Motherhood is a joyous and exciting time accompanied by moments of great sacrifice. But as we all know childbirth irrevocably changes women’s bodies. This is especially true for women experiencing their second or third child.

Fitness can do wonders for re-establishing a youthful appearance and can be started safely 6-8 weeks after giving birth along with proper diet and nutrition. Sometimes, no matter how much we exercise or follow a strict diet regimen, many mothers still struggle with the affects that childbirth and aging has on their bodies. Sagging breasts,  stretched out skin and stubborn pockets of fat in the abdomen known as “muffin-tops” are typical of post partum patients.

Luckily for moms in Houston, the “Mommy Makeover” is the answer for many Moms seeking to address these problem areas.

Contact Lou Plastic Surgery to schedule a consultation and find out if you are a good candidate for a Mommy Makeover.

Myth: Silicone breast implants are not safe.

Silicone implants were not used in the US for about 14 years due to concerns about their safety (ruptures, association with connective tissue disorder in some women, etc.). They were approved again for use in 2006 and have steadily gained popularity since. Some of the new silicone implants are marketed as silicone “gel” and have been compared (in terms of their consistency) to a “gummy bear” when pierced or cut. When this occurs, the silicone material retains its shape and does not ooze out as commonly thought. Elaborate and thorough research over the past 10 years have shown that the new silicone implants are safe for use; FDA approval followed in the fall of 2007.

There have been and are extensive studies of silicone implants, and according to the US Department of Health and Human Services, “Silicone is used not only in breast implants but also in implants located literally throughout every part of the body. It has been used: to construct heart valves and other cardiovascular prostheses; to fashion catheters which are used for purposes ranging from drug delivery to cardiac monitoring; in dentistry; in the gastrointestinal tract; as a facilitator for nerve regeneration; in ophthalmology; in the ear, nose, throat, and respiratory tract; as a prosthesis or ingredient in prostheses for many parts of the skeletal system; as a tissue expander; as a cosmetic agent for treatment of scars and wrinkle…”

Silicone implants have some aesthetic benefits. They have a lower rate of rippling and wrinkling than saline implants and may be a better fit (literally and figuratively) for some women. In fact, thin women with modest breast tissue may choose the option of having implants placed over the muscle without sacrificing aesthetics. Also, because silicone is lighter than saline, the risk of downward displacement due to gravity is lower. And many women find that they like the look and feel of silicone implants, which feel more like natural breast tissue.

Is there a downside to silicone implants? Sure. If there is a rupture of some kind, it’s still going to be difficult to detect. It is recommended that patients with silicone implants get routine MRIs and follow up regularly with their doctors. Because the implants are already filled when they’re placed inside of you, the surgeon will make a longer incision than with a saline implant. Also, some methods of insertion- such as the transaxillary (or armpit) approach- are not recommended for silicone implants for the same reason as well.

Other risks involve infection and capsular contracture. Infection rates for saline and silicone implants are comparable, thus neither being any more risky than the other. Capsular contracture is the effect of the body’s reaction to the implant. The body forms a capsule of fibrous tissue around the implant (as it does with all foreign bodies- glass, other implants, etc…), and most of the time this capsule remains soft and pliable. Sometimes, the capsule can become firm and hard, and on occasion, painful. As it is with infection, the rate of capsular contracture for the new silicone implants is comparable, if not slightly lower, than saline implants. Therefore, the two risks are not a factor of the material of the implants themselves, but more a factor of just having an implant itself.

Of course, saline implants themselves have many benefits…it’s easier to see ruptures on a scan, they can be “adjustable” (your doctor inflates them after they have been inserted – even sometimes after you’ve left the operating room).

In the end, however, the decision about which implants to use will be up to you and your doctor.

As always, be sure to ask plenty of questions and make sure that your doctor answers your questions “in plain English” so that you are making the best decision for you and your family.

Myth:It’s easy to tell if someone has had breast augmentation just by looking at them

This is a myth. You absolutely do not have to look like you’ve had implants unless that’s the outcome you desire. There are many choices for breast augmentation, and this is another reason why it’s important to ask to see your doctor’s before and after pictures and talk to other people who have implants. You definitely want to think about how you want to look and feel after your augmentation. These days, there are many, many options for the size, shape and placement of your implants… You can get high profile implants, low profile implants, silicone or saline implants… You can opt for a natural looking breast, breasts that defy gravity (and nature)…or some happy medium in between. The important thing is that you are healthy and happy after your surgery.

Before you make the decision to have breast augmentation, think about what you want the end result to be…and don’t be shy about making your preferences known.

Do you feel like your breasts have never really fit your frame and want to just add a little volume so that they fit your body better? Is one of your breasts considerably larger than the other? Do you need some help so that they match? Or do you want a whole new look?

A good plastic surgeon with experience should be able to help you get the breasts you feel you should have been born with. But you have to be as specific as possible about the end result. So you will want to think about a number of things… and be prepared to answer these questions before you talk to your surgeon.

How do you want your breasts to look under a shirt?
How do you want your cleavage to look in a bathing suit or low cut top?
What size bra do you want to wear?
Do you want to look like you were born with your new breasts?
Are you athletic (i.e. a long distance runner)?
Is there someone you know (or maybe a celebrity – A list or D list) who has a figure you’d like to achieve? – If so, bring a picture to your appointment. But please keep in mind that your end result is going to depend a lot on your own physical characteristics / frame…and that the size and shape of your implant will depend a lot on you.

When you talk to your plastic surgeon, don’t leave anything out, and don’t be shy. If you’re on the fence about the size you want, be sure to speak up. The two of you can work it out together to ensure that you get the outcome you’re hoping for… If you feel like your surgeon is not listening to you, or if you feel like they want to give you a result that is different from the one you have in mind, perhaps this surgeon is not for you. At the very least, your surgeon should be able to talk to you “in plain English” to ensure a great outcome!

10 questions to ask your plastic surgeon…in Plain English…

Are you a member of the ASPS? And why do I care?
This is very important, because your physician has to demonstrate a certain level of proficiency and skill in a number of areas to qualify. There are many doctors marketing themselves as “cosmetic surgeons” who are not even plastic surgeons and do not meet the requirements for membership of the American Society of Plastic Surgeons. The ASPS is the governing body for plastic and reconstructive surgeons. To become a member, your plastic surgeon must be board certified and have at least six years of surgical training and experience, with at least three years in plastic surgery. They are required to adhere to a strict code of ethics and operate only in accredited medical facilities. Additionally, they participate in advanced training and continuing education.

Are you board certified? And in what field?
There are doctors marketing themselves as “cosmetic surgeons” who may have little or no formal training in plastic surgery. Board certification guarantees that a surgeon has trained in and is deemed qualified to perform plastic surgery.

There are several different paths to become a plastic surgeon, and most involve training in general surgery or ENT for at least five years. According to the website of the American Board of Plastic Surgery, to be board certified by the ABPS, your doctor must have graduated from an accredited medical school and has completed at least five years of additional training as a resident surgeon in a program accredited by the Accreditation Council for Medical Education or the Royal College of Physicians and Surgeons of Canada. This includes a minimum of five years of residency training in all areas of surgery, including at least two years devoted entirely to plastic surgery. Certification is a voluntary process a surgeon seeks after this training. To become certified, the doctor then must pass comprehensive written and oral exams.

You can confirm your doctor’s certification by visiting the website for the American Board of Medical Specialties, or www.abms.org.

Where do you perform your procedures? (In the office? An accredited surgery center? A hospital?)
You should understand what kinds of amenities/ resources are available when you are having any kind of medical procedure. You need to understand if and how your physician is equipped to handle a complication; in the rare case that one arises.

Do you have privileges at an accredited emergency room?
Again, this will help you understand whether your physician is qualified to treat you. Members of the American Society of Plastic Surgery are required to operate only in accredited facilities. Also, this indicates that a surgeon has been credentialed to perform surgery at an accredited hospital facility. Should major complications arise, admission to the hospital may be necessary.

Have you performed this procedure before?
Every patient and each procedure is unique; however it is important to understand whether your surgeon has experience in your area of need.

Will I see you again after the surgery? Where? When?
These are questions you should ask your doctor at your first appointment. It will give you some insight into how the office works and help set expectations before you’re in a postoperative haze. As always, communication between the patient and the doctor is critical, and close follow up may be necessary for your care. Keep in mind that some minor procedures may not require immediate or close follow up as long as no complications arise after surgery.

What if I need help after hours?
This is something to understand before you have a medical procedure. If you have questions, will you be able to get an answer after hours, or will you have to wait until the next day (or head to the emergency room in an extreme situation)? Some physicians may have a nurse or another physician answer calls after hours. Either way, it is important to know that a qualified person may be the one responding to your call in the middle of the night.

What are the risks associated with this procedure?
Any elective procedure has risks and benefits associated with it. It’s important to understand potential risks at the outset so that you can be prepared in the rare event that something goes wrong. You might want to determine ahead of time how your insurance company handles hospital admissions after an elective procedure, and determine how much time you may take off from work. As always, it’s up to you to determine whether the potential benefits (i.e. a more beautiful you!) outweigh the risks, and it is your surgeon’s responsibility to help you understand these things. But, keep in mind that it is not the surgeon’s responsibility to make decisions for you, but to give you all the information you need to make an informed decision.

Who will be assisting you in this procedure?
Does your doctor have a regular team? Who are they? How long have they worked together? Surgeons may have physician assistants, surgical assistants, or nobody assisting them in the operating room. Sometimes, the assistants may require separate billing that you should keep in mind. This information should be presented to you before your surgery.

Do you have any before and after pictures of patients who have received this procedure?
Before and after pictures are very helpful in setting realistic expectations. Don’t be shy about asking to see them, and definitely ask tons of questions! Again, communication between the doctor and the patient is always key.