Breast Reduction & Abdominoplasty Surgery

This past winter I had a patient referred to me for breast reduction surgery. She was forty years of age, had considered a breast reduction in her 20’s, but then got married, started a very successful marketing travel business, and had 3 kids. She was in excellent health, exercised regularly, and was within 10 pounds of her ideal body weight. She knew she wanted the breast reduction since her cup size exceeded DDD cup size, but ever since her last pregnancy, she had an extra “tire roll” of skin around her midriff and a significant “potbelly”. 

When I consult with a new patient I always look at 3 things: 1) are they anatomically ready for the surgery? 2) are they psychologically ready for the surgery? 3) are they financially ready for the surgery? After examining this patient and discussing what her goals were, I realized she was anatomically and psychologically ready for both procedures. My office manager would later discuss costs with her after I finished my consultation. Now the patient and I needed to decide whether she should do the breast reduction surgery first, wait a year, and then do the tummy tuck as a separate procedure, or should she just do both procedures together?

Nowadays, when breast and abdominal wall procedures are combined for a woman who has gone through pregnancy, childbirth, and breastfeeding, the surgeries are colloquially called a “mommy makeover”.

Breast reduction and abdominoplasty surgery are ambulatory procedures performed under general anesthesia. Both are time-consuming and have risks, but the risks are acceptably low and the benefits significantly high for healthy patients who have their surgery performed by a team of board-certified and seasoned professional plastic surgeons, anesthesiologists, and registered nurses. Ultimately, this patient decided upon having her surgeries performed combined, and had a very successful outcome, and is quite pleased with her results. Already she has referred me to 3 of her friends! 

Breast

If a woman is pleased with her breast size but the breasts are just saggy, then just a breast lift (Mastopexy) is required. If a woman just feels her breasts were deflated by childbirth, then perhaps an implant (Breast Augmentation) is required. Sometimes, both are required for those that feel their breasts are deflated and saggy (Augment Mastopexy). Many of my patients are much like this patient in that they feel their breasts have always been too large for their frames and they want both a lift and a reduction (Breast Reduction).

Abdomen

Pregnancy and childbirth can affect the abdominal wall in a variety of ways. Some patients have had cesarian sections, and despite having good tone, have a shelf of extra skin and fat above the scar. These patients can be treated with scar revision and removal of the excess skin and fat (Mini-Abdominoplasty). Some patients, in addition to having excess skin and fat, have a visible “potbelly” caused by the tearing and stretching of the abdominal wall musculature. These patients require a tummy tuck (Abdominoplasty). Occasionally, patients develop protrusions of their belly buttons (Umbilical Hernias) or even severe thinning of the muscles and investing fascia of the area above and below the navel (Ventral Hernia). These patients require a tummy tuck without an umbilical incision (Modified Abdominoplasty) in order to repair the hernias at the same time that the abdominal wall is rejuvenated. Many times abdominal wall surgery is combined with minimally invasive removal of fat deposits in the love handles or inner thighs or hips (Liposuction). 

Plastic surgery is complex and time-consuming. The trick for the plastic surgeon is always to put the round peg into the round hole – in other words – to match the proper procedure to the right patient. In the world of “mommy makeovers”, there is a large variety of breast and abdominal wall procedures available so that patients can efficiently address their multiple cosmetic concerns at once.