Is a mommy makeover safe? [Shannon O'Brien, MD, Portland]

Eva Sheie (00:00):
You're listening to Where Before Meets After. What is a mommy makeover and what surgeries are included in it?

Dr. O'Brien (00:08):
Mommy makeover typically involves the breasts and the abdomen as a combined sort of set of complaints that are often seen when women have had one or more pregnancies. So typically speaking regarding the breasts, it can involve anything from an augmentation, a breast lift, a combination of that, or sometimes a breast reduction depending on how the breasts have changed during pregnancy and/or breastfeeding. And then regarding the abdomen, usually a tummy tuck of some variety, sometimes liposuction, but oftentimes the skin has changed during pregnancy. So some type of tummy tuck or abdominoplasty is necessary.

Eva Sheie (00:51):
Is it safe to do all that surgery at the same time?

Dr. O'Brien (00:55):
It's safe. Yeah. And it's common in the sense that when we think about patient safety, we tend to look at how much are we expecting the body to be able to handle, to recover in a smooth fashion without having healing issues or being too worn out for too long. And we also look at other potential complications that can happen if somebody is immobilized for too long. And basically with this combination, ladies are able to get up and move soon enough after surgery that they limit the risk for things like blood clots or maybe pneumonias or things where folks really are bedridden or on bedrest. You're not ill, and so you can get up and go. And although you have to kind of force it a little bit while you're sore, it's absolutely doable. And so it's a safe operation, both from time of surgery, healing expectations and limiting complications.

Eva Sheie (01:58):
Is there ever a circumstance where you would separate the surgeries into two stages?

Dr. O'Brien (02:03):
Sometimes we do separate the operations into two stages. Some ladies' breast anatomy is such that doing a breast lift and placing an implant at the same time is not going to be either safe or maybe not get us the results that we're hoping for. And therefore staging them out sets them up for success and safety. So doing those as two operations rather than one combined is sometimes the best path, even though it does require two operations. Obviously you're always looking for the best result, the longest lasting result. How are things going to be stable and really look the way you want them to, not only in the short term, but in the long term. And so sometimes two operations is better than one. Also, depending on a patient's health level of health, sometimes a bigger operation is maybe not the right way to go. If somebody has certain illnesses or things like that, or just if they don't have enough time to heal from one big operation, then sometimes you do two smaller operations to really get them back in a reasonable timeframe where they're not going to stress themselves out too much trying to get back too soon.

Eva Sheie (03:19):
How long does that mommy makeover recovery take when you've done both a tummy tuck and some kind of breast surgery at the same time?

Dr. O'Brien (03:26):
Most people are able to get back into work around two weeks after surgery. If they don't have a really strenuous job, they cannot have a job where they have a lot of lifting or physical requirements. That is most important when you're looking at the tummy tuck side of things because you have to sort of nurse the abdominoplasty along a little bit longer than the breasts.

Eva Sheie (03:56):
How long does it take to get back to quote unquote normal? When would you stop remembering that you had surgery?

Dr. O'Brien (04:02):
I would say the breasts tend to turn around a lot faster. And so the tummy is really the limiting factor as far as when you really feel like you're back to yourself and can do everything without noticing a pull or a little bit of pain or some tenderness somewhere. But by six weeks, I would say most people are back sort of feeling themselves. They've hit their stride from an energy standpoint. They may still have some pulling if they try to do core work or exercising, but in general, their day-to-day is as it was before surgery.

Eva Sheie (04:38):
What kinds of things do moms say to you after they've kind of made it through the woods and they're six weeks out or further out about their results?

Dr. O'Brien (04:48):
These operations are very fun for me because the outcome is so visible. The results are so positive that even though there is the healing period where folks know they have to get over that hurdle, afterwards they're smiling. They're glad they did it. They can't believe that they feel like they're back to where they were before, or sometimes they've made changes that had never been the way they wanted to see them and now they are. So it tends to be a really positive experience for ladies.

Eva Sheie (05:22):
What would you recommend doing about not the physical, but the mental aspect of maybe what we would call mom guilt, where we don't think that we deserve to actually do this because everybody else needs stuff or the house needs things?

Dr. O'Brien (05:37):
Mom guilt is real and it is a tough thing to deal with to feel like you're okay with doing something for yourself is something that you are often not in the habit of saying or of allowing yourself. And it is commonly expressed as a concern. People ask if they're being too vain or if they're neglecting something in order to take care of themselves. But afterwards, I will say that ladies really do feel like they're glad that they did it and they don't really look back and regret it because I think that everybody pushes things off to a point where oftentimes by the time they have taken that step to take care of themselves, they come back and they say, "I wish I had done it earlier. Why did I wait so long?" And when the babies are little, it's tough as they get older, they get involved in other things.

(06:39):
And so then it's like, "When am I not needed to drive?" And then they get older and you're like, "Well, am I too old to do it? " And the answer is people are happy with their results at any age.

Eva Sheie (06:52):
Does anyone ever ask you how to talk to their kids about having surgery?

Dr. O'Brien (06:56):
Sometimes people ask how to talk to their kids about having surgery, and mostly I really encourage them to only say what they feel comfortable with saying. I think that most kids just worry about their mom and making sure that she's okay. And in general, if they know that, I mean, depending on the age of the child, the conversations are obviously different, but when the kids are little, like, "Mommy's got an owie, just sit with me. I can't play today." Or as they get older, the conversations can become more complex or just sort of pushed to the side depending on someone's comfort.

Eva Sheie (07:36):
Thanks for listening. I'm your host, Eva Sheie. Follow the show and submit questions for our experts at wherebeforemeetsafter.com. Where Before Meets After is a production of The Axis.