For many moms obtaining a pre-pregnancy body shape is not easy. Diet and exercise alone cannot always remove areas of stubborn fat, remove loose skin, return volume and fullness to the breast or reduce stretchmarks and cellulite. In this interview with Aesthetic Insider™ Radio, Dr. Joshua Kreithen of Holcomb-Kreithen Plastic Surgery and MedSpa located in Sarasota, FL, discusses new options in body contouring for post-pregnancy moms and anyone seeking to improve their figure or obtain a more sculpted physique. This is an exciting time in medical aesthetics with many new advances in surgical options to improve the breasts or perform a tummy tuck, as well as non-surgical technologies that tighten tissue, and reduce the appearance of stretch marks and cellulite. Dr. Kreithen explains how the Mommy Makevoer has become a popular surgical procedure for many doctors and their patients. To learn more about Dr. Kreithen visit www.sarasota-med.com.
What is typically included in a Mommy Makeover procedure?
The Mommy Makeover is one of my areas of expertise, and has become a very common procedure for women. The goal of a Mommy Makeover is to help patients restore their bodies to their pre-pregnancy form. Mommy makeover is a term for multiple procedures that help patients get their body back in shape once they are certain they are finished having children. Usually, it includes a tummy tuck and/or liposuction and a breast augmentation and/or breast lift. Each patient is different before pregnancy, and after, so a true Mommy Makeover is as individual as the mom. In some patients, we might also help with stretch mark and cellulite reduction, or an additional liposuction procedure if needed.
What is a Tummy Tuck?
The first thing that always amazes me is the variety of different anatomies that I see. After having children, some women’s bodies look almost exactly the same as they did before they became pregnant. Their skin is still taut across their abdomen and they have little to no stretch marks. Then, on the other end of the spectrum, some women’s abdomens are ruined after pregnancy because the abdominal wall has been stretched further than the muscles can handle and require a Tummy Tuck. Regardless, after a pregnancy there are almost always stretch marks and something called diastasis. Diastasis affects the two muscles that go up and down the abdomen, called the rectus muscles. When a woman is pregnant and her tummy expands as the unborn baby grows, those muscles stretch apart, sometimes never returning to their original state. Part of the Tummy Tuck procedure involves removing the extra skin and tightening those muscles back together, almost like creating an internal corset. This also helps with the definition of the abdomen in terms of someone working towards that “6 pack”.
Does a Tummy Tuck leave a scar?
When I perform a Tummy Tuck procedure, I would love to say that the scar is imperceptible, but it is not and it is the tradeoff to the patient to have a flat tummy again. It’s part of the surgery. Typically, a Tummy Tuck requires an incision from hip to hip, but we place it low down on the abdomen so that it can be hidden by underwear or a bikini bottom. The scar does fade overtime, and we provide the patient with scar fading solutions, but a scar will remain. Often the skin over the belly button also gets stretched during pregnancy, so I use a new technique where I can remove that hooding of tissue and, using the existing belly button, create a new one that looks very natural afterwards.
What is the most common procedure in a Mommy Makeover?
Typically a Tummy Tuck, and almost always a breast procedure. The most common is Breast Augmentation in conjunction with the Tummy Tuck, and these two procedures can be performed at the same time.
How long after having a child would a woman typically undergo a Mommy Makeover?
There is no real time frame as I treat women of all ages for a Mommy Makeover. The most important factors are that a patient should wait until she is certain that she will not be having more children, and how long is it since they stopped breast feeding. I recommend waiting a minimum of 3 to 6 months after breast feeding ends before considering a breast procedure. That way we have allowed adequate time to ensure that there is no more milk being generated by the breast tissue. We also want the patient to get back into the best shape they can prior to surgery. At about 6 months the patient’s body is generally settling in to how it will look from that point on , which allows me to make the best possible plan for the breast augmentation and/or breast lift, or any other combined procedures.
How long is the surgery and recovery time for these procedures?
That varies from procedure to procedure. For example, a tummy tuck procedure lasts for about 3 hours on average. Breast augmentation is 1 ½ hours to 2 hours, but in conjunction with a breast lift, closer to 3 hours. Therefore, mommy makeover procedures can be lengthy and last up to 6 hours. They are usually performed in a hospital and patients stay overnight for pain control and safety issues. As far as recovery time, they are going to be sore for a couple of days and feeling good within the first week. However, my rule is four weeks before full exercise, heavy lifting, aerobics, heavy house work,etc.
Would you say this is one of the more life-changing procedures you perform?
Depending on your meaning of “life changing”, it definitely can be. I enjoy helping women get back to where they were before having children and feel fortunate that I can use my artistic, creative physician skills to help my patients feel great about themselves and look their best. I also do similar procedures with weight-loss patients where people lose over 100 pounds and those are very transformative operations.
If the patient required liposuction, or another procedure, would you do that at the same time as the mommy makeover?
Yes, liposuction is one of the more common procedures I do, and its part of the mommy makeover procedure. For example, if a patient has some love handles or some extra fat on their back, I’ll do liposuction throughout the procedure while I’m doing the tummy and the breast.
How do you treat cellulite?
Yes, cellulite is often exacerbated by pregnancy. Typically, women will gain anywhere from 15 to 75 pounds and that extra fat can make the cellulite look worse. We have a couple of different devices at our practice which can effectively treat cellulite, Cellulase and Cellfina. Cellulase is a laser that helps to tighten the skin, break up adhesions, and melt some of the fat. The other treatment, Cellfina is performed under a local anesthetic, helps reduce the dimples and has been very effective. I usually don’t perform these procedures during the mommy makeover operation, but it is certainly something I do in my office as an outpatient procedure to help mothers improve skin quality on their legs and buttock if they have cellulite.
For “non-mommy’s”, do you have any other types of body contouring procedures?
For patients with larger areas of fatty excess, the Smart Lipo laser procedure we offer works very well. We also have some non-surgical treatments in our office, Cool Sculpting and Sculpsure. Cool sculpting is a machine that delivers cold energy to freeze the fat cells, and overtime the fat cells absorb over a period of 2 to 6 months, resulting in a loss of fatty cells and tightening of the fatty tissue. Sculpsure, is the opposite, and uses the laser energy to heat up the skin and the fat. Then, over time, those fat cells are also absorbed. The Cool Sculpting is used for larger areas whereas the Sculpsure is designed for small areas and spot treatment.
Who is the ideal candidate for surgical and non-surgical body contouring procedures?
The ideal patient is a healthy patient, non-smoker, and someone who is motivated to look their best. These operations are not designed for weight loss, but for re-contouring of the body. Overweight patients and patients with major medical problems are not great candidates. Typically I want my patients to have their BMI at 30 or below. If someone comes in overweight, it’s not that we don’t do the surgery, but we will work together to get their BMI closer to a normal level. There is a reason for that, because I have found that patients who are overweight have higher rates of complications and have issues with healing and results. So, certainly the ideal patient is someone who is in the best shape they can be coming into the operation. They are going to heal better and be happy with the results.
What can a patient do to best maintain their results and keep what you have created for them?
That is a great question. I take a holistic approach to healing with my patients, so we look at all the factors. We provide our patients with pre- and post- surgical vitamins, so that they have the adequate supplements and vitamins to heal during the recovery process. We also make certain nutritional recommendations in terms of what to eat, including increasing protein intake. In terms of the actual operative site, we instruct some massage therapy techniques to help with swelling along with compression garments. Finally, we ramp up their activity level over a 2 to 4 week period and instruct them on their restrictions so that they can get the best results possible.
Holcomb Kreithen Plastic Surgery is renowned for its expertise in facial plastic surgery, plastic surgery of the breasts and body and cosmetic laser surgery. Additional core areas of focus within H|K MedSpa include non- and minimally-invasive body contouring, facial aesthetics, medical hair restoration, laser skin rejuvenation and medical skin care. With its comprehensive range of services and dedicated staff the practice has developed a reputation as one of the most advanced centers in Florida. Receipt of the Allergan “Black Diamond Award” is an objective benchmark for the practice’ success, ranking it among the top 1% of practices in the entire country providing Botox Cosmetic, Juvederm (including Voluma) injectable gel, Latisse, Natrelle breast implants and SkinMedica skin care. To learn more visit www.sarasota-med.com.
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