Mommy Makeover Revision

The American Society of Plastic Surgeons describes a mommy makeover as surgery meant to restore shape after childbearing, most often involving the breasts and the abdomen, and lists breast augmentation, a breast lift, liposuction, and a tummy tuck among the procedures that can be combined. A revision returns to those same areas when the first result is the problem. In the case below, the combination is a breast revision, a reverse tummy tuck, and liposuction of the abdomen.

A tummy tuck revision removes excess skin and fat and repairs muscle separation. That separation is diastasis recti, the split of the abdominal muscles that pregnancy commonly leaves. The separation can leave a protruding abdomen that exercise and diet do not flatten. Repairing it is part of how a tummy tuck revision flattens the abdomen. Removing skin, removing fat, and repairing muscle are three steps. None of them replaces the breast revision when the implants are the other complaint.

The breast revision would change breast shape. The upper abdomen was still loose skin and wrinkling. The abdomen acts as a platform for the breasts. Symmetrical breasts sitting on an abdomen with contour irregularities would compromise the result, because the two surfaces are read together. Treating the breasts and leaving the upper abdominal skin in folds would keep the platform uneven. Loose skin on the upper abdomen is a different complaint from a lower overhang. The reverse tummy tuck is the skin operation for that upper field, and it is done in the same operation as the breast revision.

To correct that upper abdomen, a reverse tummy tuck was paired with the breast revision, along with revision liposuction of the abdomen. The result of this mommy makeover revision was a harmonious upper body. The waist was narrowed to the curved, tilde-shaped silhouette she had before pregnancy. Before pregnancy that silhouette had a curve through the waist, and narrowing the waist is what brought the curve back while the breasts and the abdomen were corrected together. The back and buttocks were contoured as well, so the outline was 360-degree body contouring rather than a chest change seen only from the front. The plan was chosen at the initial consultation.

Capsular contracture is the tightening of scar tissue around the implant. Symmastia is the shift of the implants toward the center of the chest, producing a uniboob appearance. Both are reasons a breast revision is considered. In the 53-year-old operation the recorded breast steps are a lift and placement of new implants into the newly created mound.

A breast lift, also called mastopexy, lifts and reshapes a breast that sits too low. Breast augmentation uses implants to restore size and fullness after volume is lost. When both sagging and deflation are present, a lift and augmentation can be combined. A revision after breast reduction is a different complaint. It is sought for an insufficient reduction, for asymmetry, or for poor scarring. The corrective steps are additional tissue removal and reshaping of the breast and the scar.

Factors that lead a patient to ask for a revision after a tummy tuck include pregnancy, significant weight loss, and dissatisfaction with the first result. Those events change skin laxity and the abdominal contour. The request is a further correction of the abdomen after the earlier tummy tuck, once scar and a prior muscle repair are already part of the anatomy.

The issues that bring patients back are sagging skin on the abdomen, an insufficient reduction of the midsection, and a contour that still does not match the plan. The adjustments are further skin tightening, removal of excess fat, and additional muscle tightening. Each of those belongs to the tummy tuck revision. Liposuction of residual fat is not the same step as cutting away redundant skin, which is why the 53-year-old abdomen needed both a reverse tummy tuck and revision liposuction.

69-year-old female 3 months following mommy makeover revision surgery, including high definition liposuction revision and lower body lift incision line revision.

The 69-year-old patient is a different case from the 53-year-old plan. At three months her revision included a high-definition liposuction revision and a revision of the lower body lift incision line. That result returns to fat contour and to a prior incision. It stands beside the implant work and the upper abdominal skin work in the other case, and it is recorded on its own at the three-month point.

A mommy makeover revision is harder than the first operation because the tissue has already been altered. A prior breast pocket means the mound has already been opened and an implant has already sat in the wrong position. Prior belly liposuction means some fat is already gone and the remaining irregularity may be redundant skin. A prior tummy tuck, when that is the history, means the muscle and the skin have already been operated. The surgeon is chosen for skill with that altered tissue. Fees are kept on the mommy makeover cost page, and where the operation is offered is kept on the mommy makeover locations page.