Unpacking the Mommy Make-Over… a Surgical and Invasive Approach


The Mommy Makeover is a term that refers to a combination of surgical procedures that enables a woman to restore her body shape and size following childbirth.  Dr Alexandra Grubnik gives us information…

The miracle of creation is truly one of the most wonderful events of our lives – an experience of almost every woman’s dream. However, while pregnancy and childbirth are a very special time, they do take a toll on a woman’s body.

Growing pains

Hormonal surges commonly increases appetite and cravings, which ultimately leads to weight gain. As the baby grows, it stretches the skin and the musculo-fascial system of the abdomen. The breasts enlarge in preparation for nursing, and will subsequently shrink once the breast feeding stops.

It goes without saying that it’s quite a challenge for most women to return to their pre-pregnancy weight and size after the baby is born. And even if they succeed, the loose skin on their breasts and tummy is unlikely to retract. The breasts become droopy and appear deflated (and change in size compared to pre-pregnancy) – while the tummy is left with a typical skin roll and a bulge. Anatomically, the Rectus Abdominis muscles, which form the coveted “six pack”, are enclosed and interconnected by fascia.

During pregnancy, the increasing pressure within the tummy stretches this fascia, resulting in separation of the rectus muscles – rectus diastasis, or even defects in the fascia – hernias. The latter are common around the belly button or at previous scar sites. Furthermore, weight gain during pregnancy may cause diet-resistant fat deposits on the tummy, thighs and hips, resulting in the much hated “love handles”, “muffin tops” and “saddle bags”.

Fortunately, most of these effects of pregnancy can be altered by undergoing a  combination of surgical procedures that are aimed at returning the woman’s body as close as possible to her pre-child birth condition.  Termed the Mommy Make-Over’, it is invariably a combination of breast and abdominal surgery, commonly with added liposuction – and is tailored to the specific patient’s concerns and desires.

Breast Surgery

Breast Enlargement (Augmentation)

Many women notice that their breasts became deflated after breast feeding. The breasts also appear lower on the chest wall and have no upper pole projection (cleavage). Commonly, women complain that they cannot fill their pre-pregnancy bra anymore and desire more volume. Placing a breast implant offers an excellent solution for not only adding volume, but for also restoring a more pleasant shape of the breasts. The scars are normally small and are placed either in the crease under the breasts or around the areola. Recovery time is about a week.

Breast Lift (Mastopexy)

Some women are still happy with the volume of their breasts after pregnancy, but are concerned about the shape of their breasts. They notice that their nipples and areolae have descended to the lower pole of the breasts, which makes their breasts look droopy. In these cases, a breast liftis required. During a breast lift the stretched skin excess is removed and breast tissue is reshaped. The scars are placed around the areola, extending vertically down (lollipop) and sometimes extending into the crease below the breasts (inverted T). Recovery time is usually ten days to two weeks.

Breast Lift + Implant (Mastopexy Augmentation)

If a woman is concerned about droopy breasts but also would like to go bigger, it may be necessary to combine a breast lift with implant placement. The scars are the same as in breast lift, and recovery time is normally two weeks.

Breast Reduction (Reduction Mammaplasty)

Other women may have had moderate to large breasts prior to their pregnancy, where their breasts may have enlarged further. Large breasts can casue many problems, such as physical discomfort (back, neck and shoulder pain, headaches and skin rashes under the breasts), psychological embarrassment, difficulty staying active and even finding well-fitting bras and clothes. A breast reduction may therefore be hugely beneficial for women who suffer from these problems arising from their large breasts.

The procedure involves the excess breast tissue and skin being removed, with the breasts then lifted and reshaped. The scars are similar to those of breast lift and recovery time is two to three weeks.

Abdominal Surgery 

Tummy Tuck (Abdominoplasty)

Almost every woman requires this procedure after pregnancy. It is designed to repair the muscles of the abdominal wall and take out excess skin and fat. Depending on the type of abdominal deformity, tummy tucks range from “mini”, where only the lower abdominal bulge is repaired and lower abdominal skin roll is taken out – to “full”, where the skin is lifted, belly button is repositioned and the full length of rectus diastasis is repaired.

Abdominal hernias may be repaired at the same time. The resultant scar is placed in the lower abdomen and is designed to be hidden by underwear or bikini. Recovery time is three weeks.


Liposuction alone may be used for contouring the abdomen, however it will not address excess skin. It is therefore more commonly used in combination with a tummy tuck to sculpt the waist and get rid of “love handles”, “muffin tops” and “saddle bags”.

It is also an excellent modality to contour the hips and thighs and eliminate the “diet resistant” fat deposits.  In addition, the scars are almost invisible – 5mm in size, and recovery time is minimal – some swelling and bruising is all that is expected.

Final thought

The beauty of the Mommy Makeover is that it is a combination procedure specifically tailored to address your concerns and desires, and to restore the body and self confidence that you may have lost in the process of growing your family.

Written by Dr Alexandra Grubnik (MMed, FC Plast Surg SA)

Dr Alexandra Grubnik (MMed, FC Plast Surg SA)

A2 Disclaimer: This article is published for information purposes only, and should therefore not be taken as an endorsement or advertisement for any product or medical treatment –  nor should it be regarded as a replacement for sound medical advice. 

CURRENT Issue 25 – March 2018 (Autumn)

This article was written by Dr Alexandra Grubnik and edited by the A2 team EXCLUSIVELY for the A2 Aesthetic & Anti-Ageing Magazine March 2018 Edition (Issue 25). 

A2 Magazine prints only four magazines each year – reporting seasonally on everything you need and want to know about aesthetics, anti-ageing, integrative medicine, quality and medical skin care, cosmetic dentistry and cosmetic surgery in South Africa – where to go, who to see, what to expect, something new and so much more! Never miss an edition – click here for more info about where you can buy the print and/or digital copy of A2 Magazine (including back copies).

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