Transcription:
Do You Need a Mommy Makeover?

Melanie Cole (Host): After childbearing, many women are dissatisfied with the appearance of their body. Pregnancy and breastfeeding can have a negative impact on the breasts and abdomen and the way a woman feels about herself. My guest today is Dr. Jennifer Cameron. She’s a plastic and reconstructive surgeon with Aspirus Plastic Surgery. Welcome to the show, Dr. Cameron. What happens to women as they age, and specifically after that, they have had children?

Dr. Jennifer Cameron (Guest): Hi, thanks for having me. I think that – I can speak both personally and professionally on this as I am a woman plastic surgeon and also a mother. There are a variety of changes that I think happen to women's bodies, some of which are associated with having a child or child rearing. but also, I think a lot of it’s just from time. Starting from the top -- basically, one of the things we always talk about is facial rejuvenation. I think that many sleepless nights spent with breastfeeding your child or being up all night or basically just a bunch of sleepless nights in a row can lead to some bags under your eyes, so I think one of the first procedures that we talk about with the Mommy Makeover is blepharoplasty, which is where we can help tighten up some of the excess skin around the eyelids and rejuvenate some of the bags.

Going down to our breasts, I think that a lot of times with the weight gain and hopefully subsequent weight loss associated with being pregnant, women's breasts tend to lose some of their projection and become a little bit deflated and then, also, the nipple position tends to move a little bit south. Breastfeeding obviously exacerbates this problem, so I think after having children, women's breasts are a little different looking than maybe when they were like 15 or 18-years-old.

With our abdomens and accommodating the large fetus, obviously, our muscles and our fascia of our abdomen can stretch. This can cause exterior changes such as stretch marks and rippling and redundant skin, but it can also cause internal changes such as rectus diastasis, which is basically where your rectus muscles – the two muscles that give you a six-pack in the anterior portion of the abdomen – those can spread apart and have some laxity there.

And then, continuing down south, one of the fastest growing procedures that we see in the world of plastic surgery right now is labiaplasty. I think that a lot of times after having a vaginal delivery, or just, again, with the associated weight loss and weight gain of pregnancy, it can help – some women have some stretching and some loosening and some droopiness in their vaginal area that they want to tighten up some of that excess skin.

And then in your lower extremities obviously we have lovely spider veins and varicose veins and some changes down there as well that we can target as plastic surgeons.

Melanie: Boy, we sure women have it easy, don’t we? Really, all of these things --

Dr. Cameron: Exactly, I know.

Melanie: When a woman comes to you and tells you some of these feelings that she’s having or whether it’s because of self-esteem, or if it’s truly because something has really changed, what do you tell them about undergoing some of these procedures and what she should look to, and what questions that she should ask you?

Dr. Cameron: Well, I think that that is a really important point that you brought up and the stem of the question is you have to look at the woman motivation for this procedure. Obviously, some people are doing it for reasons that aren’t healthy, it’s not going to – I was reading some articles on Mommy Makeovers online, and it’s not going to change the way your spouse or your partner feels about you, so you shouldn’t do any sort of surgical procedure for someone else. The reason should always be altruistic and to better yourself. That’s one thing that people should really look at what are your reasons for having this procedure done?

The second thing that I always talk about with women, especially women who have had children and who are coming in for a quote-unquote Mommy Makeover is, are you done having children, or are you planning on more children in the future? I wouldn’t say it’s a deal-breaking if you’re planning on having more children, I just think if you want to have the most long-lasting and optimal results, you don’t want to go through the same process, which maybe led you down this road again. And I also want to make sure that – do you have support? Is there someone who’s going to be there to help watch your kids for the recovery process? Did you just start a new job and maybe you don’t have that much time to recover? Any time you’re considering a procedure, whether it’s cosmetic or for other reasons, you always have to set yourself up for success. It’s a huge investment, and I always say, “Physically, financially, and emotionally,” and so you want to make sure that you have the emotional support and then you also can take time off from your job, or your job as a mother, to give yourself permission to rest and to really heal.

Melanie: When you mentioned all the different procedures that are involved, Dr. Cameron, if you had to tell a woman, the first one, and she mentioned a bunch of things, and you’re talking about those emotional issues and why they’re doing this particular type of procedure or why they want it, what would you tell them as far as all those different ones that you think, as the physician, you would start with?

Dr. Cameron: And that’s why the preoperative consultation is so important. It’s really an exchange back and forth. It’s the same thing when somebody comes to me, and they want to talk to me about facial rejuvenation. We literally stand in front of a mirror, and I say, “Tell me what about your physical appearance makes you feel uncomfortable, or what is it that your eyes are immediately drawn to?” It’s the same thing with the Mommy Makeover because everyone’s body changes differently and everyone recovers differently from pregnancy, and also everyone has different areas that are their problems areas. You can’t do all of the different procedures that I listed in the beginning in one session. It’s just not safe to undergo that much anesthesia, and you’re probably not going to really appreciate all of the changes. It’s just a lot to do everything at once, so I always say, “What are the things that are bothering you? Is it your breast, is it—“ I think when people think of a Mommy Makeover they think of breast, abdomen, labiaplasty and then probably some liposuction, so I say, “What is going to make the biggest change for you emotionally?” And then we start there.

And also you have to look at like I said, do you have support? It takes a little bit longer time to recover from an abdominoplasty or a tummy tuck than it would from maybe some lower extremity vein work, or a little bit of facial filler, or a blepharoplasty, so we just have to really look at each person individually.

Melanie: What do you tell them about the cost when they ask you about insurance and if anything is covered and how they can pay for this?

Dr. Cameron: Well, that’s the million dollar question. Pretty much all of the things we talked about today are not covered by insurance, and that again, is definitely part of the negotiation and part of the conversation and why the preoperative appointment is so important is to come in and speak with someone who is a trained surgeon and then who can give you the realistic costs. We do things – there’s different options for payment, and I honestly, just for ethical reasons, I try to stay out of the payment and the insurance process. I give my clinical and medical decisions and recommendations and then I let some of the other people whom I work with in my office make those decisions about pricing and those are the people that negotiate with the surgery center and anesthesia costs and everything like that, just because I think that it’s a conflict of interest if I’m doing everything and I think that you can – it’s just a fine line to walk. A lot of the stuff that we do is a significant financial cost, and I think most people are aware for ballparks and then you just have to actually have to come in and get a consultation to know the actual prices of things.

Melanie: And you mentioned that one of the questions you might ask women is, is she planning to have more babies? How does that affect some of these procedures like she’s not going to have a labiaplasty if she is planning to have another vaginal birth, or the abdominal tummy tuck, as it were – are any of these things limiting if she is planning to have more babies?

Dr. Cameron: It’s kind of like I said before. I don’t think it’s a deal-breaker, but I just don’t think you’re going to get the lasting and the results that you really want. Especially when women are thinking about having a breast procedure, you have to think are you still breastfeeding? [LAUGHS] This could obviously lead to complications as far as infection -- or are you planning on breastfeeding in the future because that might be affected by the type of breast procedures that we do.

For a tummy tuck, especially if we’re going to do some rectus plication, which is where we actually sew the rectus muscles back together, then having another child and stretching that isn’t going to injure anything, it just might not return to as tight of a tummy as one would want if you had all that time, spent all that money, had all that recovery and then you get pregnant right away you might not have the same results.

And then the labiaplasty, I think the labiaplasty is fine. It probably won’t be a huge difference, but it’s just the same thing. If getting pregnant is what maybe caused some of these changes and then getting pregnant again after the labiaplasty, you might have a recurrence of some of your previous symptoms.

Melanie: So wrap it up for us, give us your best advice about the questions that you would like a woman to ask when she’s considering some of these procedures and a Mommy Makeover, and how it can affect her quality of life, her self-esteem, her emotional well-being as a mom. And you and I both know, Dr. Cameron, that these are tough times and we can get stressed out and sometimes we just need to do a little something for ourselves. So you tell the women out there what you want them to know about this.

Dr. Cameron: Oh, that’s a great question. I think the first thing is if you’re thinking about any of these procedures is to really do your homework. I would say make sure that you’re going to a properly trained, certified surgeon and not someone who perhaps dabbles in this because their price might be a little bit better. Make sure that you’re going to be doing all of these procedures in an accredited operating suite and not in someone’s office where they might not have all the safety equipment, so I think the first thing is safety above all.

The second thing is is to really evaluate why you’re doing the procedure. Make sure that this is something that you’re doing for yourself, you don’t have any external influences, you’re not doing it for ulterior motives, because I do believe, like you said, as women, as mothers, I think we give so much of ourselves so I think it’s really important also to give back. There's no amount of pushups that you can do that will lift your breasts in place. There’s no amount of sit-ups that you can do that will really correct skin-redundancy on your abdomen. I really look at plastic surgery as a spectrum and there’s certain things that we do – we eat a certain way, we work out, we rest, we dress a certain way – plastic surgery is just an adjunct to really feeling and presenting ourselves in the best possible light. Make sure that your motives are true and that you’re not doing this to gain another’s affection or something like that.

And then, second I would make sure that you really set yourself up and give yourself time to recover. Like I said, it’s a huge investment, and you need to give yourself time to heal appropriately. Sometimes there are little hiccups in the healing process, and you want to have someone who can help watch your children. You should be able to take time off of work without stressing that you’re going to lose your job. And also, like we talked about, the financial aspect is significant. Make sure that you have the finances to do this at the time that you choose to do it because what’s more stressful when you’re recovering from surgery and you’re trying to raise children than trying to pay off a large debt?

Melanie: And now tell us about your team at Aspirus Plastic Surgery.

Dr. Cameron: We have three plastic surgeons. We have myself, Jennifer Cameron, and then my two partners, James Kong, and Stephen Fox. We have an office off of Rib Mountain, and we operate at both Aspirus Wassaugh Hospital as well as out of the Wassaugh Surgery Center. We are hoping to start doing some outreach at some other Aspirus Clinics as well in the near future as we continue to expand our practice.

Melanie: Thank you, Dr. Cameron, so much, for being with us today. It’s such important and interesting information for women to hear. You’re listening to Aspirus Health Talk, and for more information, you can go to Aspirus.org, that’s Aspirus.org. This is Melanie Cole. Thanks for listening.