When Exercise Isn't Cutting it- Is Surgical Intervention the Answer?

03/05/2017 11:10 pm ET

Does this sound familiar? After having a couple of kids, you just can’t feel comfortable with the way your body looks anymore. You have been exercising for a while, but it isn’t really working. Although many consider these changes to be a beautiful part of motherhood and natural aging, embracing the badges of having children- some just cannot accept them. No one answer is the right one, but now many doctors are helping women take back their physiques via surgical means. In fact, these surgical makeovers are becoming vastly popular. L.A.’s reputable, experienced, Board Certified Plastic Surgeon Dr. Max Lehfeldt, F.A.C.S. answers some of our important questions about the details of what make up these procedures...

What does one of these makeover packages typically include?

The main procedures that we see women seeking following childbirth are the following:

a) Stretched out and loose skin of the abdomen, along with looseness of the muscles. This is addressed with an abdominoplasty or tummy tuck, where excess skin is removed, along with tightening of the muscles surgically.

b) Breasts - usually loss of volume, particularly in the upper portion of the breast. The breasts look more droopy, they are more saggy, the nipples often appear too low. Interestingly, patients often like their breasts when they are breastfeeding because they have the volume that is associated with milk production, but after they are done breastfeeding, that volume goes away and the skin has been stretched out, so they look even more deflated. Surgery can improve the shape of the breast with removal of skin (breast lift) and add in that critical volume that is more associated with a youthful breast, particularly in the upper portion of the breast. This is achieved with silicone gel or saline implants, and there’s a wonderful suite of different implants available for patients to really customize for their unique anatomies and their unique size preferences. All of this can be done in a very complimentary way, where patients' breasts look very natural. One can achieve a beautiful breast shape with a little bit of youthful fullness on top, with the appropriate implant selection.

c) Wrinkles! Genetics and lifestyle can are factors in how gracefully our skin ages. Many patients come for to us for non-surgical treatments, such as BOTOX® Cosmetic, for relaxation of fine lines and wrinkles in the area between the eyebrows and around the corners of the eyes, Volbella, which improves lines and wrinkles in the lips, and Voluma, which adds volume back into the cheeks.

What is the best time to get these procedures?

We typically will defer any surgery for a minimum of three months after childbirth because the tissue is very dynamic, so there’s a certain amount of tissue recoil. The skin may retract a little bit, the weight is going to change, so we don’t typically do any of these surgeries right at the time of childbirth. It's important to let the body recover naturally first.  We would like patients to not be breastfeeding for at least three months before we make a determination as to whether they need an implant for volume or if they need a lift or sculpting of the breast skin. And then finally, patients need to have a support network in place to help assist them with this wonderful transformation. Do they have someone at home who can help them? We have this conversations with patients as well, so they can be more prepared. Some patients have their surgery just a few months after childbirth and some patients wait until their kids are a few years old. It really just depends on the patients’ unique circumstances and then finding the timing where it works best for them.

What is the recovery time?

Recovery really depends on what is done. Every patient is a little bit different. Around 7 - 10 days is a general rule of thumb for breast surgery involving  placement of an implant. The time frame is similar for  a breast sculpting procedure where breast tissue and skin is removed. The abdominoplasty surgery is a little bit longer of a recovery time because it’s a more involved surgery. That recovery time is typically in the realm of 2-3 weeks. If you combine breast and body surgery for complete body rejuvenation following pregnancy, that may be really on the order of 2-3 weeks' recovery. Again, everybody’s different. I’ve had patients bounce back within a week, and I’ve seen others take a little bit longer than 3 weeks. I think the most important thing is to speak with a board certified plastic surgeon, get that information and have that discussion with a qualified professional who can address your unique concerns.

How can a person find a plastic surgeon to trust? What qualifications would an appropriate plastic surgeon have who is considerable for the job?

It is absolutely critical to have someone who has the appropriate commiserate training and the experience and familiarity with all of these technologies to deliver the absolute best and safe results for patients. These are elective procedures and safety is number one.  Quality of outcome of results is next in line in terms of priority. The best way to find these providers is through the American Board of Plastic Surgery Website, which lists all of the board certified plastic surgeons. Another wonderful resource is the American Society for Aesthetic Plastic Surgeons or ASAPS. Those are all board certified surgeons who are specifically focused on these types of procedures - breast enhancement surgery, breast lifting, breast lifting with implants, and also body contouring and tummy tuck procedures and liposuction.  And finally, ItsMyTurn.com also has a physician locator for physicians who are very familiar with these products and procedures.

Are surgical procedures gaining popularity? Yes. Surgical procedures are increasing in terms of number of patients, as income stabilizes and the economy improves, but we've actually seen the largest explosion in growth in non-surgical treatments, specifically facial aesthetics, like fillers and fine line relaxers. These procedures have no downtime and cost far less relative to surgery, so they are extremely popular and continuing to grow exponentially year over year.

Are there any risks associated?

All surgeries have risk, and I think it is absolutely incumbent that potential patients seek out a board certified plastic surgeon who really specializes in the treatment they are seeking, to get the best result with the safest process possible. These risks are mitigated by the wonderful advances in technology, but it’s still absolutely critical that future patients are well educated about their choices and that they understand potential risks and complications, that they feel comfortable with their doctor, and their doctor should be able to explain to them how they would help the patient with any of those potential issues.

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