Tag: skin care

Best Mommy Makeover Options

Dr. Larry Nichter
Dr. Larry Nichter

For women, having a child life-changing event. The capability to create, foster, and give birth to a child of your own distinguishes women in the human species. The nine-month transformation from a tiny embryo to a human being in itself is a magical event, but it transforms the mother’s body as well, often in a non-favorable direction. A mother goes through many different changes during pregnancy and the birth process. In many cases, areas of a woman’s body may not return to the same shape prior to pregnancy.

Thanks to current medical procedures, mothers are often able to restore their bodies back to their pre-birth shape or even better. After breast feeding is complete and you have fully recovered from pregnancy, there are various steps that can be taken to get your body back into shape. In what is commonly known as the Mommy Makeover — various procedures such as breast augmentation, breast lifts, liposuction, tummy tucks, fat transfer, and other procedures — can be done to get your body back into top condition. Most of these procedures can be done in combination to complete your makeover or can be done in separate steps.

Breasts

In most cases after childbirth, women often find that their breasts become out of shape due to breast-feeding or growth then shrinkage after pregnancy. The breast often loses volume on the top and sags and becomes less firm and out of shape (post-partum involution). This can produce visual changes that women want to fix and improve. With straightforward procedures, breasts can be transformed to the desired state with a variety of techniques including breast augmentation using fat transfer (called California Breast Lift in my practice) or implants with or without a lift. These procedures can give your breasts a natural look and maintain volume that was present prior to pregnancy. Some surveys have stated that up to 90% of patients have found success with these procedures, with remarkable results and happiness.

After breastfeeding and childbirth, mothers often find that excess skin results or the skin around the breasts is loose resulting in sagging. In these cases, a breast lift can also be done to reshape the skin envelope and uplift the areola/nipple position. By itself, this procedure isn’t done to change the size of the breasts, but is done more to affect the contour and firm up the breast skin and underlying breast tissue. Newer, minimal scar breast lift techniques, can affect the breast size if combined with a breast augmentation or reduction procedure to enhance the shape, size, and position of the breasts.

Tummy and Hips

Following pregnancy, women often find that the tummy and hip areas are the main concerns for improvement following delivery. After giving birth, women often try to return to their pre-baby weight and find that even if they lose those pregnancy pounds, that they cannot get their tummies back into the desired shape. A tummy tuck with or without liposuction can be performed in this case to remove excess skin, fat, and tone up your tummy muscles. This tried-and-true procedure in the hands of an experienced plastic surgeon will result in a firmer and smoother stomach. Weakened, stretched, and separated muscles (Diastasis Recti) are reshaped during this procedure and will transform your abdominal wall into a well-toned tummy. Giving birth can result in your abdominal skin and muscles being stretched out of shape. A tummy tuck will reshape it back into its toned natural shape, sometimes even better than before you were pregnant. Liposuction is often done at the same time and the fat removed can be used by transferring it to areas that may have lose volume such as your buttocks (Brazilian Butt Lift) or breasts.

Skin

Most women following pregnancy will get stretch marks but this doesn’t mean you can’t do anything about them. Stretch marks, also called striae, can also occur as a result of pregnancy. The tummy tuck not only reshapes the stomach muscles and skin, but also removes these a large number of stretch marks below the belly button. Certain lasers are also available that can get rid of the redness and shrink the width of stretch marks while improving the texture of your skin. Spider veins or red spots (angiomas) following childbirth can vanish seemingly instantly with special lasers and without downtime afterwards. Prominent superficial veins in the legs and other areas also can occur after having a baby. These can be treated in the office with lasers and injections (sclerotherapy).

Skin tone and texture can also be improved. For example, Cellulite and skin wrinkling can be tightened noninvasively. Likewise, circumferential reduction of the waist and thighs with a series of non painful, non-invasive treatments combining the energy sources of RF (radiofrequency), IR (infrared) aimed at improving the skin and superficial fat (e.g. Velashape III).

Fat

After pregnancy and with age, fat can accumulate in different areas that are resistant to diet and exercise. In concert with the Velashape® treatments, Liposuction or other non-invasive non-surgical fat reduction procedures are often helpful. Whether it’s the tummy, hips, thighs, back, or upper arms, liposuction can get rid of the excess fat collection that occurs after pregnancy. By getting rid of these excess bulges along with a sensible diet and exercise plan, you can get your body back into top shape. Other non-invasive techniques such as CoolSculpt® and newer techniques such as Ultrashape®, and Vanquish® are all possibilities for non-surgical fat reduction. As all techniques work differently make sure you go to an expert plastic surgeon to decide which is best for you. These techniques reshape your skin and body towards to your desired shape and best of all there is no down time and minimal if any discomfort. With regular core exercises, you are well on your way to an “abs of steel six-pack”. Exercise maintenance and a stable weight should give you a life-long result.

Belly Button

Another part of the body that might be affected post pregnancy is the belly button, also called umbilicus. The pregnancy cycle can stretch or distort the belly button area. The tummy tuck can assist with making your belly button smaller, however if this is your only concern, improving your belly button’s appearance via a procedure known as umbilicoplasty is possible. An umbilical hernia usually recognized by an “outie belly button” can also be repaired at the same time and often performed under local anesthesia as an office procedure.

Vaginal and Labial Rejuvenation

Especially following vaginal delivery, and important to femininity and intimacy, sometimes the vaginal area is stretched out and loses optimal tone. This can be corrected with a vaginoplasty to firm up and increase tone to the vaginal canal, giving increased intimate sexual satisfaction to the woman and her mate. Likewise, the labia minora (inner lips) might be overly large as a result of pregnancy or genetics. Labia reduction is corrected with a procedure called labiaplasty. The mons pubis, hair bearing area, often becomes bulky, sags, and shows through clothes following pregnancy. This can be corrected with a “monsplasty” procedure. These procedures are often performed as an outpatient procedure, often at the same time as other mommy-makeover procedures.

Skin Pigmentation

Lastly, persistent darkened skin pigment changes may occur on your face, also called Chloasma or Melasma (“mask of pregnancy”). Tailored medical grade lightening creams, peels, and lasers can be done to help with the discoloration that can occur following pregnancy in the facial and other areas.

Conclusion

All of these mommy makeover procedures and others are done in an effort to regain your ideal image, shape and composure following pregnancy. Just because you’ve had a baby, this doesn’t mean your body should be neglected. You can choose from a combination of procedures to get your body back into shape, firmer, and smoother following pregnancy. As always, consult an experienced board certified plastic surgeon before any procedure, discuss treatment options, as well as recovery time, risks, and possible non-surgical alternatives to surgery. Where the gift of lift is a wonderful thing, a mommy makeover can be the best gift you give yourself after pregnancy.

Top Three Characteristics of Facial Aging

Three Ways the Face Ages –

Loss of elasticity and gravity over time

Volume redistribution – loss of volume in some areas, fat pockets in other areas

Surface characteristics – sun exposure, acne, etc.

All three of these issues are evaluated by Dr. Nichter during the consultation and recommendations are made as to which procedure or combination of procedures will provide the best outcome. Treatment may include any one or more of the following: facelift, neck lift, fat transfer or fillers, liposuction, laser resurfacing, laser tightening, chemical peel, skin care regimen.

The Best Skin Care is at a Plastic Surgeon or Dermatologist’s Office

To look your best, see a plastic surgeon.

The Surgeons at Pacific Center for Plastic Surgery have combined efforts and created a medically based program for patients to look their best. Although many dermatologist are trained in ways to keep your skin looking the best it can, Plastic Surgeons have the unique ability to know the limitations of skin care and offer aesthetic surgical correction as needed to complement the improved texture, tone and color blending that skin care affords.

Medical Skin Care

At Pacific Center for Plastic Surgery, we have developed a medical skin care program called BioSpa. BioSpa has the highest trained and experienced plastic surgeons, nurses, and medical aestheticians. Doctors Larry S. Nichter, MD, FACS and Jed H. Horowitz, MD, FACS are the medical directors of this program. Strict guidelines for care using physician approved protocols are crucial to providing efficacious and safe treatment outcomes. Our goal is to provide medical grade skin care in a spa setting in a safe manner with results not obtainable by non-medical aestheticians.

We are committed to becoming the gold standard exceeding patients’ expectations whenever possible. Our care and treatments are to be contrasted with the multitude of skin care programs that are not directly supervised by a Plastic Surgeon or Dermatologist and cannot use the prescription-strength products, injections, or lasers that we utilize. We work in concert with these centers rather than compete with them, and often refer our clients back to them for routine maintenance care such as facials or microdermabrasion.

When should an Aesthetician refer to a Medical Aesthetician working with Plastic Surgeons and Aesthetic Nurses?

Aestheticians and Medical Aestheticians need to work hand-in-hand to develop a successful skin care program. Each offers different levels of services. Identification of those conditions requiring advanced services or medical products are key to the success of this program.

Clients with the following conditions should be referred to a medical aesthetician:

  1. Hyperpigmentation and irregular pigmentation, age spots
  2. Acne and its complications – e.g. scarring, hyperpigmentation, and large pores
  3. Rosacea
  4. Rhytides (Wrinkles) treatment
  5. Patients with medical conditions such as Diabetes, Exzema, history of cold sore, shingles, psoriasis, rosacea, or steroid use
  6. Scar Management
  7. Previous chemical peel or laser treatment
  8. Severe sun damage (actinic changes of the skin)
  9. Plateau of results by conventional spa services requiring more aggressive medical based protocols
  10. Patients with a history of Skin Cancer or pre-cancers ( e.g. Actinic Keratosis, pigmented sores, or scaling lesions)

The following constitutes some of the treatment tools restricted to Medical Aestheticians:

All products consisting of skin care lotions, ointments, liquids, substances, creams, powders, preparations, tonics, antiseptics, and other skin care items and products which the manufacturers or distributors will make available only to a physician or to persons who are working under the guidance of a physician as to their proper use. For example these include all products within the Obagi and / or Biomedic lines, as well as retinoids (e.g. RetinA), antiviral agents, 4% or greater hydroquinones, TCA, etc.

Medical procedures and use of medical equipment which must take place by physician protocol and/or oversight:

  1. Depth of Treatment as solo procedure with a non medical machine based on a more thorough treatment determined by number of passes or time per area; any procedure which requires recovery time because of redness (erythema).
  2. Medical Grade Machine, e.g., limited distribution to medical professionals, options for increased power settings, or medication delivery systems.
  3. Treatment of Patients with Medical Problems Acne, Roseacea, scars, stretch marks, non-uniform pigmentation (dyschromias), history of skin cancer, herpes, diabetes, hepatitis, HIV, previous laser or chemical peel prescription, etc.
  4. Non-medical grade microdermabrasion coupled with other treatments, e.g., glycolic, TCA, lactic acid or Jessner Peel, 4% hydroquinone, Oxymist, Dermaplaning, Micro Peel, Cryotherapy, etc.
  5. Chemical exfoliation (peels) within the scope of a cosmetologist’s license and affecting non-living tissue only, including Blue Peel, TCA peels and medical grade glycolic peels.
  6. Dermaplaning living tissue only per protocol.
  7. Laser treatments such Permanent Laser Hair reduction, IPL (photofacial) laser, vascular lasers (for broken capillaries or veins and red spots), color and scar improvement, and lasers for facial resurfacing.
  8. All injectibles such as Jeuvederm, Restylane, Sculptra, Radiesse, Voluma, Botox, lipoinjection (fat transfer). Surgical procedures.

Larry S. Nichter, MD, MS, FACS