Why is my Stomach Shape So Different when Sucking In? (photo)

            I think that a full breast lift, tummy tuck, and liposuction of the flanks will produce a very nice result.  If you want additional superior pole fullness of the breasts, a small implant can be placed.  Find a plastic surgeon with ELITE credentials who performs hundreds of mommy makeovers each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Thank you for the question and pictures.

 Based on your pictures, you seem to be an excellent candidate for “mommy makeover surgery”.  Your abdominal wall looks  less flat when you relax it because of the status of your abdominal wall muscles. These muscles have spread apart from one another during pregnancy (diastasis recti).  During the tummy tuck procedure, these muscles are typically re approximated in the midline and allow you to achieve the flatter abdominal wall appearance that you see when you “suck it in".

 In regards to the breast surgery, discuss your goals clearly with your plastic surgeon. In my practice I would advise you to show me pictures of what you are trying to achieve. Generally speaking, it is difficult to imagine that you will have a “round shape” without the use of breast implants.

 I have also attached some advice I provide to my patients who are undergoing mommy makeover surgery:

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.
I hope this helps.