“There is nothing more beautiful than becoming a mother… but those body changes may not always feel beautiful.”
Common name – Mommy Makeover.
Technical name/also known as – Abdominoplasty plus Mastopexy/Reduction Mammoplasty/Augmentation Mammoplasty.
Benefits of a Mommy Makeover
This surgery is for women who have had one or more children and are not planning future pregnancies. It is the combination of two areas which commonly change after childbirth, the breasts and the abdomen. Sometimes liposuction or other procedures may also be performed at the same time. It is important that enough time has passed for the body to recover from the pregnancy and that women who opt for this have returned to a weight that they are comfortable with. They also should have stopped breast feeding for at least six months. You do not need to be a mom to have this makeover.
How it is done:
Abdomen: How the tummy is “tucked”
This procedure removes excess skin at the abdomen and tightens the rectus abdominis (the six pack) muscle. This is typically performed after a woman has had one or more children or in men or women with a history of large weight loss. This operation makes the abdomen flatter and helps to restore the continuity of the abdominal wall muscles often alleviating the “still pregnant” appearance of the abdomen. It can remove stretch marks if the stretch marks are below the belly button. The muscle repair may make core exercises more effective and in some can help back pain. Dr. DeLuca-Pytell performs this procedure without the use of drains.
For a stretched abdomen with stretch marks and hanging skin, a tummy tuck gives a flatter abdomen which responds better to toning exercises. Patients report feeling better in bathing suits and clothing and increased self confidence.
The tradeoff for a flatter abdomen is a long scar that spans hip to hip, and sometimes longer, as well as one around the belly button. Drains must be used and may stay for two weeks or so. Skin sensation may decrease below the belly button. Not all stretch marks can be removed. Sometimes, the excess skin may continue around the back for which a belt lipectomy (a tuck for the back) may help. The end of the scar may stick out after healing is over (called a dog ear) and need revision.
Breast Lift: How the breast is lifted
This surgery repositions the nipple to a higher position on the breast and removes excess skin. The areola is often made smaller. This surgery can sometimes be combined with a breast augmentation to make the breast larger in size. Two types of breast lift are offered: the inverted T/anchor scar or the vertical/lollipop scar. You will find which is right for you at your consultation.
The nipple position is corrected and the breast restored to a more youthful shape. This rejuvenation can be done without an implant, but size is not changed unless an implant is placed.
Permanent scars are a tradeoff. Sensation to the nipple can change.
Breast Augmentation: How the breast is made larger
An incision is made, and a pocket is created below the breast pectoralis major muscle. The attachments of the muscle to the lower portion of the breast are surgically divided as well as the attachments of the muscle near the border of the sternum to approximately nipple level. A temporary sizing implant is placed on both sides and brought to the volume chosen by the patient. At this point, the breasts are evaluated for shape and symmetry. If any changes need to be made, they are done with the temporary sizing implant. The permanent implant is selected based on the sizing implant and prepared carefully for placement into the breast pocket. Sutures are used to close the tissue and skin in layers. A bra is placed to hold dressings in place and for gentle support.
For women unhappy with the size of their breasts, an augmentation restores or improves breast volume with (almost) instant gratification. Patients report feeling better in bathing suits and clothing. Increased self confidence is commonly noted.
The final result is not seen right away. For most patients, the implants will “ride high” initially as the muscle pulls the implant up the chest. This is temporary and improves with time, but may take two to three months to drop. Because the muscle in the chest is cut, pain is expected. You will not be able to do all of your usual activities for up to six weeks. No breast implant is a permanent device. You will need at least one, if not more, operations in your lifetime for maintenance of the implants and the appearance of the breast.
Breast Reduction: How The Breasts Are Made Smaller
This surgery reshapes and resizes the breast by removing excess breast tissue and skin and repositioning the nipple and areola (the colored skin around the nipple) into a higher position on the chest (a breast lift is done with a reduction.) The inframammary fold, or the crease below the breast, is the reference point to determine where the nipple should be placed. The areola is almost always made smaller. In some cases, the nipple and areola are removed completely and reattached as a skin graft. Two types of reduction are offered: the inverted T/anchor scar or the vertical/lollipop scar. You will find which is right for you at your consultation.
For women suffering from pain in their back, neck, and shoulders, this operation gives almost instant relief from the strain of their overly large breasts on their body. Other benefits include better proportion, an easier time fitting bras, clothing, and bathing suits, and improved self-confidence. Women have also reported improved balance and an easier time participating in sports.
Initially, drains may be used after surgery. The size improvement comes with a trade-off for permanent scars. These are located around the areola (the colored skin around the nipple), vertically from the areola down to the fold, and may also include a scar in the fold itself. Nipple sensation may change or be absent after surgery. Women who want to breastfeed after this operation may be unsuccessful.
Who pays for this
This is a cosmetic procedure, paid for by the patient. For some patients with very large breasts who suffer from back, neck, or shoulder pain, health insurance may cover a portion of the procedure. It almost always requires precertification, meaning there is a list of qualifications that must be met in order to meet the criteria the insurance company puts forth to meet medical necessity. This can only be determined by examination. If criteria are not met, cosmetic pricing is offered.
My Post-Operative Bra Suggestions
Please click this link for suggested bras to be worn after surgery.
What to expect
Length of operation
4 – 8 hours (depending on the extent of procedure).
General anesthesia, you will be asleep and monitored the entire time.
In or out patient
An overnight stay in the hospital is required.
Length of results
Long lasting, especially when diet and exercise regimen are maintained.
Temporary swelling, bruising, and some pain commonly occur. Irregular skin contour may be noticed initially. For the first two weeks after surgery, sutures will remain in the hairline and facial skin which will be removed in the office. Sensation of the face may be different initially. Fluid collections below the skin are possible. Scars are permanent and may stay red for 6-12 months, but can be concealed with makeup once scabs resolve.
Risks of procedure
All surgery carries risk. I recommend patients carefully weigh the benefits of having surgery against the potential risks which may arise. Risks include pain, bleeding, infection, damage to nearby structures, need for other procedures, recurrence of skin laxity, dissatisfaction with appearance, asymmetry, seroma, sensory changes including permanent loss of sensation, temporary or permanent changes in facial movement, wound healing delays requiring wound care, deep vein thrombosis, and pulmonary embolus. A complete list of risks will be discussed with you before surgery.
“I love when patients tell me their friends and coworkers ask if they’ve gone on vacation or lost weight—their results are seen as a natural improvement. They look like themselves, just better rested.”
– Dr. Danielle DeLuca-Pytell
While we are under social distancing and shelter at-home instructions, I am offering virtual consultations for new patients interested in meeting with me.
You can do this from a computer (via an invitation) or a smartphone (via an invitation and the Google Meet app).
There are four parts to the consultation:
1. Arrange a consultation by phone or email,
2. Download the new patient forms. Click here.
After you fill them out, you can either fax or email them to me.
3. Once the consultation is arranged, a meeting invite will be sent to you with the link for the consultation. At our prearranged time, follow the link to our secure and private consultation.
There, you and I will have time to talk about your goals, medical history, and all about the procedure.
While the examination is limited to observation in two dimensions, I should be able to determine whether or not you are a candidate for surgery.
4. If you are indeed a surgical candidate, you will be contacted by Andrea, my patient coordinator, to get a surgical quote (or if insurance-based, your expected out of pocket costs), and an opportunity to hold a surgical date.
You will also be given a follow-up visit to confirm with your exam that you are a candidate and preoperative visit time for us to prepare you for surgery.
I hope to virtually see you soon!
Your Next Step!
Call or email us to schedule an appointment and find out if you are a suitable candidate for this procedure.
Our phone number
Give our office a call Monday to Thursday, 9am to 5pm, Friday 9am to 3pm.
Our email address
Please also email us anytime with questions you have.
Quick Contact Form
Before and After Gallery
When you come into the office for your appointment, you will be able to see more ‘before and after’ photos of this procedure including different options.
If healing proceeds as expected:
Rest at home (princess treatment) 2 weeks (no housework or exercise). Outsource housework a while you rest. Walk around the house, but do not work out. Rest with your head up and sleep with your neck extended (to avoid creasing) for the first two weeks.
Return to gentle exercise and household chores at two weeks, but no heavy lifting or strenuous activity for six weeks. May cover scars with makeup once scabs are gone. May resume work if it is sedentary. May color hair at three weeks after surgery.
Return to full activity 6 weeks after surgery.
Returning to Work
This depends on the type of work that you do. Many women can return to sedentary work at three to four weeks, though not everyone is ready to return to work by then. Surgery affects different people differently. If your work is more strenuous, six weeks off work may be needed.
Time until final appearance
3 to 4 months, depending on how swelling resolves
Length of results
Long lasting, but varies from patient to patient.
Smoking and Surgery
If you smoke, it is imperative that you quit six weeks both before and after surgery. To better understand why, please click this link:
A binder will be placed after surgery to help support the abdominal repair, similar to the idea of a splint for a sprained wrist. A high waisted girdle or compression garment is to be worn following the binder for a total of six weeks. A bra will be worn postoperatively to help support the breasts and hold dressings in place. A list of suggested bras will be provided after your surgery to wear until you can be fitted for a new bra at approximately three months after surgery. The scars usually take a long time to fade, often a year and a half.
If you color your hair, do so right before surgery as you will not be able to color your hair until three weeks following the procedure. Plan to bring a scarf with you to the hospital on the day of the procedure as well as dark glasses to camouflage your temporarily swollen appearance on leaving the hospital.
See what her patients have to say about their surgical experience.
Follow the link to read some of the many letters received by Dr. Danielle DeLuca-Pytell.
When you visit the office for your appointment, we will talk about the side effects and risks of this procedure.
You will have the chance to ask any questions you might have.
Don’t forget: it is your body! There is no such thing as a bad or silly question!