You should be at your ideal weight and fitness level before a "mommy makeover"

Karen M. Horton, MD answers: Tummy Tuck for skin, fat, and stretch marks after pregnancy?

I'm 5'11 and 249 lbs. After pregnancy, I have a hanging mass of skin, fat, and stretch marks. I went from 186 lbs to 277 lbs. I have zero elasticity, and 1 week after I had my daughter, I had dropped from 277 lbs to 231 lbs. I am still overweight and currently trying to lose the weight, but I have this hanging mass on my stomach of stretch marks and fat. It's horrific. I want a tummy tuck and have done a lot of research, but how much will it cost me? How much do I need to lose before I should have the surgery? I don't accept blood at all, is that a concern?


By Karen M. Horton, MD - San Francisco Plastic Surgeon

For any Mom considering Plastic Surgery such as a "mommy makeover", I always advise women to achieve their weight loss goals prior to seriously considering surgery.

You should have lost as much weight as you feel is reasonably realistic, be physically fit, and have healthy nutrition as part of your lifestyle.

There should also be "calmness" in your personal and/or professional life. Chaos is never a good fit with surgery!

Most Moms seek a full abdominoplasty (tummy tuck), which removes excess lower abdominal skin and fat (including some stretch marks!), tightens the muscles of the abdominal wall back together, and decreases the waist line. Sometimes liposuction of the flanks and/or upper abdomen are added to the procedure, if needed.

For women who have not yet reached their ideal weight but who have a large overhang of skin and fat (a "pannus") in their lower abdominal region, it is possible as an interim procedure, to do a limited "panniculectomy". This will only remove the overhang but will not address the abdominal muscles or the upper abdomen.

Be sure to visit a Board-Certified Plastic Surgeon with a great deal of experience in these types of procedures!

Karen M. Horton, MD, MSc, FRCSC

Abdominoplasty and liposuction have different goals and outcomes

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Karen M. Horton, MD answers:

Lipoabdominoplasty vs regular abdominoplasty for post pregnancy body?

"Does it make a difference? I've had 3 kids and definitely need some help in my stomach area, but I'm not sure what procedure I would need to get my pre-baby figure back."

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Abdominoplasty and liposuction have different goals and outcomes

Answer by Karen M. Horton, MD

San Francisco Plastic Surgeon

If you are a mother who has completed her childbearing, congratulations both on your wonderful family you have created and to entering the next stage of motherhood!

Many women find their abdomens have permanent changes following pregnancy, including stretch marks, loss of abdominal tone, excess skin and extra fat deposits that have accumulated since having babies.

Most mothers do not have complete recovery of their bodies after children.

Moms often seek rejuvenation of their tummy areas once they have finished having kids.

A "mommy makeover" surgical procedure should only be considered at least 6 months after the birth of your last child so that your body has the chance to recover as much as possible and to enable you to achieve as much as you can on your own, with a healthy diet and regular exercise.

Two main Plastic Surgery procedures apply to the post-pregnancy tummy:

Liposuction will remove excess fat in areas that are stubborn to weight loss, such as the abdomen, flanks, pubic area, and thighs. Liposuction will not address excess skin or stretch marks, and will not help to tighten abdominal tone.

An abdominoplasty or "tummy tuck" addresses both the inside and the outside of the abdominal wall, in a three-dimensional manner:

Tummy tuck surgery not only removes excess skin and fat from the lower abdomen (including some stretch marks), it tightens the muscles of the abdominal wall through "rectus plication" which "corsets" the fascia overlying your abdominal muscles together in the midline and truly decreases the diameter of your waist from the inside!

Depending on your particular situation, either liposuction or a tummy tuck, or both, may be recommended to achieve your specific goals.

Be sure to consult with a Board-Certified Plastic Surgeon with specific experience in these types of surgeries to learn more and to evaluate all of your options.