Mommy Makeover

Dr. Bob Basu: It's quite frequent that I say that mommy makeovers are truly transformative procedures, and I don't think that's an exaggeration at all.

Speaker 2: Welcome to Behind the Double Doors, the Houston plastic Surgery podcast with Dr. Bob Basu, telling the stories of plastic surgery patients and bringing you behind the scenes to learn everything you need to know.

Dr. Bob Basu: On today's show we're talking about mommy makeovers. Here's a question from Felicia in Sugarland that was submitted in writing. Felicia wants to know how long after I am done having kids can I have a mommy makeover? And is it safe to do more than one procedure at the same time?

Dr. Bob Basu: We typically want moms to have lost their baby weight, and operating too soon is not a good idea because remember, it takes some time for the tummy to settle down after having kids, and then that can take anywhere from two to three months. The other thing is if a patient's construing breast surgery, you don't want to be breastfeeding while you're considering any elective breast surgery, because the breast remember when you're breastfeeding, the breasts are engorged for the milk ducts and the activity in the breasts. And so you want to stop breastfeeding for at least two to three months to allow the breast volume to settle down. But typically I've found approximately three months after having kids is the earliest you should consider any elective surgery for your tummy at three months after you've stopped breastfeeding.

Dr. Bob Basu: Common question that I hear is what is a mommy makeover? Now, mommy makeover's not a medical term it's an umbrella, almost like a marketing term, it's an umbrella term that describes a set of procedures designed to restore a mom's breast, body, or other parts of her body to what it was before having kids, and for a lot of moms even better than what it was before having kids. The common procedures that are typically performed on the breasts are an augmentation, augmentation with a lift, a lift by itself, or maybe a lift with a breast reduction. And now we're also adding in a lift with fat transfer augmentation. The common denominator procedure for most moms is a tummy tuck procedure, which is removing excess skin and fat and stretch marks from the tummy and tightening up those muscles that have been stretched out after having kids, and for moms that have C-sections, we clean up all that scar tissue. Very common for us to do some simultaneous liposuctioning.

Dr. Bob Basu: Now, most recently, there've been a lot of focus on curves in the buttock. And now I'm seeing moms request, not a combined breast and tummy surgery, I'm actually seeing moms wanting tummy contouring with buttock contouring. So oftentimes, a mommy makeover for these patients means fat transfer to the buttock, a procedure known or referred to as a Brazilian buttock augmentation with 360 liposuctioning, which means liposuctioning 360 in the tummy waste and the posterior flank. So mommy makeovers mean different things to different patients.

Dr. Bob Basu: Now, is it safe to do more than one procedure at the same time? Different surgeons have different answers to this question. I can only answer this question based on my experience level over 17 years, and I think in healthy patients, who are good candidates for elective surgery, it's very safe to do multiple procedures in one setting. The reason why different surgeons have different answers to that question is every surgeon has a different surgery time for procedures. In my hands, my most common procedure that I do as a mommy makeover, which is a cosmetic breast surgery, can be a breast augmentation, breast augmentation lift, or a lift with a reduction in combination with a tummy tuck with liposuctioning.

Dr. Bob Basu: It's quite frequent that I say the mommy makeovers are truly transformative procedures, and I don't think that's an exaggeration at all. I'm thinking of one patient in particular, early in my career, she was a mom of three and she came in for a consultation with me. This is a long time ago and she had guilt. She was telling me, "I don't want to be vain," but she felt guilty that she was taking away resources from her family to even consider a mommy makeover. And I often hear that from moms.

Dr. Bob Basu: In addition, when she walked in, her posture was slouched over, you could kind of sense almost a negativity about how she was feeling about herself. She had a very supportive significant other who was encouraging her to get this done finally, now that the kids are a little bit older and they were in a financial place that they could do this for her. And she had an augmentation with lift and we did a tummy tuck with liposuction of the waist. And I remember when I saw her a couple of weeks after surgery, she's just healing great, a whole different person was walking into the office. Literally posture straightened out, she was walking straight, she was glowing, she had positive energy and it was a new lease on life for her. It just changed her confidence.

Dr. Bob Basu: She felt confident, she was ready to exercise, she wanted to go out, she wanted to go on the next family vacation. And so that's what it's all about. The worst thing that can happen is a mom undergoes a mommy makeover and they have not given any time for them to recover. That's just a recipe for disaster. And so what we do is we tell patients to prepare for the healing process, that's really important. And what I mean by preparing, number one, if they've got a little kids at home, they need to get help with the kids. You cannot recover from surgery in a healthy way if you're running around chasing after kids, and you've got to take them to the sports activities and school. So it's a really important to either have some help with the kids, a family member, a nanny, au pair or your significant other, be available so that they can take the stress of childcare off your plate. Super important.

Dr. Bob Basu: Number two, you have to plan for rest and recovery. And so that means immediately after surgery, you have to have some time that you can rest and focus on your nutrition, your recovery, and continue with your follow-up appointments. So it's important to plan ahead so that you can have a safe outcome. If you do too much too soon, you can challenge the healing process. Comply with our recommended recovery plans, patients do really well. And so I think it's all about preparation. Breast surgery is relatively easy to recover from. Patients who have breast surgery by themselves will have the surgery on Thursday and they're back to the office in a desk job by Tuesday, Wednesday, the following week. It's the tummy tuck that's more involved with the recovery. And I typically tell patients that they should plan to have help with the kids for about seven to 10 days.

Dr. Bob Basu: They should feel after a baseline in about 10 to 14 days after surgery. Most women, after a tummy tuck from a mommy makeover, are comfortable to go back to a desk job at the office in about 10 to 14 days approximately. So in terms of taking care of the kids, I think they need to have some help for at least a week. When I say a week, I'm talking about five days plus the weekend. So we're talking about 10 days and then they should be fine to start resuming some limited childcare activities. But it's really important to plan ahead.

Dr. Bob Basu: Traditionally, we've talked about mommy makeovers as surgical procedures, but now there are effective noninvasive technologies that are alternatives to or compliments to surgical procedures. I'll give you a couple examples. Part of mommy restoration after having kids is not only the surgical or incisional procedures, but we also offer ThermiVa. ThermiVa is radio-frequency vaginal rejuvenation. And this is a nonsurgical minimally invasive radio-frequency technique that my nurses perform on patients all the time, and they're incredibly happy with even just one treatment.

Dr. Bob Basu: Other non-surgical procedures can now include CoolSculpting for noninvasive fat reduction. You can also include other radio-frequency treatments such as body types. So some moms are blessed that they don't need a tummy tuck, but they do have some mild or moderate loose fat and skin, which can often be improved with just doing minimally invasive radiofrequency skin tightening using a technology called body tight. So a tummy tuck typically takes me about two to two and a half hours. If we're doing a larger tummy, say and extended tummy tuck, it might take three hours. The operative time also depends on if we're doing any additional liposuction at the same time. About 80% of the time I'm doing tummy tucks, I'm doing simultaneous liposuctioning to help achieve a really nice hourglass shape that everyone wants.

Dr. Bob Basu: And again, if I'm looking at a typical tummy tuck with liposuction in the waste, that takes me typically about two and a half hours. By itself, it can be safely performed as outpatient surgery. Typically our patients are walking immediately after surgery within at least an hour after they're done surgery. One of the reasons why our patients are comfortable to walk almost right away after surgery is we love using long acting numbing medicine. Of course our patients are asleep during surgery, my board certified anesthesiologist is watching them like a hawk during surgery. But before I finished my procedure, I actually inject a long acting numbing medicine or local. And that numbing medicine, I inject it throughout the incision, that incision is that [inaudible 00:08:44] line, incision that goes hip to hip. But what really hurts after the tummy tuck, it ain't the incision. It's the muscle tightening that I do to give you that flat washboard belly.

Dr. Bob Basu: And so what I do is I take that numbing medicine, I inject numbing medicine into the muscles and around the muscles and that numbs up your muscles and the numbing medicine I've been using for many, many years now. It's called Exparel. Exparel is FDA approved, it's very safe. I use an all my tummy tucks, all my body contract procedures. And the numbing effects of Exparel lasts at least three days. It's a huge game changer for my patients who are having tummy tucks and body lifts and larger procedures because I now have tummy tuck patients, and I'm not exaggerating, I now have tummy tuck patients that do not need a single narcotic pain pill after surgery. Now we give all our patients a one week supply of pain pills because pain varies from patient to patient, but I would say a good 20, 25% of my patients come back now and they're just taking Tylenol after surgery and they're doing well.

Dr. Bob Basu: Again, pain varies from patient to patient and we don't want our patients to experience pain, but the nerve blocks make a big, big difference in the recovery of our patients. Some surgeons may keep a mommy makeover patients overnight in a hospital and that that's definitely an option, there's nothing wrong with that. We screen our patients pretty thoroughly and I make sure my patients are healthy enough to have elective cosmetic surgery in my hands because we do some advanced pain control techniques, my patients are comfortable to go home the same day. In fact, they want to go home the same day, it's much more comfortable to sleep in your own bed. And like I said, one of the reasons why my patients are comfortable to go home the same day as we use nerve blocks to numb out the tissue. So they're not feeling any pain for three days after surgery. So my patients are walking in the recovery room before they even leave here. So they're more than comfortable to go home the same day.

Dr. Bob Basu: So what can be done about all C-section scars or hernia surgery scars? First, it's so common for us to see C-section scars when we're evaluating a mom for a tummy tuck or a mommy makeover. And we remove the C-section scar at the time of the tummy tuck, and I try to place the tummy tuck incision line below the C-section scar. The reason why it's important to remove that C-section scars because oftentimes the C-section creates scar tissue underneath that scar and it creates a tether band where the tissue above the C-section kind of hangs over it. Think of it kind of like a pivot point, right? And so we got to clean up all that scar tissue so that they can get a much flatter contour on their tummy.

Dr. Bob Basu: And so typically it is very common for us to remove C-section scars. There are some folks that asked me, "Is it possible to do a tummy tuck with a C-section?" And let me be blunt, that's a really bad idea, and I'll tell you why. When you're getting a C-section done, first of all, the OBGYN needs to be focused on delivering your baby safely and keeping you safe. And oftentimes during the C-section, there is some blood loss, it's simply not a good time it's not safe time to do any elective cosmetic surgery at the time of a C-section.

Dr. Bob Basu: The second reason is you're not going to get a good cosmetic outcome because you're trying to tighten the tummy over a big enlarged uterus. What really needs to happen is that you need to give time for your uterus to shrink back to its normal size, which can take two, three, four months or longer. Once that's shrunk down, then your tummy will settle back down, then we can bring you back and do a tummy tuck where you're going to see the results. So I think it's a really bad idea to consider any elective cosmetic surgery at the time of the C-section.

Dr. Bob Basu: No two mommy makeovers are the same and I'm not suggesting that each mom is a snowflake, but I'm saying that each procedure is unique and let me give you the example. Mommy makeover number one could just be a breast augmentation and a tummy tuck. Another mommy makeover could be a breast reduction with a breast lift with liposuction to the lateral chest wall with an extended tummy tuck and liposuction have the upper and lower waist. So the costs do vary, there are ranges, and I think the first point to start out with is to go to our website, but to really get granular information about the cost it's important to speak directly to our patient consultants. And that's where you're going to get the most accurate information.

Dr. Bob Basu: And our patient consultants are experts at helping patients get the right financing package for them should they choose to finance their procedure, which is very, very common. So it's quite common for patients to fly in for surgery. Our patient consultants are experienced at helping patients with logistics in terms of travel arrangements. And so typically we try to facilitate the consultation with an initial virtual consultation, so that at least we can have a discussion. Obviously there are some inherent limitations with a virtual consultation, but I think that's a great first step for patients to be educated about what their options may be. I can evaluate their photos before the virtual consultations, at least give them a preliminary assessment of what may need to happen. Of course, a physical exam is required before any surgery, which I do perform so that I can confirm what we're going to be doing or if we need to modify the plan based on the anatomy. But it's quite common for patients to fly out of state for their mommy makeovers.

Dr. Bob Basu: And prior to the COVID pandemic, we were seeing patients flying internationally to Houston as Houston is the energy capital of the world and we have a lot of international patients that fly in and out of Houston. And hopefully as the pandemic gets behind us, sooner than later, we'll start seeing our international patients again. So to learn more about mommy makeovers, I encourage you to visit our website. We have hundreds of mommy makeover before or after photos on our website, which is Basu, B as in boy, A-S-U plasticurgery.com. Or you can follow us or find us on Instagram @basuplasticsurgery.

Speaker 2: Take a screenshot of this or any podcast episode with your phone and show it at your consultation or appointment to receive $50 off any service at Basu Plastic Surgery and Aesthetics. Basu Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. To learn more about the practice or ask a question, go to basuplasticsurgery.com/podcast. On Instagram follow Dr. Basu and the team @basuplasticsurgery. That's @basuplasticsurgery. Behind the double doors is a production of the The Axis, theaxis.io.