Mommy Makeover Miami

Although pregnancy brings with it a variety of body changes, becoming a mother is probably one of the most rewarding life experiences a woman can have. The changes a woman’s body undergoes during pregnancy and her ability to regain her pre-pregnancy shape depends greatly on genetics. However, women who have not been blessed with the ability to bounce back on their own now have another option, a Mommy Makeover with Dr. Sam Gershenbaum, who is an award-winning, board certified, plastic and reconstructive surgeon in Miami, Florida.

Each Patient is Unique

A Mommy Makeover consists of a set of procedures specifically tailored to meet the needs of the patient. Dr. Gershenbaum and his staff know that each patient is unique; therefore, not every patient will need the same procedures in their Mommy Makeover plan. For this reason, Dr. Gershenbaum tailors each Mommy Makeover plan he creates to meet the needs of a specific patient.

Procedures frequently incorporated into a Mommy Makeover in Miami include:

• An abdominoplasty (tummy tuck)
• A breast augmentation (breast implant surgery)
• A Mastopexy (breast lift)
• Liposuction/Liposculpture (to remove excess fat deposits and contour the body)

The Elasticity of the Skin and Fascia

The elasticity of a woman’s skin and fascia are inherited traits. The elasticity characteristics of her skin and fascia determine how successful a woman’s body will be at addressing the stretched skin on her abdomen as well as on the other areas of the body.

During a Mommy Makeover with Dr. Gershenbaum in Miami, the excess skin on the abdomen can be addressed with an abdominoplasty and liposuction/Liposculpture.

How Pregnancy Affects the Abdomen

The hormones produced during pregnancy create an environment to support the growth of a healthy baby: However, these hormones also cause the mother’s body to change.

Abdominal Stretch Marks

As the mother’s abdominal skin stretches, her dermis (second layer of skin, directly beneath the epidermis) tears. Although her epidermis (outermost layer of skin) remains intact, stretch marks result. Unfortunately, this excess, overstretched skin hardly ever retracts, thus causing the skin of the abdomen to hang over the pelvis. In addition, to accommodate the growth of the baby, the abdominal wall becomes distorted.

The Rectus Abdominis Muscles Separate

The paired rectus abdominis muscles in the abdomen become separated: This separation leads to an increased abdominal circumference and permanent bulges above, and below the navel. Exercise cannot reduce these bulges because the fascia between these muscles has not retracted and does not respond to the strengthening of the muscles.

A Slightly Distorted Abdominal Wall May Only Require Liposuction

If the patient’s skin quality is favorable and her abdominal wall is only slightly distorted, she may only need a combination of Tumescent and Ultrasonic Liposuction on her abdomen included in her Mommy Makeover plan. However, the majority of women will need to have a full abdominoplasty in conjunction with liposuction to attain the results they desire.

An Abdominoplasty as Part of a Mommy Makeover in Miami

As part of their Mommy Makeover, many women in Miami choose to have an abdominoplasty. During an abdominoplasty, Dr. Gershenbaum restores the abdominal wall and removes excess skin on the abdomen.

An Abdominoplasty in Miami– The Procedure

1. Anesthesia

So they remain comfortable throughout their procedure, patients receive medication: Medications used during an abdominoplasty include general anesthesia and intravenous sedation. These medications are administered by an anesthesiologist.

2. Creating the Incision

To perform a full tummy tuck, Dr. Gershenbaum will create an incision that runs horizontally from one hip to the other. This incision is created in the area between the belly button and the pubic hairline. The length and shape of this incision are determined by the amount of excess skin Dr. Gershenbaum needs to remove.

3. Repairing the Abdominal Muscles

After lifting the skin, Dr. Gershenbaum uses stitches to tighten the weakened abdominal muscles.

• If Necessary, a Second Incision is Created

If excess skin needs to be removed from the upper abdomen, a second incision will be created around the navel.

• Excess Skin from the Upper Abdomen is Removed/Navel Incision is Closed

Following the incision around the navel, the excess skin on the upper abdomen is trimmed away and the skin that remains is joined together with stitches. Dr. Gershenbaum will create a new opening for the navel. The patient’s natural navel is then brought to the surface and sutured into position.

4. Closing the Incisions

Dr. Gershenbaum uses stitches to close the incisions.

5. The Results

Following a tummy tuck as part of a Mommy Makeover, patients enjoy a firmer, flatter abdominal contour.

Although the scar from an abdominoplasty is substantial (generally running from one hip to the other), it is placed directly above the pubic area, therefore, it will not be visible while wearing a two-piece swimsuit. The majority of Dr. Gershenbaum’s patients have little concern when it comes to the scar because they are happy with the results achieved from their tummy tuck procedure. Furthermore, with time, this scar fades.

The Breasts

Another area of the body that is frequently affected by pregnancy (and breastfeeding) are the breasts. Dr. Gershenbaum can address stretched, sagging, deflated-looking breasts as part of a Mommy Makeover with a breast augmentation and/or a Mastopexy.

How Pregnancy and Breastfeeding Affect the Breasts

As the breasts prepare to produce milk, the glandular components of the breasts enlarge. Furthermore, the fat storage and weight gain caused by the hormonal changes a woman experiences during pregnancy can also increase the size of the breasts substantially.

Reduced Breast Size Following Pregnancy/Breastfeeding is Not Uncommon

Once a mother is no longer lactating and the pregnancy hormones have subsided, the volume of her breasts reverts back to their pre-pregnancy size. Some women notice that their breasts do not return to their original pre-pregnancy size, but instead, shrink. Now, the skin is stretched and the breasts themselves are smaller.

Overstretched Skin Affects the Appearance of the Breasts

Regrettably, on many occasions, the skin on the breasts remains stretched because it is unable to return to its original pre-pregnancy state. This overstretched skin typically causes the breasts to sag: Furthermore, it causes the breast mound to lie lower on the chest, which makes the upper portion of the breast appear deflated.

A Breast Augmentation as Part of a Mommy Makeover in Miami

If the patient’s nipple-areolar complex remains unaffected and the distance between the fold to the nipple is not significantly elongated, and the skin itself is not excessively enlarged, Dr. Gershenbaum may recommend that the patient include a breast augmentation in her Mommy Makeover plan. Once the breast implant is placed, the patient’s breast will have a fuller, more appealing shape.

A Breast Augmentation – The Procedure

1. Anesthesia

Patients receive medication to ensure they remain comfortable throughout their breast augmentation procedure. Prior to surgery, medications are administered by an anesthesiologist. Medication options include intravenous sedation and general anesthesia.

2. Creating the Incision

Incision locations vary depending on the degree of enlargement the patient desires, the type of breast implant she chooses and whether she would like the implant placed above or below the pectoral muscle.

Breast Augmentation Options in Miami

Breast implant options include:

• Silicone, saline or gummy bear implants
• Textured or smooth implants
• Round or teardrop shaped implants

Breast implant placement:

• Subglandular/Submammary – over the pectoral muscle
• Submuscular – under the pectoral muscle

Incision Options

• Inframammary – this incision is made on the underside of the breast near the crease
• Periareolar – this incision is made in the dark skin (areola) that surrounds the nipple
• Axillary – this incision is made in the armpit
• Trans-Umbilical – this incision is made in the upper portion of the navel

3. Inserting the Breast Implant

   The breast implant is inserted. The insertion method Dr. Gershenbaum uses depends on the degree of enlargement a patient desires, the type of implant she chooses as well as the patient’s body type.

   4. Closing the Incisions

   Dr. Gershenbaum will use layered sutures to close the breast tissue. He then uses a skin adhesive, sutures and/or surgical tape to bring the outer skin together.

   5. Bandage Placement and Support Bra Application

   Directly following the breast augmentation surgery, patients are bandaged and then a support bra is placed over the breasts.

   6. The Results

   The results of a breast augmentation are visible immediately.

   A Breast Lift

   If the nipple-areolar complex is positioned low, with or without an increase in the length of the skin from the nipple-areolar complex to the fold, Dr. Gershenbaum will most likely recommend a breast lift.

   A Breast Lift in Miami– The Procedure

   1. Anesthesia

   Patients receive medications during their breast lift. Although the majority of Dr. Gershenbaum’s patients receive general anesthesia to ensure they remain asleep throughout the procedure, in some instances, he chooses to use local anesthesia with intravenous sedation instead.

   2. Creating the Incision

   There are three incision options for a breast lift:

• Around the areola and then vertically down towards the breast crease (lollipop incision)
• Around the areola (donut incision)
• Around the areola, vertically down to the breast crease and then along the breast crease (anchor incision)

3. Reshaping the Breasts

   Once the incisions are made, Dr. Gershenbaum will improve the contour and firmness of the breast by lifting and reshaping the underlying breast tissue.

   4. Repositioning the Nipple and the Areola

   The nipple and areola are repositioned to a natural-looking, higher location on the breast. When necessary, Dr. Gershenbaum decreases the size of the areola by removing excess skin in that perimeter.

   5. Excess Breast Skin is Removed

   To address the loss of elasticity, excess breast skin is trimmed away.

   6. Closing the Incisions

   Following the reshaping of the breast and excess skin removal, Dr. Gershenbaum tightens the remaining skin as he closes the incisions. Just as with a breast augmentation, Dr. Gershenbaum layers the sutures within the breast tissue. These sutures provide support for the newly shaped breasts. Sutures are placed predominantly below the skin’s surface. This technique avoids cross-hatching sutures and optimizes the likelihood for less noticeable, fine scars.

   7. Applying Dressings, a Support Bra and/or an Ace Bandage

   Directly following closure of the incisions, a light dressing and support bra are applied. Some patients may also receive an ace bandage.

   8. The Results

   The results of a breast lift are visible immediately. Patients should expect some visible incision lines directly following their breast lift, however, these incision lines usually fade significantly as time passes.

   Using Liposuction During a Mommy Makeover to Address Areas of the Body with Excess Fat Deposits

   Despite exercising and eating healthy, many women have difficulty losing the weight that they gained during their pregnancy. Although plastic surgery is not intended to be used as a substitute for diet and exercise, it can be a used as a tool to assist women in regaining their pre-pregnancy body. For example, Dr. Gershenbaum can use liposuction to eliminate fat deposits in certain areas of the body that are typically resistant to diet and exercise.

   Typically, resistant areas include the:

• Lower abdomen and back
• Chin
• Inner knees, waist and hips
• Upper arms
• Thighs, calves and ankles
• Buttocks
• Neck
• Cheeks

Liposuction – The Procedure

1. Anesthesia

To ensure the patient remains comfortable throughout her liposuction procedure, she receives medication: Choices include general anesthesia, intravenous sedation and local anesthesia. These medications are administered by an anesthesiologist.

2. Creating the Incisions

To perform liposuction, Dr. Gershenbaum makes several tiny incisions in the areas being treated.

3. Infusing Diluted Local Anesthesia

Prior to inserting the thin, hollow tube (cannula) that will be used to remove the excess fat, the patient receives diluted local anesthesia. This anesthesia is infused directly into the area being treated: It is used to reduce the incidence of bleeding and trauma.

4. The Cannula is Inserted

Dr. Gershenbaum inserts the cannula through the tiny incisions he previously made. Using a controlled motion, he moves the cannula back and forth, dislodging the fat.

5. The Fat is Removed

Once dislodged, the fat is removed through suction via a surgical vacuum or a syringe that Dr. Gershenbaum attaches to the cannula itself.

6. The Results

Once the swelling decreases and the excess fluid dissipates, patients will be able to see their results.

If you are interested in learning more about the various procedures that can be combined during a Mommy Makeover in Miami, contact Dr. Sam Gershenbaum’s office today. To schedule an appointment by phone, please call 305.933.1838.