Cosmetic Surgery Trends and Options

The physical demands of pregnancy can take a toll on a mother’s body. Winter Park based, board certified plastic surgeon James Baker, MD, FACS, explains that “the abdominal muscles separate and the skin stretches to allow the uterus to grow. The mom is often left with loose or sagging skin that is frequently attributed to the relaxation of the anterior abdominal wall muscles.” In addition to diet and exercise, many mothers are reclaiming their pre-pregnancy bodies with the help of cosmetic surgery. Plastic surgeons are answering the demand with what’s been coined the “mommy makeover,” which typically includes a tummy tuck, breast lift or augmentation, and liposuction.

Figuring Out Your Figure Options

“As new approaches develop, more women are choosing cosmetic procedures to improve their body and self-confidence. The decision can be driven by post-pregnancy issues, general dislike or sense of inferiority surrounding a particular body part, or even a divorce that puts her back on the dating scene and looking to regain her best appearance,” Dr. Baker said. “Enhancements in body contouring, like ultrasound liposuction versus conventional (lipo), and other new techniques, now offer less bruising and less discomfort. We want patients to recover as quickly as possible and, therefore, resume their normal lives.” Statistics from the American Society of Plastic Surgeons (ASPS) show that mommy makeover procedures are, in fact, on the rise with percentage increases steadily climbing since 2000. In 2010, women had nearly 112,000 tummy tucks (up 85%), 90,000 breast lifts (up 70%), and 296,000 breast augmentations (up 39%).

“Pregnancy can cause significant changes to the body, including breast volume from lactation,” explains George Pope, MD, FACS, an Orlando physician, board certified in plastic surgery and otolaryngology (ENT).  “Breastfeeding may cause involution of the breast or tissue to shrink. However, the skin envelop is still large and doesn’t always contract down to its original size. Therefore, replacement of volume and sometimes lifting of the nipple is most effective.” That was the case for 42-year-old Ocoee resident Gloria Boisvert, who breastfed each of her two children for over a year. “I didn’t want bigger breasts, per se, but just to restore what I had before.” Bosivert opted for a fat grafting method, a technique growing in popularity, which uses one’s own fat to enhance the breasts’ volume.

Based in Lake Mary, Carlos Mercado, MD, a Cosmetic Medicine Affiliate member of the American Academy of Cosmetic Surgery, says that many patients, like Gloria, are looking to obtain results without the use of traditional implants. “Our Natural Breast Enhancement technique uses a simple fat transfer procedure to add natural volume and increase breast size by one to two cup sizes. Your own fat cells are a rich source of regenerative cells,” says Dr. Mercado. The technique harvests fat cells from one’s abdomen, hips or thighs to redistribute into the breast and uses gentle liposuction to contour the harvest site. Dr. Mercado says that his patients receive desired outcomes with little discomfort and faster recovery, but notes that fat grafting is not ideal for all patients. “It’s one alternative to restore some volume, which may have been lost from pregnancy, rather than a patient who lost a significant amount through weight loss.”

Dr. Baker prefers to use fat grafting to supplement the “fatty layer” of the breast, but not the breast tissue itself, “Fat is helpful to contour a breast that may have an indentation from a biopsy. However, I include prostheses (implants) for augmentation, because as much as 20% of fat can be absorbed or lost.” Dr. Pope agrees, “Fat grafting is beneficial for women who need reconstruction to assist with holing, especially after a mastectomy. However, fat grafting research continues to expand, and is now the hot topic in the field.” According to Dr. Mercado, “fat grafting and stem cell rejuvenation are the way of the future.” In fact, he now offers patients fat banking services to store fat for future procedures and treatments.

Breast augmentation continues to top the 14.6 million cosmetic procedures performed each year, with the majority being silicone implants, followed by saline implants. Earlier this year, the FDA approved the Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Gel Filled Breast Implant, known as “Gummy Bear” implants because of their feel and consistency when held outside the body. The teardrop shape is said to give a more natural-looking result with less likelihood to wrinkle or show visible edges, in comparison to existing silicone gels.

More than 13 million minimally invasive cosmetic procedures were performed in 2012, according to ASPS, such as Botox, soft tissue fillers, chemical peels, laser hair removal, and microdermabrasion. “Aside from breast augmentation, women in their twenties are deciding to relax forehead muscles at an early age with Botox, in hopes of preventing permanent lines and wrinkles later on,” said Dr. Pope. Dr. Baker adds that minimally invasive treatments are often a way for patients to “get their feet wet” with cosmetic procedures. Additionally, Dr. Pope has observed that trends, “for women in their thirties include Botox (and the mommy makeover), then progression to facial fillers and breast lift/reduction in the forties, and face/eyelid lift in the fifties.” Lesser known cosmetic options are gaining popularity. “Botox is now used for hyperhidrosis (excess perspiration) with a superficial injection of 50 units per armpit to stop sweat gland production for up to one year; whereas Botox injections in the face usually last three months,” explains Dr. Pope.

Celebrities’ body types can influence hikes in specific cosmetic procedures…including the toned limbs of Michelle Obama! Last year, more than 15,000 women had arm lift procedures, a growth of 4,378% since 2000; many citing the First Lady as inspiration. However, arm lifts are not typically associated with mommy makeovers. “An ideal candidate might be an obese patient who lost weight and wants to cut off the ‘bat wings.’ But, as with any surgery, patients need to decide if the deformity from the procedure (the scar) will outweigh the existing body deformity (current state),” Dr. Baker cautions.

Similarly, the ‘bum’ of Pippa Middleton, sister to Princess Kate Middleton, joined the ranks of celebrities’ most admired derrieres. Originally from Colombia, Dr. Mercado says his innovative Colombian Butt Lift creates natural and defined buttocks without the use of implants. “The key is to define the angle of the glute, in addition to enhancing volume. The technique uses Aquashape Liposuction to remove unwanted fat deposits in the body, such as from love handles or lower back, to achieve the desired silhouette.” The fat is then processed in an onsite laboratory and sometimes combined with stem cells; then, re-injected into the buttocks. Dr. Mercado also utilizes ‘Cell-Assisted Therapy’ for treatments to the face, hands, joints, and even sex organs to help address sexual dysfunction.

Mommy’s Date with the Doctor

The ASPS advices mothers to: 1) find a board certified plastic surgeon and review his/her work through before & after photo testimonials; 2) wait at least six months to one year after having their last child; 3) communicate specific body goals to one’s surgeon to determine the most appropriate procedures, and; 4) optimize the final outcome ─ for example, if you are trying to lose weight, do so before undergoing procedures. Boisvert acknowledges that losing weight after her fat grafting breast augmentation did, in fact, alter her results, but overall, she says, “I am 100% happy with my lift. I feel more confident.”

A surgeon will, of course, speak to a patient about the elements of a mommy makeover, including recovery. Conversely, it’s up to the patient to decide how much to share with her children about how and why her body looks different. A mother of young children might reassure them that the procedure doesn’t mean that she is sick or hurt. Some choose to have children stay with relatives during recovery to limit exposure to visible bruising and bandages. Others use the time as a way to empower youngsters. “If the child is old enough to walk, they can do big boy or girl tasks, such as bring mommy a glass of water or help daddy in the kitchen. The child will feel good to be a helper,” says Dr. Pope. Parents of tweens or teenagers may choose to explain the decision with caution, not to put too much emphasis on the importance of beauty and self-acceptance.  “I explained to my teenage son and my tween daughter that having babies changed the shape of my body. Because I was comfortable with my former body shape, cosmetic surgery would restore that, and ultimately make me feel better,” said Boisvert. Most importantly, Dr. Pope stresses, mothers should ensure that children do not internalize the conversation into guilt, or that he/she altered mommy’s body. For more information, including local surgeons and procedure costs, visit PlasticSurgery.org.

OrlandoFamilyMagazine.com Parent Poll results:

Which cosmetic procedure would you consider having done?

• 68%  Breast augmentation
• 32%  Botox / Fillers
• 21%  Face lift
• 16%  Lipoplasty (liposuction)
• 16%  Rhinoplasty (nose job)
• 0%    Eye lid (blepharoplasty)