Mommy Makeover Breast Augmentation

"Mommy Makeover" is a popular term used to describe a combination of procedures done to reverse the physical effect of pregnancy. Most commonly the breast and body are addressed in one single procedure.

Pregnancy related changes in the breast can be characterized as follows:

Involutional changes: the breast becomes smaller as it reverts back to its prepregnancy size
Skin changes: the breast skin becomes stretched during pregnancy often resulting in looser skin once the breast involutes back to its normal size
Drooping/ptosis: the breast can appear droopy or ptotic meaning that the breast and/or nipple sag in relation to the breast crease
Shape: the breast can develop a loss of fullness in the upper pole, loss of cleavage, and generally a loss of roundness
Nipple/areola: the areola can become stretched, darkened, and enlarged and the nipples can become elongated or misshapen

Breast drooping or breast ptosis is defined based on the relation of the areola to the inframammary breast crease.

With Pseudoptosis or Grade I ptosis, a breast augmentation alone without a breast lift will correct for the droopiness or ptosis and restore shape and size to the breast by adding volume. For Grade II or III ptosis, a breast augmentation combined with a breast lift is necessary to achieve an optimal outcome.

A mommy makeover breast augmentation is slightly more complicated than one done on a breast without these pregnancy related changes. It is always advisable to place the implant under the chest muscle or in a submuscular plane. Placing the implant under the muscle provides more coverage over the implant, a smoother contrast in the upper pole, and a more natural result. Submuscular implants also have a lower incidence of scar tissue formation around the implant known as a capsular contracture.

In a post pregnancy breast simply placing the implant under the muscle can result in the implant and breast mound not lining up correctly. In this case the implant can be positioned higher than the breast resulting in two distinct projections: implant and breast. This is called a double bubble deformity. To ensure that the breast and breast implant perfectly line up, a technique called dual plane is used. A dual plane means that some of the implant will be covered by both breast and muscle and some of the implant with just the breast or, in other words, the implant is partially under the muscle. This allows the breast to slide up over the implant so that the breast and implant are projecting as a single unit.

There are three types of dual plane techniques depending on the level of breast ptosis and amount of muscle release needed to center the implant and breast.