuction and Breast Augmentation in Melbourne, Florida

While, of course, it is always good to be in your ideal body weight range before having body contouring surgery, the reality is that many people never get there and often one can perform some type of procedure and feel that you’re getting a jump start for your diet and exercise regimen, so that you can see some results from your efforts. From your description, it sounds like you could possibly benefit from an abdominoplasty and liposuction, as well as an augmentation; however, I would encourage you to seek a consultation from a well-qualified board-certified plastic surgeon and discuss your specific goals in order to get some recommendations which would be most appropriate for you.

Amy Ortega, MD
Melbourne Plastic Surgeon
5.0 out of 5 stars 40 reviews

Achieve Long Term Weight before Body Contouring Surgery.

Thank you for the question.

I think you will be much better off  postponing any type of body  contouring surgery until you have reached a long term stable weight. Waiting until that time, will minimize the risks associated with surgery as well as decrease the chances that further surgery will be necessary in the near or distant future.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

5'4" & 200 Pounds - What Portion Of The Mommy Makeover Best For Me?

Dear Rachel, Thank you for this challenging question and it looks like it is going to get some controversy.  There are many excellent plastic surgeons from around the world answering questions on Real Self.  Dr. Tholen is, in my opinion, one of the best consultants Real Self has.  He is a man with strong opinions and I respect that.However, in this instance, I need to disagree with him. 

I believe you may be a great candidate for liposuction.  If I had the advantage of photographs as well as an in person physical exam, I would be able to give you a better answer, but I will assume that you are a tight skinned, 200 pound, 5'4" female, and that liposuction is the #1 portion of the Mommy Makeover that would make any sense for you. 

At 45 years old, your hormones have changed and burning fat is not an easy thing to do.  Some people get stuck in a rut holding excess weight, and at times, aggressive and yet judicious fat suctioning can be an outstanding way to break the logjam.  If you are cleared by your internist for cosmetic surgery, if you don't smoke, if you have a high HCT, if you have given diet and exercise a full court press and it's unsuccessful, then I would consider liposuction of your hips, probably mid back and outer thighs.  This could give you a head start.

All that being said, you need to be seen by a reputable Board Certified plastic surgeon with lots and lots of experience in body lifts and liposuction, and then I would follow his or her program to the "T".

You would benefit most from gastric bypass or lap band procedure rather than cosmetic surgery..

I'm sorry, but at 5'4" tall and 200 lbs, you will not be able to receive a result you like and your surgeon is proud of via tummy tuck and breast augmentation. Plus, your health is (eventually) at risk. If I were to see you in consultation, I would try to, as kindly and gently as possible, tell you that your money would be "wasted" on cosmetic surgery for which you are really a suboptimal candidate, if not a poor candidate. Plus, your results will still be an incompletely-tightened abdominal wall (due to excess intra-abdominal contents, mostly mesenteric and omental fat), and larger breasts that will become ptotic (sag) when you lose weight, and even if you do not. This helps neither you nor your surgeon's reputation.

Rather, if you have been unable to lose weight any other way (diet/exercise), then your family doctor, internist, or OB/Gyn can refer you to a general surgeon experienced in surgical weight loss options. After you lose 70 or 80 pounds (safely and over a year or two), THEN you will be a fabulous candidate for cosmetic surgery (and may need a breast lift rather than implants, or a lower body lift rather than tummy tuck).

Not to mention that you will be healthier and around much longer to have a safer plastic surgical experience, enjoy your new looks, and be with your family and friends. Honest! Good luck and best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Which Procedure(s) Is/are Best??

Thank you for your question. Were you able to attach some photos you will get more useful answers.

From what I can gather from the question, you may well be a good candidate for a tummy tuck which can remove some excess skin and fat, and tighten the abdominal wall to some extent.

A breast augmentation can increase your bust size, and make the sizes more even if that is the cause of asymmetry. If the asymmetry is from shape of the breasts or nipple/areolar position, a breast lift may also be needed. Indeed, a lift may be needed regardless of symmetry if the nipples and areolae are too low.

Best for you is to see a plastic surgeon for an evaluation and recommendation.Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Cosmetic surgery or weight loss

At 5'4 and 200 lbs, your BMI is 34.  Liposuction can safely take approximately 11 lbs off.  I do not believe liposuction would be very effective in achieving your goal.  Breast augmentation from a B to a D may produce minimal improvement.  I recommend you consider medical treatment and an exercise program to get your weight under control.  After this, you should consider cosmetic surgery,

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

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.