The Mom Job

Growing numbers of women are getting Mommy Makeovers to erase the signs of pregnancy. Here's what you should know.

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Jodi Brown hated the “kangaroo pouch” she acquired after her second pregnancy. But even more onerous—physically and aesthetically—were her large breasts that now seriously sagged. So last year, at 47 and after eight years of rumination, Brown, who lives in Grand Rapids, Mich., underwent a “mommy makeover,” a package of cosmetic surgery procedures that includes a tummy tuck, breast work and liposuction.

“For so many years, my kids came first, but I hit the point when I said, ‘I’ve ignored myself; my body has taken a toll,’ ” Brown recalls. “I put a ton of thought into it. When you’re a mom, you think, ‘What if something happens to me [as a result of having surgery] and it’s because of vanity for the most part?’ ” But Brown couldn’t be happier with her post-surgery body. The 5-foot-1-inch woman went from a size 16 to a 12, her back no longer hurts from the weight of her chest, and, she says proudly, “My boobs are beautiful.”

Unable to exercise or diet away a postpartum bulging belly or find the right uplifting bra, more women are turning to the mommy makeover, aka “the mom job.” Among women in their 30s, there was a 9 percent to 12 percent rise in tummy tucks and breast surgery between 2005 and 2006. In 2007, 59 percent of American Society of Plastic Surgeons members surveyed said they saw an increase in patients seeking post-childbirth cosmetic surgery procedures in the previous three years. “Many of my patients are young moms who are doing their best to take care of themselves, but their bodies have gone through some irreversible changes that they find discouraging,” says David Stoker, M.D. of Marina Plastic Surgery Associates in Marina del Rey, Calif.

What Childbirth Does to Your Body

Often, abdominal skin that becomes stretched during pregnancy doesn’t snap back after the baby is born. In addition, the rectus abdominis muscles, which run vertically, can separate and become lax, adding to the abdominal protrusion, explains plastic surgeon Dennis C. Hammond, M.D., of the Center for Breast and Body Contouring in Grand Rapids, Mich.

The breasts often sag after delivery and/or breastfeeding because the skin covering them gets overstretched when breasts become engorged during pregnancy and nursing but remains lax after they return to their prepregnancy size. The result is less support for the breasts. Some women also lose breast volume as a result of pregnancy. (Nursing does not result in smaller breasts.)

These physical changes are common but not inevitable. Plenty of moms—even those who have had several children—don’t have to contend with these aesthetic issues. “While age and how much weight you gain [during pregnancy] are likely contributing factors, your genetic predisposition is by far the most important,” Stoker says.

What the Critics Say

The surgical mommy makeover worries some experts, concerned that the trend pathologizes a natural course of change in the body. “Yes, we all know that pregnancy does change our bodies, but let’s not see this as a disaster that needs to be surgically fixed,” says psychologist and public health expert Diana Zuckerman, Ph.D., president of the National Research Center for Women & Families (center4women.org) in Washington, D.C.

On the other hand, the trend is a logical extension in our culture that idolizes youth and fitness (read: perky breasts and flat bellies) and teems with images of celebrity “hot mamas” who seem to whip their post-baby bodies back into shape in no time. “It’s the trickledown effect of the most beautiful women getting surgery to look even more beautiful, then having their photographs computer-enhanced, and the rest of us saying, ‘Why don’t I look that good?’ ” says Zuckerman.

Others point out that many mothers today are not “just” mothers—they have professional and personal lives outside of the home and don’t want to look like the stereotypical mom. They want to feel better about their bodies, and that desire shouldn’t be dismissed or criticized, says sociologist Victoria Pitts-Taylor, Ph.D., author of Surgery Junkies: Wellness and Pathology in Cosmetic Culture (Rutgers University Press). “I don’t think we should judge women for wanting to look like they did before they got pregnant,” Pitts-Taylor adds. “Social approval is empowering in our society.”

Do Your Homework

Some critics point to the potential medical risks (not to mention the out-of-pocket expenditures) posed by what are essentially cosmetic, nonessential procedures (see below).

Studies have shown that performed properly, combining a tummy tuck with breast surgery and liposuction is no more risky than performing them separately. “But the more you do, the more difficult it is and the more things can go wrong,” warns Stoker. Ideally, he says, surgery should not last much longer than four hours, you should undergo a medical screening beforehand, and your surgeon should be certified by the American Board of Plastic Surgery and a member of the American Society of Plastic Surgeons (not the American Academy of Cosmetic Surgery). Complication rates vary widely among physicians, but major life-threatening problems are rare. If your surgery is to be performed at an ambulatory (outpatient) center, it should be properly accredited; to find out, go to aaahc.org or aaaasf.org.

Pitts-Taylor worries about the ethics of marketing procedures together. “Cosmetic surgeons suggest that pregnancy brings about a series of bodily distortions that has to be repaired, and you don’t need just one surgery, you need a whole package,” she says. “Surgery should be performed only when you really desire it, not because it’s included in a package.”

And keep in mind that getting a mom job may not transform your life: If you think surgery will improve your marriage or your long-term mood, you might be in for a disappointment. Says Zuckerman, “Studies have repeatedly shown that people who have cosmetic surgery are happy that a body part has been fixed, but they are not happier with their lives and don’t feel better about themselves.”

Procedure/Cost* What It Is Things To Know Tummy Tuck $5,063 Excess skin and fat are cut away in an elliptical (football) shape from hip to hip (the scar is usually hidden below the panty line). Vertical abdominal muscles are also tightened. Two- to three-hour procedure is done under general anesthesia. You may be able to return to work in a couple of weeks but can't exercise for four to six weeks. Breast Lift $4,220

Augmentation $3,600 (when combined, cost is reduced) Many surgeons do a breast lift first, followed in several months by implants if desired, allowing skin to heal and breast tissue to settle. Excess skin is removed to restore fullness to the upper breast, and nipple is often moved higher. Takes about two hours and is performed under general anesthesia. Recovery time may be shorter than after a tummy tuck. Some surgeons will perform both procedures at the same time; done properly, this does not increase risks. Liposuction $2,750 Fat is removed through a canula (a hollow pen-like instrument) or via laser or an ultrasonic probe that breaks it up into small pieces. Takes from 30 minutes to two hours depending on volume of fat removed (this also determines anesthetic). You can usually return to work the next day. Has a lower complication rate than the other surgeries.

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