Mommy Makeover: Podcast and Infogram

Ariel: Hello and welcome to Plastic Surgery 90210. My name is Ariel, and we're here with board-certified Plastic Surgeon Dr. Katzen. How are you doing?

Dr. Katzen: Good, thanks. How are you?

Ariel: I'm wonderful, thank you.

Dr. Katzen: Yes.

Ariel: Let us talk about mommy makeovers.

Dr. Katzen: Mommy makeover is a term to address the female body after pregnancy. With pregnancy, the tummy gets bigger, you deliver the child, and the tummy shrinks. A lot of women are left with some excess skin in the tummy. Typically, a mommy makeover entails addressing the tummy portion with a tummy tuck. There are a variety of types of tummy tucks I do. Typically, the most common tummy tuck is called a horizontal tummy tuck, where we're making the incision horizontal-like in your belt line. From that area, we can get rid of the extra skin, get rid of some extra fat, and tighten up the six-pack muscle, giving you a nice flat tummy.

In addition, with pregnancy, the breast develops milk for the baby. Then you nurse your baby. After you finish nursing, the breast involute or goes down. The breasts shrink, and then plastic surgeons can step in and do breast surgery. Typically, a mommy makeover involves a tummy tuck of some form and breast surgery. The breast surgery can entail just a lift, lifting the breasts back to where they need to be. Sometimes, if women want the breast larger, plastic surgeons will place a breast implant. If some patients want their breasts smaller, plastic surgeons perform a breast reduction.

Ariel: Therefore, procedures for a mommy makeover are the tummy tuck and the breast tuck or a breast lift.

Dr. Katzen: Correct, breast lift.

Ariel: Okay. And what can they do in combination with those procedures?

Dr. Katzen: Some Plastic surgeons also do liposuction with a mommy makeover. Traditionally, the term mommy makeover is a tummy tuck and a breast lift procedure. It could be an augmentation or a reduction. However, you can do a liposuction of the arms, neck, back, hourglass lines on the side, or maybe even liposuction of the thighs. All these can be combined with the mommy makeover. However, by definition, it is different than what is classically interpreted as a mommy makeover.

Ariel: Yes, but don't worry. Even though what you want might not be classified as a mommy makeover, your plastic surgeon will tailor the surgery to your needs as long as it is safe and recovery is undoable for the patient. Do you want to talk about that?

Dr. Katzen: Yes. When I meet with patients, I spend a lot of time with them, trying to understand what bothers them the most. It is not what bothers me the most; it bothers the patient the most. When I assess the tummy, I try to determine what bothers them the most. Is it the belly button, is it the area that hangs over the pubic region, or is it the stomach bulge? The breast, we spend a lot of time figuring out exactly what bothers them most. I wouldn’t say I like operating in areas that don't bother the patient. It doesn't make sense. So if your tummy and breast bother you … “Boom” mommy makeover; if your arms and other body parts bother you, I may combine those into one safe surgery.

Ariel: Yes. Dr. Katzen is different from the type of plastic surgeon who will recommend a rhinoplasty if you're coming in for a tummy tuck because that is not what you believe in.

Dr. Katzen: Yes. I don't like that style. Some patients will walk into a plastic surgeon's office and think, okay, I've been setting up this consultation for months now, and I think I need a tummy tuck. Then they meet with the plastic surgeon and say, "Oh wow, my gosh, this is great. The plastic surgeon goes through head to toe what they need. And then finally, the plastic surgeon, not the patient, the plastic surgeon decides, oh, you need a rhinoplasty. The patient leaves with a quote for a nose job. They came to the office initially for a tummy tuck. The patient got completely turned around into what they wanted.

Ariel: Especially because so much of it, what we care about is what bothers the patient. It is not about what bothers you, Dr. Katzen. We want the patients to be happy at the end of the day. It is not our place. It is not your or anyone's place to judge the patient for what they want.

Dr. Katzen: Correct.

Ariel: Cool. Let us talk about other procedures we can combine for a mommy makeover. Can we do a mommy makeover and arms?

Dr. Katzen: Mommy makeover and arms, yes. During a mommy makeover, I am performing a tummy tuck and a breast procedure. You can do arms, but that is pushing the envelope. Also, it depends on what I am doing on the arms. Am I doing liposuction in the arms, or are we doing a full arm lift? Just be aware with the tummy tuck, your core is taken out. Doing a sit-up or flex isn't easy, so you rely on your arms to lift you. It is hard to maneuver if your arms are operated on and your core is wiped out. If you have help, you can do the arms with a mommy makeover.

Ariel: Got it. Do people ever do tummy and thighs?

Dr. Katzen: Tummy and thighs, Yes. I do that quite frequently. I often combine the tummy with a circumferential 360 lower body lift with the thighs because it is the lower body. When I perform the lower body, you can use your arms as the upper body to maneuver and get around.

Ariel: Great. What is recovery like for a mommy makeover?

Dr. Katzen: Yes. The surgery is done under general anesthesia. You're completely asleep and monitored by an anesthesiologist. You're completely asleep. The procedure takes anywhere between 6 and 8 hours, depending on how much work needs to be done. The tummy tuck takes 3 to 4 hours; the breast takes about 3 to 4 hours depending on wherever I am putting an implant in, how much a breast lift I am doing, how much of a reduction I am doing, et cetera. And then the recovery is usually about 10 to 14 days. It depends on what activities you do. It depends on if you are mostly a sitting job or lifting a lot of heavy stuff in a hardware store—usually about two weeks. Recovery also depends on how much tummy I am doing. Is it just a tummy tuck, or am I taking off 20 pounds? That is a bigger procedure and a longer recovery.

Ariel: Right. Do you require your patients to reach their goal weight before their procedures?

Dr. Katzen: Not necessarily. We like to see trends. Instead, I have patients who may have weighed 400 pounds and lost a significant amount of weight, like 200 pounds. Their gastric surgeon is happy with their results and their progression. However their weight has plateaued at the 200-pound weight loss level. It is a good weight loss. They've lost 200 pounds, but they still weigh 200 pounds. Those patients may have yet to reach their ideal body weight. Since they've lost 200 pounds, their bodies may not be able to lose that much more weight physiologically. Then, they're able to undergo these surgeries.

Ariel: Great. The other question that we always get asked is, what are your BMI requirements?

Dr. Katzen: It depends on the patient. More and more plastic surgeons are realizing that not all patients are physically capable of reaching that BMI of 30. They may have lost 400 or 500 pounds, and reaching a BMI of 30 is physiologically impossible. One of our procedures, fat transfer, needs patients to have a higher BMI. To have that fat to allow us to do that BMI and fat transfer. If you have a lower BMI, you don't have the fat, and how will I be able to transfer fat if we don't?

Ariel: True. When you're doing these massive skin removal surgeries, that will affect the BMI, too, right?

Dr. Katzen: Absolutely. The other day, I removed 28 pounds by removing the skin of the fat That will drastically change that patient's BMI result, bringing them down to a healthier level. Getting rid of that skin and fat also enables people to exercise more because that apron of skin is gone, and they can move around more.

Ariel: What do you find satisfying about mommy makeover surgeries?

Dr. Katzen: The result is on the table. Depending on the patient, I sculpt the body for 6 to 8 hours. The results can be extremely dramatic. You can see it right on the table-nice concave tummy and younger, perky breasts.

Ariel: You help many moms get to the bodies they've always had or even better and still see themselves having, you know?

Dr. Katzen: Yes.

Ariel: For patients it must be difficult to go through all these changes and not recognize yourself anymore.

Dr. Katzen: Correct. After children, your body and life change. Some moms wish they had a body like before pregnancy, and some imagine a body they've never even had. Getting those moms as close to or even past that goal with plastic surgery is exciting.

Ariel: Do you see a lot of happy tears when people look at their results?

Dr. Katzen: Yes, it is quite exciting. We take off their dressings, and they look in the mirror, and they're like, oh wow! Oh, my gosh. “Is that me?” A lot of patients will do double takes in the mirror at home. They'll walk past a mirror and go, “Whoa! Is that me?”

Ariel: That is interesting. And right. Thank you, Dr. Katzen, so much for joining us for Plastic Surgery 90210. Please give us a call or DM us if you guys have any questions. We are doing consultations with Dr. Katzen all the time.

Dr. Katzen: Yes.

Ariel: Yes. Thank you so much. I will see you next week. Bye.

Dr. Katzen: Bye-bye.

About the Author: Dr. J. Timothy Katzen is an experienced, board-certified Plastic Surgeon. Dr. Katzen has Beverly Hills, CA, , and Dubai offices. Dr. Katzen specializes in reconstructive plastic surgery after massive weight loss and the removal of silicone injections from the buttocks, breasts, and face. He loves kite surfing, SCUBA diving, and underwater photography in his spare time.

Call 310-859-7770 or email [email protected] to schedule a consult with a board-certified plastic surgeon like Dr. J. Timothy Katzen in Beverly Hills. View his before and after photos and watch his procedure videos on Youtube.