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Dr. Delgado for Mommy Makeover Surgery


Board-certified plastic surgeon Miguel Delgado, MD is internationally renowned for his Mommy Makeover technique and results. He has performed thousands of these complex procedures and has been featured in worldwide audiences. He has an artistic eye to bring the best out of one’s body after childbirth. This is a truly customized treatment, requiring a sensitive staff and surgical team to obtain the best results while holding safety in the highest regard. Dr. Delgado takes great pride in building trust and developing a great working relationship with his patients and their families—and he would be honored to do the same with you and yours.

What Is a Mommy Makeover?

Mommy Makeover is a marketing term that defines the surgical treatment combination of a tummy tuck, breast surgery, and liposuction. As a rejuvenating procedure for women, it is primarily geared toward women who have completed childbearing years. The goal of a Mommy Makeover is to return one’s body to its pre-pregnancy appearance by addressing sagging breasts, excess abdominal skin, stubborn fat along the waistline, and/or a variety of other breast- and midsection-related aesthetic concerns.

Many mothers who are unhappy with their bodies after pregnancies can readily identify with the   term Mommy Makeover. Since most women find that exercise and dieting fall short in restoring their body to their pre-motherhood condition, those who are serious about finding a solution will often turn to this ultimate fix, a Mommy Makeover.

At our practice, all Mommy Makeovers are custom-planned and performed by Dr. Delgado, our board-certified plastic surgeon. Based on your unique needs and goals, he can personalize a surgical approach to achieve the look you desire, often using computer imaging to both fine-tune the plan and show you predicted results prior to moving forward with treatment. Ultimately, Dr. Delgado’s aim for Mommy Makeover patients is not simply to enhance your appearance, but also significantly improve your self-image and esteem.
 

What Changes Does Pregnancy Have on the Female Body?

The goal of pregnancy is to provide a perfect environment for the fetus—to provide plenty of nutrients, easy expansion of the abdomen area, and adequate breast milk. The breasts enlarge during pregnancy and endure further stretching with engorgement from milk throughout the breastfeeding phase. The skin stretches, but it often does not recover to its former integrity because the elastin and the collagen fibers have been permanently altered. This stretching of the skin changes the shape of the breasts, and the breastfeeding process can reduce the overall size. Women often note that they wear a smaller bra size after their pregnancies than they did beforehand.

In addition, the effect of a fetus carried in the abdomen is generally extensive stretching to the abdominal wall; with multiple pregnancies having an even more profound effect. The skin stretches to a point that stretch marks commonly occur. Even years after delivery, the skin remains loose and may even sag so much that an apron of loose skin exists. If a Caesarian Section has been performed, a ledge may have formed above the C-section incision. Not only has the skin been stretched, but the underlying abdominal wall has been stretched out as well, resulting in a bulge of the abdomen. This is referred to as diastasis recti.

Women who have children a bit later in life tend to suffer a larger impact from their pregnancies on their breasts and abdomen than younger mothers. Their skin tone is already compromised somewhat by the passage of time, and the changes wrought by pregnancy and breastfeeding only add further insult to the wonderful experience.

Most women find it difficult to manage their weight after pregnancy. This has to do with the body changes of pregnancy, hormone fluctuations, and the extreme work required to raise a child. This is why liposuction is a common additional procedure in a Mommy Makeover.

Fortunately, a Mommy Makeover can address all of these issues, restoring volume and youthful contours to the breasts and a firm, flatter profile to the abdomen with a shapelier waist. The procedure flowcharts in the “What Are My Mommy Makeover Options?” section below illustrate the problem areas a woman may have after her pregnancies are completed and how surgery can restore her figure in ways that no amount of dieting and exercise can ever achieve. It is important to note, however, that these are generalized illustrations, and an actual consultation is needed to customize a Mommy Makeover to meet your particular needs.

Am I a Good Candidate for a Mommy Makeover?

The best candidates for a Mommy Makeover are women who have completed their childbearing. It is unadvisable to have a tummy tuck before your desire to have children has completely passed. This is because a tummy tuck involves surgical tightening of the abdominal wall and removal of abdominal skin. After a tummy tuck, these structures no longer have the same stretching capabilities to accommodate a growing fetus. However, you can still have breast surgery and liposuction even if another pregnancy is in your future. Also, a tummy tuck can be done without tightening the abdominal wall, but the skin will stretch again.

It goes without saying that a Mommy Makeover is a major surgery and a significant recovery. So, good health is critical for undergoing this procedure. If you have a significant weight issue or medical problems—such as heart disease or diabetes—treatment may need to be broken up into two surgeries. Even though this involves two healing periods, safety is most important.

Dr. Delgado and his full-time anesthesiologist, Dr. Riddle, will evaluate your condition and make the appropriate recommendations.

What Are My Mommy Makeover Options?

Breast Surgery

Breast surgery is one of the two essential components of a Mommy Makeover. Breast surgery may be simply a breast lift (mastopexy), breast augmentation, a combination of breast lift and augmentation, or a breast reduction.

As illustrated in the procedure flowchart, the critical question is whether or not you are satisfied with your current breast volume. If you feel your volume is sufficient, a breast lift can work wonders, while avoiding the long-term maintenance involved with breast implants. If possible, it is always better to work with a woman’s natural breast tissue.

If you feel your breast volume is inadequate, then breast augmentation is needed. The primary goal is for you to be happy with your breast volume, and the use of saline or silicone breast implants may be necessary to achieve that status.

Often, increasing the breast volume with saline or silicone breast implants may solve all of your breast issues, as long as the nipple-areolar complex is pointing forward in a reasonable position. However, if the nipple-areolar complex is too low, or if the nipples are pointing downward, a breast lift is generally indicated in combination with augmentation.

Another alternative to breast implants is the use of your own fat. This technique is gaining popularity, and fat has become the “Gold Standard” in volume replacement as seen in facial volume rejuvenation and the Brazilian Butt Lift (BBL). Breast augmentation with fat injections can increase the volume by one size as a general statement. The issue with fat injection into the breast is the calcium deposit that can develop. Breast cancer is one of the primary causes of death among women. Calcium is seen in breast cancerous lesions, so the fat injection can potentially cause confusion. Also, fat injections infuse stem cells into the area, as well. More studies are needed, but fat injection to the breast is, nonetheless, very common—and with this understanding, the procedure can be performed.

Tummy Tuck

Loose abdominal skin and a protruding abdomen are two things with which many women wrestle, especially after bearing children. Gone is the flat, taut abdomen of their youth. While breasts can be contained and enhanced with a myriad of patented padded or push-up bras, an overly ample abdomen is more difficult to hide. Elasticized body slimmers are uncomfortable, limited in what they can accomplish, and definitely not the answer for intimate situations. A woman can find herself relegated to a closet full of loose, baggy clothing, which can be depressing.

A tummy tuck (abdominoplasty) is the treatment of choice for this condition. The tummy tuck procedure tightens the underlying muscular wall, which flattens the abdomen and pulls in the waist. Dr. Delgado specializes in an advanced waist tightening procedure that accentuates the waistline even further. This is often an option if you wish to have as small a waist as possible. After the muscle wall is tightened with Dr. Delgado’s special suture technique, the loose abdominal skin is superficially pulled downward. This extra skin is then excised, and the remaining skin is sutured into position, restoring pre-pregnancy tightness to the abdomen.

Without changing its anatomical position, the belly button can then re-emerged through the tightened abdomen skin. This is where the skill of an experienced surgeon shines—a nice-looking belly button is critical to a successful tummy tuck. The incision must be tucked inward (creating an inward belly button), and the size must be just right. Dr. Delgado will discuss this element of the surgery in greater detail with you pre-operatively.

An extra benefit of an abdominoplasty is that much, but not all, of the stretch marks can be removed with the excision of the excess skin. The lower abdominal stretch marks are the ones primarily impacted; stretch marks on the upper abdomen and torso will remain. So, not only does the abdomen regain a firm, youthful profile, but with the removal of many of the stretch marks, the appearance of the skin is improved as well.

Liposuction

The final component of a Mommy Makeover is liposuction. Techniques vary, so it could be tumescent liposuction, ultrasonic liposuction, VASER® Liposuction, or any combination of these. Liposuction is very useful for contouring the flanks and back areas, as well as narrowing the waistline. You can see the difference this makes in a waistline in the before and after photos on our website.

Put together, breast surgery, tummy tuck surgery, and liposuction 
can be an extremely positive, life-altering experience, 
enhancing your self-confidence and self-esteem throughout your lifetime.

What Can I Expect in My Initial Mommy Makeover Consultation?

In your initial consultation, you and Dr. Delgado will discuss your cosmetic concerns—as well as your short- and long-term goals—and he will describe what the Mommy Makeover encompasses. He will then perform a physical examination, from which he will advise you as to which procedures are the best for your situation and where the incisions would be located. Dr. Delgado has an extensive library of before and after pictures, and you will have the opportunity to review photographs of his previous patients. He may also use computer imaging of your abdomen and waist to give you an approximate idea of the outcome you could expect, as well as better illustrate where the incisions would be placed. Once this is completed, a quote will be given and explained in thorough detail.

Dr. Delgado will also review your medical history and determine how extensive your pre-operative testing will be, or if other medical consultations will be required. This will determine if the surgery can be performed as one operation or staged into two.

How Do I Prepare for My Mommy Makeover?

The primary preparation for your Mommy Makeover is reading Dr. Delgado’s 20-page handout on how to prepare for surgery. Some of the most important aspects are preparing your family and your house for your recovery. In addition, arranging two to three weeks away from work will be required for recovery. There will also be lab tests to do and prescriptions to fill ahead of time. In most instances, Dr. Delgado may encourage colon cleansing before surgery. Smoking must be stopped two to four weeks before surgery, because this has a detrimental effect on healing. A disinfectant wash is also provided, which is to be used starting two days before surgery to cleanse the entire body.

How Is the Mommy Makeover Procedure Performed?

A Mommy Makeover procedure is performed under general anesthesia. The liposuction of the waist is performed first as the body is positioned side-to-side to remove the fatty tissue back to the spine region, which greatly slims the entire waist and recontours the top of the buttock region (making it appear more full and plump at the top). Dr. Delgado’s patients have been overly satisfied with this liposuction approach.

The breast surgery is performed next, which could be breast augmentation and/or breast lift—or possibly a breast reduction. Lastly, the abdominoplasty is performed. During this process, the diastasis recti repair (or the loose abdominal muscles) are repaired. A long-acting pain medication, Exparel, is also injected into the tissue, which provides pain relief for up to four days. The operating table is then flexed at 60–70 degrees, and the skin is pulled downward and trimmed. This is why the patient is bent over for five to seven days after surgery. If necessary, the bellybutton is brought outward and meticulously inset.

“To drain or not to drain” is one of the current discussions. Dr. Delgado has done both, and for the aggressive type of tummy tuck, this is performed. He feels that using drains for a short period of time helps to avoid the dreaded seroma (fluid build-up) complication. In fact, Dr. Delgado never sees this potential complication.

The last step of surgery is the body dressing and placement of the compression garment. Once these are situated, the patient wakes up immediately due to the light anesthesia utilized.

What Is Recovery from a Mommy Makeover Like?

A Mommy Makeover will require a 23-hour stay at the Marin Cosmetic Surgery Center Recovery Center. You may go home the following morning, after Dr. Delgado examines you and you are discharged to the care of a responsible adult.

Full recovery after a Mommy Makeover is generally about six weeks. While you will likely be up and walking the day after surgery, you will not be able to do so at your usual pace just yet. By the end of the first week, your ability to get up and move around more frequently should be improved, but not quite to the point you are able to drive a car. It will take approximately two weeks before you are comfortable enough to drive a car.

All of the sutures and drains will usually be out by the two-week mark. You should be able to return to work after two to three weeks and resume your usual exercise routine at about six weeks. Due to the tummy tuck and the fact that you had multiple procedures done at one time, the recovery period is significant and can be fairly intense the first few days. That said, the use of Exparel (a long-acting pain relief) injections and pain killers should effectively control your discomfort so that you can move about and sleep as needed.

What Long-Term Mommy Makeover Results Can I Expect?

Following a Mommy Makeover, your figure will always look amazingly different than your post-pregnancy body. While you will continue to age and your skin and body composition will gradually mature, your body will always be tighter, trimmer, and have a more proportional shape than if you never received treatment in the first place.

The factors in life which can create significant unwanted changes are often under one’s control. For example, if you have a moderate to large weight gain—whether due to lack of exercise, dietary changes, or illness that restricts a healthy lifestyle—this will affect your entire body. Your breasts may increase in size with the possibility of some laxity. The abdomen and flanks can accumulate adipose tissue, as well. After liposuction, it is true that fat can change how it distributes within the body, so excess fat tissue may accumulate a little more in the inner and/or outer thighs, or on other parts of the body.

Of course, if you become pregnant again, this can certainly change the body completely. In addition to the undesirable impact a pregnancy following Mommy Makeover surgery can have on your physical appearance, this is not recommended (and explained in advance) due to the negative effect abdominal repair could have on a successful pregnancy. Luckily, Dr. Delgado has personally never witnessed this issue—but the risk does exist.

Ultimately, the Mommy Makeover procedure can be a lasting change in your body for life. Dr. Delgado’s patients’ satisfaction with this surgery is exceptionally high, and they feel it is well worth the financial investment and recovery.

Will I Have Mommy Makeover Scars?

Since Mommy Makeover surgery involves incisions, some degree of scarring is inevitable. The breast incisions are typically made along the lower fold of the breast (infra-mamary fold), if solely an augmentation is done. If it is a short-scar breast lift, it is generally a lollipop type of incision, which encircles the edge of the areola and includes a straight line incision from the bottom edge of the nipple down to the where the breast tissue meets the chest wall. Part of this vertical incision will be hidden in the fold under the breast. If it is a breast reduction, the incision may be a lollipop short scar, or it may be the lollipop incision with the additional curved anchor incision hidden under the breast fold in the event of a larger reduction. The tummy tuck incision generally runs from hipbone to hipbone across the lower abdominal area, falling below the pubic hairline and underneath the underwear/swimsuit coverage area. Liposuction scars are very small and usually in areas hidden by clothing.

Dr. Delgado also uses new technology in the suture technique. The use of “barbed” sutures is great technology for closure of large incisions, like in a Mommy Makeover surgery. The advantage of these sutures is that no knots are required, therefore resulting in more even tension, more secure closure, no spitting sutures, and better-quality scars.

Although the incisions do leave scars—and they will be reddish and very evident at first—surgical markings typically fade to pink over time, ultimately blending to your natural color in most cases. Depending on the natural pigmentation of your skin, they may fade to be nearly invisible. Generally, the scars are fine lines. If they heal too widely, it is possible to revise them at a later time to be more of a fine line. A new scar management system called “Embrace” is a great addition to scar maturation. It is a disposable device that lasts seven to ten days at a time, and you are able to bathe and exercise with it in place. It is used for four to six weeks, and patients are very happy with the outcome. The use of Embrace on fully healed incisions will promote the formation of a flatter, finer scar. Dr. Delgado has developed a scar management program for shorter incisions—like on the breast—with the use of silicone sheeting. This is incorporated in his post-operative instructions.

What Are the Potential Risks and Complications of Mommy Makeover?

As with all surgical procedures, there is the risk of complications and adverse events for Mommy Makeovers. The combination of procedures—i.e. breast surgery, tummy tuck, and liposuction—can take from six to eight hours or more in some cases to complete. In order to determine if you are a suitable candidate for these combined procedures, Dr. Delgado and the anesthesiologist conduct a detailed review of your medical history, lab values, and if indicated, EKG results. If you have certain risk factors, Dr. Delgado will split the procedures and stage them appropriately. Both Dr. Delgado and the anesthesiologist participate in this process to determine if you are physically and mentally able to proceed.

Generally speaking, the risks of this procedure are infection, bleeding, incision scarring, and contour abnormalities. With the breasts, the risks are capsular contraction, deflation of implants (if they are used), and asymmetry—as well as the risk of blood clots or thromboembolism. Thromboembolism is a serious and potentially life-threatening complication of plastic surgery and is a risk which is particularly associated with tummy tuck procedures. At Marin Cosmetic Surgery Center, we practice extensive precautions to prevent thromboembolisms from occurring. Specifically:

  • Anti-embolic custom-fit stockings, which are worn at all times
  • Pneumatic leg compressions, which are placed at surgery and also sent home with the patient to be worn at all times (unless walking) during recovery
  • Initial compression garment, which is not tight and obstructive to flow
  • Instructions to walk around the house every hour when awake
  • Prescription of a blood thinner, Loninox, which is an injection that starts the day after surgery for seven days; all patients do not require this, so potential need will be determined at the time of the pre-op visit
  • Directions to place a pillow underneath the knees to encourage unobstructed blood flow when sitting or laying in bed

Complications can occur with any surgery, though an experienced surgeon can keep these to a minimum and handle them conscientiously with sound judgment. As you look to choose a plastic surgeon, be mindful that Dr. Delgado will remain just as engaged, concerned, and caring about your results after surgery as he was prior to surgery and during the surgical procedure itself. Not only is he a perfectionist with his surgical technique, but his commitment to his patients’ satisfaction extends well beyond the day of surgery.

Additionally, be aware that the best choice is a physician who is a plastic and reconstructive surgeon who is in good standing and certified by the American Board of Plastic Surgery. Although these credentials do not promise a good outcome, they do assure that you will be working with the gold standard of the plastic surgery industry. For even further assurance that you are choosing the most qualified surgeon, look for members of the Aesthetics Society, ASAPS (American Society for Aesthetic Plastic Surgery). The Aesthetics Society requires extensive continuing education of its membership. This group of surgeons specializes in cosmetic surgery, such as tummy tuck, breast surgery, and liposuction combinations.

How Much Does a Mommy Makeover Cost?

The cost of a Mommy Makeover generally falls within a $15,000–$20,000 price range. A key factor that influences pricing is the specific breast surgery performed, as Dr. Delgado’s plastic surgeon fee is set and the cost for tummy tuck and liposuction is fairly fixed. In addition, anesthesiologist and surgery center fees are based on how long it takes to complete the surgery, so the time estimate for surgery can impact the overall expense. For example, a breast reduction or breast lift with implants takes much longer than a breast augmentation alone, so the former options would likely be more expensive than the latter. Other fixed costs typically include compression garments (2), Exparel, Embrace, and the overnight fee in the Marin Cosmetic Surgery Center. (The overnight facility has a specially trained nurse and a second assistant who care for your needs throughout the night following your procedure.)

At the time of your consultation, Dr. Delgado can provide a more personalized price quote for Mommy Makeover based on your unique needs and goals.

Contact Dr. Delgado and Marin Cosmetic Surgery Center

Mommy Makeover patients are some of the happiest patients at Dr. Delgado’s practice. The results from these procedures are positive and life changing. If you think that you would benefit from a Mommy Makeover, schedule a consultation with Dr. Delgado to discuss your situation. He will take the time to hear your concerns and, with his extensive expertise and experience, present the best options for you and your budget to achieve your goals.

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