So you’ve had a few kids and now you’re 20-40 lbs heavier with breasts that are deflated, stretch marks all over your tummy, belly button & breasts. You have skin that hangs over your pubic area that prevent you from being able to tuck in any shirt or find clothes that fit nicely.

You try to eat well, exercise, and be healthy but all you see are your flat saggy breasts and hanging tummy skin. You get discouraged and depressed and you eat that extra piece of cheesecake because … what’s the use, nothing makes any difference!

Let me tell you, break the vicious cycle and take charge of your life. It is true, you will not be able to make the skin shrink or lift your breasts with diet and exercise but it will make you mentally feel better until you can get a MOMMY MAKEOVER!!

What is a MOMMY MAKEOVER? It can consist of a breast augmentation with a breast lift, tummy tuck with liposuction, and/or brachioplasty to reduce the skin of the arms. You can have all of these surgeries done at one time with one recovery depending on how much excess skin and fat will be taken off.

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An abdominoplasty or “tummy tuck” does require general anesthesia and can take up to several hours in the operating room. The length of time for the operation depends on the amount of skin that needs to be removed and how large a tummy you have.

If you are of “good health,” that is, if you do not have health problems with your heart and lungs, and have been cleared of any previous heart and lung problems, then you are a candidate for a tummy tuck or what I call a MOMMY MAKEOVER.

You also MUST be cigarette smoke free for at least 2 weeks before and for 2 weeks after the surgery. In fact, better results are had by those who don’t smoke at all in terms of better incision healing and fewer wound healing complications.

During a tummy tuck, I repair the rectus muscles that have become split as a result of pregnancy or perhaps were split even from birth. The result is a trimmer shape and waistline!

It is misleading to think that you will be able to sustain your new shape and size after plastic surgery if you are not willing to change your eating habit and/or exercise habits. While I will change your body absolutely remarkably in a way that you couldn’t have with diet and exercise alone, your shape will not be maintained if you don’t watch what you eat afterward.

My suggestion then is to get into the habit of at least walking 2-3 times a week to begin with for 10-15 minutes at a time. Once you get used to that level of activity then you should progress to at least 30 minutes 3 times a week then to everyday.

When I speak of changing eating and lifestyle habits, it can be as simple as portion control and giving up regular soda and skipping dessert 2-3 days a week and limiting the amount of carbohydrate intake without giving it up entirely.

A tummy tuck is an absolutely EXCELLENT way of getting rid of all your excess skin, stretch marks and fat that overhangs your midriff after children or weight fluctuations. In fact, it is the ONLY way to get rid of all that excess skin. You can lose the weight and tone up the abdomen with exercise and diet but  become extremely frustrated and discouraged when you see that torso has not changed one bit and in fact may look worse with the weight loss, when the skin looks even more saggy and flaccid.

Many of my patients such as yourself will come for a consultation when their weight loss or shape change plateaus with the exercise and diet and want to know what more can be done. This is an extremely important time not to “fall off the wagon, become discouraged” and bounce back to your previous  destructive eating binges and habits.

This is an ideal time to intervene with plastic surgery which can take you to the next level of a healthier lifestyle and new body. The tummy tuck is the “kick in the rear” that you need to stay on track and to maintain your healthier lifestyle.

When you can actually SEE the results of all your hard work with an incredible new body shape, you are much more willing and likely to maintain this new lifestyle permanently.

I hope this is encouraging and helpful and I will write more on the costs and recovery in my next MOMMY MAKEOVER BLOG.

If you are sick and tired of being trapped by your saggy, lifeless, flat breasts and hanging skin with stretch marks after pregnancy and breast feeding there is something you can do about it.

Plastic surgery to remove all that excess skin and fat and lift your breasts to their original position with fullness on top can be achieved safely.

If you are looking for a MOMMY MAKEOVER, you have found the right person in Dr Michele Koo, MD, FACS, St Louis, MO, who is a Board Certified Plastic Surgeon. She will listen to exactly what you want and be able to get rid of that frustrating hanging large belly that has made you depressed for years with liposuction and a tummy tuck (abdominoplasty). At the same time you can address your breasts which may have lost most of the nice sexy full volume and is now hanging on your abdomen. She will examine you and determine if you need a breast lift alone or a breast lift along with a breast implant (breast augmentation) to achieve that full, firm, sexy and lifted breast that you used to have.

MOMMY MAKEOVERS addressing the breasts and tummy in one operation is very safe and Dr Koo will let you know how much can be done at one time safely, and whether you can achieve what you are looking for with only a breast augmentation and liposuction or if you need more contouring by removing skin with a breast lift and tummy tuck.

One of the most important aspects in the success of any surgical procedure is the physical condition of the patient at the time of surgery. Even though liposuction, breast augmentation and a tummy tuck are elective procedures, Dr Koo assesses you using the same standards as those used for anyone who is undergoing any type of surgery. This is very important for your safety and well being. Dr Koo emphasizes your safety above all and ensures that you will have an excellent outcome safely.

Dr Koo specializes in contouring the body after pregnancy and weight loss. She obtains a thorough medical history from all patients who are to undergo a MOMMY MAKEOVER and a diligent physical examination is performed. Surgical history, including previous procedures is obtained for the YOUR safety.

Patients with comorbid conditions such as tobacco use, hypertension, coronary artery disease, chronic obstructive pulmonary disease, diabetes mellitus, hepatitis C, and human immunodeficiency virus are screened carefully. Patients with a history of pulmonary embolism, deep vein thrombosis, or blood clotting disorders require added precautions, such as chemoprophylaxis and sequential compression devices.

Dr Koo uses sequential compression devices in the majority of liposuction, tummy tuck, and breast lift and breast augmentation procedures. Conditions that may increase the risk for deep venous thrombosis include chronic venous insufficiency, family history of thrombotic syndromes, obesity, trauma, severe infection, polycythemia, central nervous system disease, malignancy, homocystinemia, a history of pelvic or lower extremity radiation therapy, and use of birth control pills or hormone replacement therapy.

Medications that the patient may be taking is reviewed, as many common prescribed and over-the-counter medications may affect wound healing and blood clotting. Medications such as aspirin, nonsteroidal antiinflammatory agents, birth control pills, vitamin E, and herbal preparations such as St. John’s wort are recognized to interfere with the coagulation mechanism. Dr Koo recommends avoidance of such agents before surgery. Some medications may also interact with medications used during surgery.

MOMMY MAKEOVER BLOG continues on next Blog

Dr Michele Koo, MD, FACS, Board Certified Plastic Surgeon, St Louis, Missouri, 314-984-8331.

The patient is a 47 year old Missouri woman who started her journey of weight loss at 230 lbs and a size 22. On the day of her surgery, she weighed 185 lbs and was a size 16.

Dr Michele Koo performed a tummy tuck (abdominoplasty) and ultrasonic liposuction of her hips, waist, and thighs. She is shown in her after pictures at four months at 155lbs and a size 8. She couldn’t be more thrilled. The surgery performed by Dr Koo changed her life.

When the patient started dieting and losing weight, she consulted Dr Koo. The patient felt trapped and frustrated by her loose hanging skin, stretch marks and did not feel that she could continue her dieting and exercise without some type of plastic surgery procedure such as an abdominoplasty or tummy tuck and some type of liposuction. She needed help to continue to take charge of her life and her body.

Dr Koo was very encouraging and understanding and stressed the fact that the patient had already done the bulk of the hard work losing the weight and should not feel discouraged by the appearance of her trunk and belly (midriff) area. So many patients bounce up and down with their weight because they hit a plateau and can’t go any further with their appearance after working for so long exercising and restricting their diet. They feel completely exasperated that they cannot further change their tummy and get rid of the loose hanging skin.

Enter Dr Michele Koo, St Louis, Missouri, 314-984-8331, Board Certified Plastic Surgeon and a Member of the Aesthetic Society. She can and will safely take you the rest of the journey toward a flat tummy and a skinny waist. She will encourage you to continue your activity level and healthy diet without using supplements or crazy ultra restrictive diets. She might suggest a gastric bypass or a gastric banding first if you are extremely obese prior to any body contouring and liposuction procedures.

Dr Koo will be very honest with you that this is a long process and lifestyle change that she wants for you. After the tummy tuck (abdominoplasty) and liposuction, you will need time to recover over 2-4 weeks and more than likely will need even 6 weeks to full recovery of returning to strenuous work. However, Dr Koo will tighten your abdominal muscles stretched from pregnancy and remove all the excess loose hanging skin of your belly and make you look like a totally new person with the tummy tuck and liposuction.

Dr Michele Koo wants you to be well informed and the following exerpt from Heller, et al, Yale Medical Center should provide some background information. Functional abdominoplasty was first described by Kelly in 1899 and popularized for cosmetic purposes in 1967 by Pitanguy, who introduced the low transverse (i.e., bikini line) incision that could remove lower abdominal scars. Since this time, abdominoplasty procedures have rapidly gained popularity, with 102,497 being performed in 2004, an increase of 510 percent from 1992 levels and an increase of 24 percent from 2002 levels.

During this period, surgeons focused increased attention on reducing complications. Local complications such as hematoma, seroma, wound dehiscence, and skin necrosis occur in up to 32 percent of nonsmokers and as many as 52 percent of smokers. As such, greater effort has been set forth to define the vasculature of the abdomen to limit these complications. Huger described three vascular territories of the abdominal wall: zone 1 ranges from the xiphoid to the pubis between the lateral borders of the rectus abdominis and is supplied by the superior and inferior epigastric arteries; zone 2 is the trapezoidal area defined by anterosuperior iliac spine superiorly and by the groin inferiorly-its blood supply is from the superficial inferior epigastric, superficial circumflex iliac, and external pudendal arteries (superficial system) and from the deep inferior epigastric vessels (deep system); zone 3 is the area of the lateral abdomen and flanks and is supplied by the segmental lumbar, subcostal, and intercostal arteries. Traditional formal abdominoplasty with its low transverse incision and wide undermining to the costal margin sacrifices zone 1, zone 2, and to a limited extent zone 3. Furthermore, the skin of zone 1 experiences additional vascular compromise caused by tension on the suture line and thinning of the abdominal flap. Thus, many surgeons have proposed less extensive approaches to abdominoplasty in an attempt to maintain adequate vascularity, but the best aesthetic outcomes remain with the classic abdominoplasty.

To improve contour, liposuction has been offered to abdominoplasty patients, but previously as two independent procedures separated in time by at least 6 months. Caution concerning the advisability of such an approach was based on the belief that the traumatic forces of liposuction would limit the vascularity of the flap and thereby increase complications. Matarasso studied the safety areas for lipoplasty combined with abdominoplasty and recommended limited and cautious liposuction of the epigastric and mesogastric areas (zone 1) with full type 4 abdominoplasty. With advances in superficial liposuction, Saldanha et al. performed lipoplasty of the abdomen, sparing the epigastric and mesogastric areas, followed by an abdominoplasty with rectus muscle plicature, and found a complication rate no higher than that of a formal abdominoplasty. In a study performed by Lockwood, patients who underwent high lateral tension abdominoplasty and superficial fascial system repair with and without liposuction experienced complications that did not exceed historical controls. In 2006, the most recent survey of 497 surgeons reveals that 56 percent of surgeons perform some sort of liposuction with a full abdominoplasty but also stresses the need to differentiate complication rates in patients who received liposuction with their abdominoplasty versus those who did not.

Dr Koo believes that liposuction of the abdomen to achieve the “finished look” of a smooth flat tummy can be performed simultaneously with minimal complications. She takes extra precautions with her unique surgical procedure of a refined high lateral tension abdominoplasty that achieves amazing results as seen in the featured before and after picture.