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Mommy makeover – abdomen and breasts after pregnancy and breastfeeding
Pregnancy and breastfeeding change the body. If the abdominal wall and breasts no longer recover, specifically combined procedures may be an option – individually planned, without a package solution and with honest advice.
Many women come to me for a consultation some time after the birth of their children. Their concerns are similar: the abdomen bulges despite postnatal recovery exercises and sport, the skin has become slack, and the breasts have lost shape and fullness after breastfeeding. This is not a flaw but a normal consequence of what the body has achieved. However, if you feel permanently uncomfortable with it, you can seek advice on the options offered by plastic surgery.
What a mommy makeover is
A “mommy makeover” is not a surgical procedure in its own right. The term covers procedures that treat the typical changes to the abdomen and breasts after pregnancy and breastfeeding – usually in combination, sometimes in two steps. Which components make sense for you is something we decide together after the examination. I do not offer a fixed package.
The components in detail
Tummy tuck
In a tummy tuck (abdominoplasty), I remove excess skin and fatty tissue from the lower abdomen. If the straight abdominal muscles have separated during pregnancy, I can bring them back together in the midline during the same operation. The navel is repositioned at its natural position. The scar lies low above the pubic area and can usually be hidden under underwear or swimwear. More on this on the page Body contouring and tightening.
Breast lift – with or without volume
After breastfeeding, the breasts have often lost firmness and sit lower. In a breast lift, I reshape the glandular tissue, raise the nipple and remove excess skin. If volume is also lacking, the lift can be combined with an implant or with your own fat. If, on the other hand, the breasts are very large and a burden, a breast reduction may be an option. More on this under Breast surgery.
Liposuction
Stubborn fat deposits on the waist, flanks or thighs can be treated with liposuction. In combination with a tummy tuck, the aim is a harmonious transition from the waist to the abdomen. The suctioned fat can – if suitable – be used for breast augmentation with your own fat. More on this under Liposuction.
Diastasis recti: when the abdominal muscles separate
During pregnancy, the straight abdominal muscles move apart to make room for the child. In many women, the gap closes again after birth; in some, it remains. The abdomen then bulges – especially when tensing – despite training, and back pain or an umbilical hernia sometimes occur as well.
The first step is always targeted postnatal recovery, ideally with physiotherapy. If the gap remains large after a few months, it can be closed during a tummy tuck. Whether there is a gap and how large it is, I examine during the consultation, with ultrasound if necessary.
The right timing
A mommy makeover makes sense once your body has recovered from pregnancy and breastfeeding. I recommend waiting until these conditions are met:
- Breastfeeding finished – at the earliest six months after weaning, so that the breast tissue has stabilised
- Stable weight – as close as possible to your desired weight and constant for several months
- Family planning completed – a further pregnancy can change the result again
- Postnatal recovery completed – ideally with physiotherapy in the case of diastasis recti
- Support organised – for the first few weeks you will need help looking after your children
- No smoking – smoking significantly increases the risk of wound healing problems
In one or in two operations?
The abdomen and breasts can often be treated in one operation. This means one anaesthetic and one shared recovery period. However, the procedure then takes longer, and the strain on the body is greater. Whether a combination is justifiable for you depends on your state of health, the extent of the procedures and your personal circumstances. Sometimes it is safer to operate on the abdomen and breasts in two steps, a few months apart. Your safety always takes priority.
Process: preparation, procedure, aftercare
We decide on the place of the procedure during the consultation.
- 01a few weeks beforeConsultation and planning
Examination of the abdominal wall and breasts, goals and expectations, choice of components and sequence, preliminary examinations, informed consent and time to reflect.
- 02Day of surgeryOperation
Procedure under general anaesthesia; depending on the extent, with an inpatient stay.
- 03Weeks to monthsAftercare
Compression garment and support bra, wound checks, gradual return to everyday life and sport.
Recovery – planning well with children
- Day 1–3Feeling of tightness and swelling; a slightly bent posture when walking is normal
- Week 1–2Wound checks; office work possible after about two weeks, depending on the extent
- Week 1–6Wear the compression garment and support bra; do not lift anything heavy – not even your child
- from week 6Gradually resume sport – after consultation
- Month 3–12Swelling subsides completely, scars become lighter and softer
For mothers, the most important point is this: in the first few weeks you must not lift your child. So plan for support from your partner, family or friends. These figures are guidelines; the actual course depends on the extent of the procedure and on your healing.
Contact us immediately if you have fever, increasing pain, shortness of breath, calf pain, redness or discharge from the wound.
Risks
A mommy makeover involves major procedures. General risks include secondary bleeding, seromas (fluid collections), wound healing problems, infections, thromboses and embolisms, as well as conspicuous or widened scars. On the breasts, the sensitivity of the nipple may change; the ability to breastfeed may be restricted. After liposuction, irregularities of the skin surface are possible. If several procedures are combined, the risk increases with the duration of the operation. I discuss all risks with you in detail – and advise against a combination if it is not justifiable for you.
My approach
It is important to me that you make this decision for yourself – not because of other people’s expectations and not under time pressure. The goal is not to restore the body as it was before pregnancy, but a shape in which you feel comfortable again and that suits you. This also includes an honest assessment of what an operation can and cannot achieve. Stretch marks, for example, can only be removed by an operation where skin is removed.
Costs
A mommy makeover is generally a self-pay service. The costs depend on which components are combined, how complex they are and whether an inpatient stay is required. Whether an insurer covers part of the costs needs to be clarified in advance in each individual case. After the consultation, you will receive an individual cost estimate.
Frequently asked questions
How long should I wait after giving birth?
The body needs time to recover. I recommend operating at the earliest six months after weaning and waiting until your weight is stable and postnatal recovery is complete. For many women, this is about a year after giving birth or later.
What happens if I become pregnant again afterwards?
A further pregnancy is generally possible but can change the result again – especially on the abdominal wall and breasts. It therefore makes sense to wait with a mommy makeover until your family planning is complete.
How long may I not lift my child?
For about the first six weeks, you should not lift anything heavy – not even your child. Exactly how long depends on the extent of the procedure. Be sure to plan for support during this time.
Will stretch marks disappear?
Only where skin is removed during the tummy tuck – usually on the lower abdomen. Stretch marks above the navel remain but are often shifted somewhat downward. There is no guarantee of this.
Can I still breastfeed after a breast lift?
In a breast lift, the connection between the nipple and the glandular tissue is generally preserved. Nevertheless, a restriction of the ability to breastfeed is possible. We discuss this during the informed consent discussion, especially if a further pregnancy cannot be ruled out.
Will health insurance pay for a mommy makeover?
A mommy makeover is generally a self-pay service. Whether an insurer covers part of the costs needs to be clarified in advance in each individual case – please check with your health insurance before the treatment.
How visible are the scars?
The tummy tuck scar lies low and can usually be hidden under underwear; in addition, there is a small scar at the navel. In a breast lift, the scars run around the areola and, depending on the technique, vertically below it. Scars take about a year to become lighter and softer.