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The Mommy Makeover: Considering Postpartum Plastic Surgery

I have enjoyed the inflationary effects that pregnancy and breast-feeding have had on my breasts. But I know that my joy is short-lived. Once I wean this latest nursling, I will be faced with a stranger in the mirror—a saggy stranger.

Yes, all of that stretched-out skin and tissue will soon sag and shrink—and the end result won't be pretty.

Initially, I tried to cheer myself up by focusing on why my breasts will be different: Because I'm a mother! I have gone to term with three pregnancies, and my children are the greatest accomplishments of my life.

Though I don't mind that certain parts of my body are wrecked as a result, I don't know if I can live with small, saggy breasts for the rest of my life.

So I called Eric Mariotti, MD, a board-certified plastic surgeon who works near San Francisco, and took my breasts in for a look-see. If I wanted to get my pre-baby breasts back, what would it take?

In Dr. Mariotti's language, it would take a "subpectoral augmentation with standard mastopexy." In other words, a boob job.

Pregnancy can wreak havoc on our breasts

"It's mainly the pregnancy, not the breast-feeding that stretches the connective tissue," he explained to me as I absentmindedly squished my fingers into the sample breast implants he keeps on the examining room shelves. "The ducts and glands enlarge, then they empty out and (the breasts) get smaller."

However, Grant Stevens, MD, the medical director of Marina Plastic Surgery, reminded me that every woman's experience is different. Some women's breasts get larger and stay larger after pregnancy, and these women sometimes approach him for a postpartum breast reduction.

No such luck over here—I would not only qualify for an implant, but also a breast lift.

As we talked, Dr. Mariotti showed me a gallery of work he'd done. "Oh these poor women," I said as I flipped through the "before" images. Scanning through those fallen, emptied breasts, I realized I was not alone.

Not only does pregnancy affect your breasts, but it can also change the areola—it grows darker, and in some cases, larger, during pregnancy. During breast augmentation surgery, a surgeon can also tidy up the edges of an areola or reduce the length of the nipple.

Are there any downsides?

Paying to get my breasts returned to their pre-pregnancy state is tempting. However, you always hear about surgeries gone horribly wrong. According to Dr. Mariotti, though, there's not much to fear. The myth that breast implant patients normally lose sensation in the nipple isn't true—only about 5% of patients will experience a "numb nipple."

There is a lot of buzz about silicone implants rupturing and having to be removed at some point. However, according to Dr. Mariotti, only 1.1% of patients, after 10 years, find that the silicone is leaking.

And since the U.S. Food and Drug Administration (FDA) lifted restrictions on the use of silicone breast implants in 2006, 90% of Dr. Mariotti's patients have opted for silicone because it feels more realistic. The FDA recommends that a woman with these implants have her first MRI three years after her initial Breast implant surgery and then have one every two years thereafter to check for a rupture in the implant.

My fears about surgery and anesthesia were obliterated by my back-to-back wrist surgeries and C-sections, and—I'll be honest—I love the idea of a breast augmentation. I would love to have my old shape back, or maybe just a little bit more.

I could always use the excuse of postpartum breast deflation to transform myself into a D-cup knockout. And if I can fix my breasts, what else could I solve with surgery?

What if I went for the whole Mommy Makeover —a term coined by Dr. Stevens — and added a tummy tuck to the procedure? I'll save that revelation for the next entry.

By Erica Kain from

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