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The Advanced Mommy Makeover

New Options in Body Contouring 

Pregnancy and its after effects can be tough on a woman’s body. From rapid weight gain, then weight loss, following a rapid expansion of the skin, there is a collective fascination with some of the changes that the body goes through before, during, and after pregnancy. Following pregnancy, there are often deposits of excess fat around the abdomen, hips, and trunk. The breasts may have lost volume, dropped, and lost their support. The skin may also have developed new stretch marks, as well as areas of brown patches or hyperpigmentation on the face and other areas.

New technologies, services, and options have created some exciting new possibilities for women after pregnancy. Dr. Frank Barone, board-certified plastic surgeon in Toledo, OH, explains the many new options available in body contouring today.

Abdomen and Trunk

After pregnancy, there are some permanent changes of the body, buttock, and abdomen. These include the muscles of the abdominal wall and the rectus muscle which can become stretched and separated. They will often not return to their preexisting state where they’re connected in the midline, providing support for the abdomen and back. This condition is called diastasis recti.

Another condition caused by pregnancy is long-lasting laxity and loss of support of the skin, accompanied by stretch marks. The tummy tuck, or abdominoplasty, is a procedure that addresses these issues by removing excess skin and fat in the lower abdomen below the belly button. Separated abdominal muscles are then repaired, and the sides of the body are contoured with liposuction.

-Advanced Concepts in Abdominoplasty and Body Contouring

New concepts of abdominoplasty include extending the contouring and shaping all the way around the body or to the sides. This technique can lift a drooping buttocks or correct laxity on the lateral side and hips as well as cellulite. These extended abdominoplasties, or circumferential abdominoplasties, are categorized as “body lifts.” Augmenting or improving the projection of the buttocks with fat buttock augmentation is also a possibility, as well as thigh lifting.

Other new concepts in body contouring surgery include surgery without the need for traditional suction drains based on a new surgical technique called progressive tension sutures and new options in reducing post-operative discomfort. In our practice, these procedures are always done on an outpatient basis and improving patient comfort is a priority. A new medication called Exparel® is injected by the surgeon during the procedure in order to block sensory nerves, and provides a significant reduction in patient discomfort, reducing the need for post-operative narcotics and improving the overall experience.

-Advanced Concepts in Liposuction

Finally, while contouring the body with an abdominoplasty or body lifting, we are also improving overall body shape contour with selective fat reduction by ultrasonic techniques. In our experience, ultrasonic liposuction, or VASER Liposuction, is the most efficient method of reducing excess fatty deposits. VASER ultrasonic energy releases fat cells, which makes removing the excess far more efficient and less traumatic. It also preserves nerves and blood vessels, consequently reducing post-operative swelling and downtime.

VASER ultrasonic liposuction also has the unique advantage of contracting or tightening the skin, which is very important for improving body contour after fat is removed. This has improved our results for patients having mommy makeovers and abdominal contouring. It is also important to understand that abdominal contouring surgery is not a free pass for poor lifestyle choices. It’s vital that patients remember that their overall health has a major effect on the outcome of their surgery. So, healthy lifestyle habits, such as proper nutritional intake and regular exercise, should be emphasized.

-Advanced Non-Surgical Abdominal Contouring Options

Non-surgical options are also present for abdominal contouring, be reducing both excess and firming skin, such as the new Vanquish ME™, Cellutone and Exilis Ultra™ devices, which remove fat cells by an external applicator. The Vanquish applicators do not touch the skin, and can also improve abdominal contour without any downtime. These procedures are done in the office and do not require anesthesia. The new Cellutone™, which uses sound waves to reduce the appearance of cellulite, is used with Vanquish ME™ to improve results in less time.

Read about the scientific study on Vanquish ME™ for nonsurgical fat reduction here.

Improving Breast Shape and Contour after Pregnancy

The combination of age and gravity will cause a woman’s breasts to droop and lose volume, but when you add pregnancy and breastfeeding to this equation, the changes are much more significant. This after-pregnancy breast change goes beyond actual sagging, but can result in changes in the nipples and the areola, as well as loss or deflation of the breast due to the hormonal changes of pregnancy.

-Breast Lift and Augmentation

To restore youthful shape and size a breast lift can be performed, which will elevate the tissue back to its pre-pregnancy position and restore a youthful shape. For some patients, more volume is necessary if there’s been a deflation of the breasts, and a breast implant and or fat grafting can be beneficial. Dr. Barone has extensive clinical research experience with the FDA approved cohesive gel breast implants. Available in round or anatomic shapes, cohesive gel or ‘gummy bear’ implants are composed of a semi solid soft gel and are more long lasting and will have no issue with potential leakage. They also hold their shape very well and are available in a wide variety of dimensions to correct asymmetry or side differences.

-Fat Grafting for Breast Enhancement

For appropriate patients, Dr. Barone may recommend fat grafting enhanced with PRP, or platelet-rich plasma, to restore natural volume to the breasts. The new breast lift or mastopexy involves shorter scars, and the vertical mastopexy is one example of that short scar procedure for breast lifting. Again, pain control with Exparel® allows this to always be an outpatient procedure, and makes the overall experience much more comfortable.

Skin Rejuvenation for the Post-Pregnant Woman

Telltale stretch marks on the stomach, hips, and buttocks after pregnancy can be very frustrating for women. Topical creams have never been proven to be effective, despite some unsubstantiated marketing claims. Dr. Barone and the professional staff at evolv will only recommend or utilize research proven products and services that have been clinically verified as safe and effective.

-Microneedling, Infini

Stretch marks are physical tares in the deep layers of the skin that are commonly seen after pregnancy or excessive weight gain. There are now promising technologies that can improve them. One option is microneedling, which stimulates collagen production while breaking down the scar and fibrous tissues. Microneedling with radiofrequency energy is even more effective, as has been proven by clinical results with the Infini RF by Lutronic.

Infini RF delivers a radio frequency charge to the tips of the insulated needles which results in a more vigorous response in collagen production and skin tightening than microneedling alone. Adding PRP therapy which is a powerful combination of multiple growth factors and regenerative platelets obtained from the patient’s own blood, to microneedling or Infini RF procedure has resulted in significantly more improvement in stretch marks and overall skin quality.

In addition, treatment of the skin with new formulations of retinol, which is a vitamin A derivative, has been shown to increase collagen production, improve circulation to the skin, and can improve stretch mark appearance, as well as skin health. I prefer Retinol and skin care products from ZO Skin Health because of their unique advanced bioengineering and proven efficacy.

If stretch marks are still pink or red, using light therapy, such as broadband light (BBL), is very effective in reducing their appearance. Fractional lasers are also beneficial in these situations, which is another new and exciting technology for skin improvement. The new HALO laser from Sciton Medical is particularly effective in improving stretch marks.

-Pigmentation

Pigmentation can be very challenging in the postpartum female. Brown spots and even deeper pigmentation in the lower levels of the skin, called Melasma, can be particularly frustrating. Melasma is often made worse from heat, so the use of lasers can be risky and must be used cautiously with proper skin preparation. Some chemical peels can be very effective for removing excess pigment in Melasma and hyperpigmentation. We have seen significant improvement with the use of medical skincare products from ZO® Skin Health, which has been the world’s leader in treating excess pigmentation in the skin.

Broadband or pulsed light and the use of Hydroquinone and other lightening agents to reduce pigmentation can be very effective if the skin is prepared properly. Of course, sunscreen and limited sun exposure is critically important in pigmentation and Melasma patients, and using a certified medical grade sunscreen with antioxidants is important.

The Advanced Mommy Makeover Summary

In summary, new technology and services have significantly improved the options as well as the results for women after pregnancy in repairing, restoring, and rejuvenating their bodies. These include non-surgical and surgical services. Shorter recovery times with increased comfort and reducing the length of scars are now a reality contouring the body after pregnancy in the advanced mommy makeover, and the combination of procedures has provided even better results.

Finally, the new science of regenerative medicine using fat grafting, stem cells, and growth factors with PRP harvested from the patient’s own blood and tissues are really going to be the future of body contouring due to the long-lasting effects and rejuvenate capabilities.

To learn more about these services, contact evolv Plastic Surgery & Medical Aesthetics today – (419) 464-9422.

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