Motherhood is God’s precious gift, but when you look at the mirror, you shall discover that pregnancy does take its toll on your body, especially your breasts and abdominal areas. There is no need to be depressed about your sagging skin…Nor should you be placed at a disadvantage at the competitive work place…Today, there are plenty of solutions that can be designed just for you.

Mommy Makeovers Counter the Physical Effects of Pregnancy.

On average; most women gain 10-16 kg during pregnancy. This weight is stored as fatty tissue in the breasts, abdomen, flanks (love-handles), hips, lower back, buttocks and thighs. The breasts also grow due to weight gain and to prepare for nursing. Once the pregnancy is over, and if you are lucky enough to lose the extra weight you gained, you may be left with saggy skin. To some extents genes play a role. Some skin can regain its elasticity after it is stretched and some never does. Living in the Gulf may also mean more sun exposure and skin damage due to sunbathing. The combination of weight loss and sun damage is more likely to create sagginess. Should you also be a smoker or a second hand-smoker then your prospects of sag city multiply. But don't despair; a mommy makeover can help you look your best again.

As the baby grows, so does the abdomen. This may result in a weakening and separation of the abdominal muscles, and stretching of the abdominal skin. This stretching may cause a breakage of the skin collagen, also known as stretch marks. These unsightly marks are purple-red in colour and concentrated around the belly button and lower abdomen.

These effects often become even more apparent after childbirth and nursing. A mommy makeover can help reverse these effects.

Many new moms do lose the excess weight – eventually. Unfortunately, the weight loss is not proportional to the amount of fatty tissue in a given area. That means for some, more weight may be lost from the breasts or buttocks than the abdomen and waist.

The result?  Smaller breasts despite fullness of the waist and abdomen. In these cases, a mommy makeover may be in order.

Once a woman finishes breastfeeding, the breasts deflate even further and begin to sag. The weak abdominal muscles and the excess abdominal fat appear as fullness and bulging of the belly. Many new moms may still look pregnant even as their child is taking his or her first steps. Once again, a mommy makeover can help.

What is a Mommy Makeover? A mommy makeover is performed using a unique combination of plastic surgery procedures designed to counteract the physical effects of childbearing, and restore and enhance your body.

The mommy makeover trend is becoming so pervasive that there is even a children's book – My Beautiful Mommy – by Florida plastic surgeon Michael Salzhauer that helps moms explain the procedures to their children.

In general, a mommy makeover may include:

- Breast augmentation: this procedure is ideal for patients with minimal sagging but who suffer from loss of breast tissue after breastfeeding

- Breast lift or reduction: If the breast is saggy and empty then we can perform a breast augmentation with an implant and a lifting of the saggy skin at the same time. For example, some women need breast augmentation to correct severely deflated “pancake” breasts, while others may need breast implants for augmentation in combination with a breast lift. Still, some women may actually desire a breast reduction with a lift.

-Armlift: the new Acculift laser is the latest version of the smart liposuction machines and can be used to perform liposuction of the arms and tightening of the saggy skin at the same time with no visible scars. The traditional arm lifts leave unsightly scars and are reserved for cases of massive weight loss following morbid obesity. Most mild and moderate cases of arm sagging respond to this newer laser.

- Liposuction Some women may also benefit from liposuction to sculpt the back, hips and thighs; and smooth out their contours. Mommy makeovers can include any or all of these body contouring procedures depending on your wishes and needs.

- Tummy tuck (abdominoplasty): this is the most common procedure after performed after a pregnancy
In the abdominal area, many women need a full abdominoplasty with tightening of the muscle layer as well as removal of the excess skin and fat, while some may need a mini-abdominoplasty.

- Buttock lift: Finally, an increasing number of women have also been requesting a buttock lift as part of their mommy makeover. This procedure requires a three week recovery.
Vein removal: many mothers develop haemorrhoids (dilated veins in the rectum) and unsightly veins in the legs which can be treated either with seclerothearpy injections if they are fine or with endovenous lasers if they are large.
Posterior repair and vaginal tightening: after childbirth, many women suffer from damage to the ligaments that can create urinary incontinence or loss of pleasure affecting their intimal relation with their husband. This condition can be addressed as well as we address their appearance.
The length of the surgery varies based on the amount and type of procedures performed. Some surgeons may perform a mommy makeover as two or more separate operations.
Non invasive or non surgical options: no amount of exercise can correct a saggy abdomen. If sagginess is mild then the newly improved wider Thermage tips can help. This procedure is done in the office with moderate pain and no scars as heat is applied through the radiofrequency waves. For severe sagginess surgery is the only solution.

Preparing for Your Mommy Makeover
It is important to ask yourself certain questions before deciding to have a mommy makeover.

Are you done having children?
If you plan to have more children, wait. The vertical muscles in the abdomen (which are tightened during a tummy tuck) can re-separate.

Are you at a stable weight?
Being at a stable weight before surgery can help maximize the results. Lose all your baby weight with diet and exercise before having plastic surgery. Weight loss may require
Are you finished breastfeeding?
You should wait until you are finished breastfeeding before having breast surgery because the enlarged ducts and increased blood vessel activity of the breast during nursing increases bleeding and the risk of infection.

What body parts have changed since you had children?
Your plastic surgeon can help you devise a personalized mommy makeover that targets these trouble areas in one or more surgeries.

The next step in preparing for your mommy makeover is discussing your options with an experienced plastic surgeon. Your surgeon will help determine if your expectations are reasonable and develop a plan for your mommy makeover. Most surgeons recommend that you wait six months or more after having a baby before considering cosmetic surgery. This allows for ample time to give your body and your life a chance to normalize.
Once you set a date for your surgery or surgeries, you will be given a list of preoperative instructions. These may vary based on your doctor's preferences and the type of procedure(s) you are undergoing.

Your doctor will likely tell you to stop smoking and drinking alcohol as these can impede healing. It is also a good idea to avoid aspirin and non-steroidal anti-inflammatory drugs which are known to increase the risk of bleeding. Certain herbal supplements can also increase bleeding risk, which is why it is paramount to tell your doctor about everything that you are taking.

In addition to what you should stop taking, your doctor may also suggest that you take certain herbs and supplements like bromelain and arnica to help reduce bruising and swelling.

Recovery
Your recovery process will vary based on what your mommy makeover entails. Still, there are some basic precautions and instructions that you can take to help this recovery go as smoothly as possible, including:

- Arrange for someone to help you get around the house and help you with your medication for at least the first 24 hours after your mommy makeover. You may need medication for the pain and to control nausea caused by the pain medication.
- Try sleeping on several pillows on your back and keep your legs slightly bent at the hips to minimize the tension on your incision, reduce pain and result in a thinner scar.
- Avoid heavy lifting, contact sports and jogging for up to six weeks.
- Call your surgeon immediately if you notice an increase in swelling, pain, redness, drainage, bleeding in the surgical area or if you develop fever, dizziness, nausea or vomiting. Other red flags include shortness of breath, chest pains and unusual heartbeat.


You will need to wear an abdominal binder after your tummy tuck. You can shower once the dressing, sponges and gauze pads are removed. This usually occurs within 72 hours of your mommy makeover. After showering, pat your incisions dry and replace your abdominal binder.

You will likely go back for follow-up with your surgeon within five days. During this visit, your doctor can remove the drainage tubes. Swelling should subside within five weeks, and the results are apparent in within three months.

Mommy Makeover Risks
All surgeries have risks, though longer surgeries that involve multiple parts of the body increase these risks. Risks may include (but are not limited to):
- Unfavorable scarring
- Bleeding
- Infection
- Poor wound healing
- Anesthesia risks
- Deep vein thrombosis, cardiac and pulmonary complications
- Possibility of the need for additional surgery
- Unsatisfactory results
For best results you must avoid smoking for two weeks before and two weeks after tummy tuck and breast surgery.

If the patient does not require extensive liposuction, then it is safe to consider combination surgery such as a tummy tuck and a breast surgery.
Mommy Makeover Cost
The cost of your mommy makeover will vary based on the body contouring procedure(s) involved and could include liposuction, tummy tuck and breast augmentation cost. Multiple procedures often increase operating time, which can result in higher fees.

In general, the cost of sugary includes the surgeon's fee, anesthesia fee, implant fees (if applicable) and the operating room fee. The cost for mommy makeover are typically one-time fees that can only be determined after a physical exam by our plastic surgeon. A breast lift or a tummy tuck can run between 22000-26000 Derhams. If additional skin procedures are desired, then fees may be ongoing for multiple treatments, as would be the case for the cost of laser hair removal.
All above procedures play a major part in addressing the post-partum blues that affect the mother and help her regain her self esteem and confidence and hence her marital and professional life.
Max Sawaf, MD Medical Director, CosmeSurge and Emirates Hospital