The Beauty of Parenthood: Why I’m Not a Fan of the Term “Mommy Makeover”
– Asheville, North Carolina

As an experienced plastic surgeon who puts good patient care above all else, I have had the pleasure of working with numerous patients seeking to enhance their confidence and improve their quality of life. Among these patients are women who, after giving birth, wish to address changes in their bodies through procedures such as abdominoplasty (tummy tuck), liposuction, and various breast procedures. 

While I enjoy performing these surgeries, I must admit that I am not a fan of the term “mommy makeover.” In this blog post, I will share my perspective on this popular phrase and discuss procedures we offer women following pregnancy.

The Problems With “Mommy Makeover” Language

The term “mommy makeover” implies that there is something inherently wrong with a woman’s body after having children and that she needs to be “fixed.”

I strongly disagree with this notion. 

Pregnancy is a beautiful and transformative journey that naturally brings about changes in a woman’s body. These changes are a testament to the incredible strength and resilience of mothers and should not automatically be viewed as flaws that require correction.  

While some women may choose to have cosmetic surgery to feel more confident and comfortable in their bodies, others may feel perfectly content without it, and we need to respect that. This is a very personal decision and, therefore, requires an approach that prioritizes your unique goals and preferences.  

Many patients, because they have heard and read the phrase “mommy makeover” so much, assume it is a specific procedure, usually abdominoplasty (“tummy tuck”) and breast augmentation. As pregnancy affects women differently, and as women have different and unique goals for their own bodies, it is clear that addressing post-partum changes can involve a variety of procedures, especially when it comes to the breasts.  

However, not all women want to have larger breasts, and not all women want implants to enhance their breasts.  

Cosmetic Surgery Options for Women

The following are some of the more common procedures we offer mothers seeking plastic surgery:

• Abdominoplasty (tummy tuck): A procedure designed to remove excess abdominal skin. The most common approach leaves a scar across the lower abdomen in the bikini line and a scar around the umbilicus (belly button). Stretch marks in the lower abdomen that arise from pregnancy are removed during abdominoplasty, although some in the upper abdomen may remain. When performing tummy tucks at my Asheville, NC surgical center, I advise patients that recovery is about two weeks for those with a desk job and four weeks or more if a job is very physical. Assistance around the house with small children is required for at least the first two weeks to optimize healing. 
• Diastasis repair: A procedure that eliminates the central abdominal bulge some women have after pregnancy. Rectus diastasis refers to the separation of the rectus abdominis (“six-pack”) muscles after pregnancy. It is normal for these muscles to have about 1cm of separation between them, and the fascia that separates them is strong. During pregnancy, the fascia between the rectus muscles can stretch, weaken, and thin out. If this does not reverse itself, rectus diastasis occurs. Patients with this problem have a vertical “bulge” in the center of their abdomen when they bear down, cough, or lift anything heavy. This can be uncomfortable, and as it affects core strength, it can result in lower back pain. Diastasis repair is not covered by insurance, unfortunately, and therefore, it is most commonly performed in conjunction with abdominoplasty (which is also not covered by insurance). Strong permanent sutures are used internally to repair the separated muscles. This can lead to a bit more postoperative pain, and we usually recommend avoiding heavy lifting (>10lbs) for up to three months after this type of repair to prevent recurrence. Even with proper precautions, recurrence is a possibility, so we caution patients to avoid repetitive heavy lifting.  
• Global fascial laxity: This term refers to the generalized weakening of the abdominal wall fascia. Many women with this condition also have rectus diastasis. Pregnancy stretches all of the abdominal muscles and fascia, not just the fascia between the rectus muscles. If this does not reverse itself, patients can present with abdominal protuberance, even in the presence of good core strength. If a rectus diastasis repair is performed without addressing global fascial laxity, patients may not get the result they were hoping for. There is no standard textbook approach for this condition, as it has not been very well described or studied. At the very least, the same type of sutures used to repair rectus diastasis can be used to tighten the remaining abdominal fascia, but there is possibly a role for the use of lightweight slowly reabsorbing mesh. It’s most important to understand that if you have this condition, it may be improved, but it is unlikely that your abdomen will look exactly like it did before pregnancy, despite our best efforts.  
• Breast procedures: Includes procedures like augmentation, mastopexy, augmentation mastopexy, breast reduction, and nipple reduction. There is no one-size-fits-all approach to breast surgery after childbearing — the particular approach depends on the goals/preferences of the patient. Breast augmentation refers to the use of implants to increase breast size and add upper pole fullness and a rounder look. This procedure can fill out some loose breast skin, but it is not a substitute for a breast lift (mastopexy) if there is significant ptosis (“droop”) to the breast. Some surgeons will place very large implants in an effort to avoid mastopexy, but this is a misguided approach that commonly leads to problems down the road. Mastopexy (breast lift) removes excess breast skin and places the nipple in a higher position, but the breast will still have a natural shape.  Mastopexy does not result in “high, round, perky” breasts. Combining augmentation with mastopexy is very common after childbearing, as women will have deflated breasts with excess skin and ptosis (“droop”). Mastopexy will remove the excess skin and elevate the nipple into a better position, while augmentation will add upper pole fullness and give a round, perkier appearance. This can be a challenging procedure, as removing excess skin and adding breast volume are basically competing interests. Breast reduction involves the removal of excess breast tissue, but it always includes mastopexy (removal of excess breast skin). As with mastopexy, the result is a very naturally-appearing breast. The upper pole will be concave, and the breast will not have a high, round, perky appearance that is associated with breast augmentation using implants. Nipple reduction is commonly requested after breastfeeding. This procedure can be performed during any of the procedures described above, or it can be done separately under local anesthesia only. Different techniques are used to reduce the projection and/or diameter of the nipple.  
• Liposuction: A procedure that removes unwanted fat using small incisions. It is rare that I’ll do liposuction as an isolated procedure for women after childbearing. This procedure is usually combined with abdominoplasty to address excess fat in the lower back, hip area, abdomen, thighs, and other locations. The procedure involves injecting a dilute solution of local anesthetic with epinephrine into the fatty tissues and then sucking out excess fat using blunt cannulas. Many patients come in wanting liposuction of their abdomen to avoid the scars associated with abdominoplasty, but the amount of skin tightening achieved with liposuction alone is limited. Most women seeking improvement of their abdomen after pregnancy have excess skin that can worsen if only fat is removed. Therefore, this procedure is most commonly an adjunct procedure in the setting of more comprehensive surgery to treat postpartum changes. 
• C-section scar revision: Whereas most C-section scars heal nicely, some women have an indented scar with a small fold of skin above it or an unfavorable scar due to other factors. A simple scar revision under local anesthetic can usually improve this, however, it may require a “mini-abdominoplasty” to also remove some excess lower abdominal skin.  

 More Than Just a “Mommy Makeover” in Asheville, NC

At Halvorson Plastic Surgery, I strive to approach each patient with empathy, understanding, and respect for their unique preferences. When it comes to mothers seeking plastic surgery, I believe it is crucial to listen carefully and focus on the individual needs and goals of each patient, rather than perpetuating a singular narrative of what a “mommy makeover” should be. 

Overall, I believe that the term “mommy makeover” carries with it certain negative implications that can undermine the beauty and value of motherhood. Instead, let’s celebrate the incredible strength and resilience of mothers and support their individual choices when it comes to their bodies and their lives.

If your search for a “tummy tuck near me” (or other relevant cosmetic surgery) led you here and you’re interested in any of the procedures mentioned above, feel free to contact my team to set up a consultation. We’re happy to work with you in achieving the cosmetic goals that make you feel more at home in your post-pregnancy body.