Mommy Makeover (Breast implants & Liposuction Tummy tuck)

Breast Lift (w/ implant removal) and Liposuction Tummy Tuck

Before & After "Mommy Makeover"

After pregnancy and breast feeding, the breast and belly often have lingering or permanent effects.  The skin can be stretched and lose its elasticity after the pregnancy is over and even after additional weight loss is accomplished.  The “Mommy Makeover” is a phrase that is used to describe the combination of breast and abdominal (belly) procedures to improve or restore the body to its pre-pregnancy condition.

Many people assume that the “mommy makeover” means having a breast implant placed but for those patients who don’t want to increase the size of their breasts, a mastopexy or breast lift can be done.  There are many ways to lift the breast:  from a small crescent shaped incision above the nipple-areola region to adding a vertical and/or horizontal incision in the fold under the breast.  Belly procedures range from liposuction to “tummy-tucks” or a combination of both.

One of the nicest reasons to combine procedures is that you also combine the healing phase:  Two procedures with only one recovery period.  Because every patient is different and is trying to reach different goals, the best way to determine if a “mommy makeover” is for you is to schedule an appointment for a complimentary consultation.  Dr. Maria Lombardo will discuss what bothers you and to go over expectations for surgery.  Call to schedule today!  760-610-8990

Everyone should be doing a few basics to take care of their skin (and men, this means you too!):

AM: wash, moisturize using a lotion with SPF for sun protection

PM: wash, mechanically exfoliate and moisturize with a richer/heavier lotion.

AND… every 6 months to a year…. Get a chemical peel! (for some people even more frequently)

A TCA (trichloracetic acid) Chemical Peel is a powerful and effective tool for resurfacing your damaged skin to yield the skin you are looking for and deserve. This medium depth peel will improve many of the skin conditions that we all see (and wish we didn’t!) when we look in the mirror. After peeling, your skin will be softer, smoother, with improved texture and tone and greatly reduced hyper-pigmentation (sun damage). Those are the differences on the surface of your skin. But the real magic is going on under your skin where collagen is being stimulated. This is what plumps up the lines and scars, yielding a smoother, more refined and beautiful complexion. This light to medium peel helps with the following skin conditions:  IMPROVES: Fine Lines, Acne, Sun damage, Blackheads, Improves skin Tone, Improves skin Texture, Rosacea, Milia, Age Spots, Shallow Acne Scaring, Enhanced penetration of topical skin care products (moisturizers, serums etc.)

How it works: Chemical peels are versatile tools that are used to resurface the upper layers of your skin by loosening the bonds between the dead skin cells that dull your skin, while stimulating the collagen beneath the skin to form and align, which in turn plumps up the fine lines and scars from below the surface. They have been around since Cleopatra bathed in sour milk (containing lactic acid!) to make her skin smooth. Fortunately, science has made a lot of progress since then and the chemical peels available now are sophisticated and effective. Peels vary in strength and provide different benefits.  Light peels (15% TCA) provide substantial results by removing sun damage and over time will help smooth very superficial lines. These peels have light peeling and flaking, not usually enough to avoid social situations. Medium peels (TCA 20% – 30%) are where the results really start to show. These peels can have heavy peeling, crusting and take 7–10 days to completely finish the peeling process. These are our most popular peels because they make the most difference, helping to smooth lines, plump up skin, strip off sun damage and reveal smooth, even skin. Skin must be taken care of very gently and carefully, but these peels are fantastic for damaged skin. This is one of the most commonly performed chemical peel in medical offices because it is one of the most effective and has the most impressive results. This is a very safe peel and is suitable for most skin types; however, some darker skin tones, particularly African American run a small risk of post peel hypo-pigmentation (areas of lighter discoloration).

After the peel your skin may be red, this is normal, and you may wear makeup to tone it down if you would like. Applying a moisturizer (e.g. Eucerin) will help with the tight sensation and keep the new skin lubricated.  About 2 days after the peel your skin will start to dry out and look leathery, brownish and aged, but don’t panic, this is what we want! Your skin is preparing to shed off, and that will occur over the next 3-5 days. You can encourage peeling by using warm compresses and taking hot showers, but you cannot pick at the skin! It must come off when it is ready to, not when you are ready for it to! By peeling off the skin you risk scaring by exposing skin that is not ready for the world yet, so allow the skin to shed on its own. As with all exfoliating products, the use of sunscreen is essential to obtaining the results you are looking for. If you are not able to commit to using a sunscreen, this is not the treatment you should choose as you will just damage your skin all over again!

People who are not candidates for Chemical peels:  Pregnant or Breast Feeding, Have Herpes, Using Accutane, Are immune impaired, have had problems with atypical scaring in the past (keloids, etc)

Call for an appointment today!     760-610-8990

Before Breast Reduction

After Breast Reduction

Most women want to have a curvy figure but there are many women whose overly curvy figure causes problems.  A disproportionately large chest can make it difficult to find clothes that fit.  From undergarments that are supportive enough but still look feminine to shirts that won’t button across the front with out gapping, shopping can be a chore.  If you can find something that fits across the chest it very often doesn’t fit through the waist and you can look wide or thick because of all the extra fabric.

5 months after breast reduction

But clothing fit is not the worst of the problems that women with large chests face.  Carrying around extra weight can cause stress and pain to the neck, upper back and shoulders.  Some women have grooves in the shoulders where the bra strap sits, holding up all the extra weight.  Infections between and under the breasts are quite common as well.  Often women with large breasts are not as physically active as they would like to be because the extra tissue “gets in the way” or makes running and jumping sports impossible because of uncomfortable or painful bouncing.

Breast reduction surgery is a wonderful option to improve back and neck pain, re-establish a more proportionate figure and restore self-confidence.  The surgery is a same-day procedure, so the patient goes home after surgery and usually feels less neck and back pain and can stand up straighter almost immediately.  Breast reduction patients are very happy with their new shape and regret not having done the surgery sooner.

For more information and for your complimentary consultation with Dr. Maria Lombardo call 760-610-8990 to schedule today.  Lombardo Cosmetic Surgery Center in Rancho Mirage offers a full range of cosmetic surgery procedures, call to see what Dr. Maria Lombardo can do for you.

Breast Reduction with axillary liposuction & tissue excision

Before

After Breast Reduction

Saline Breast Augmentation

Saline Breast Augmentation

Saline Breast Implants

Silicone implant on top of the muscle

Before & After Saline Augmentation

Breast augmentation or enlargement, also known as augmentation mammaplasty, can be performed on women with underdeveloped breasts or whose breasts have a ptotic or “drooping” appearance. This often results from pregnancy, breast-feeding, weight loss and as part of the normal aging process.

The surgery involves placing an implant either under the muscle or underneath the breast tissue itself to lift the overlying breast tissue, giving it a more “filled out” and natural appearance. Implant choices include saline (salt water) or silicone. The goal is to create a soft, natural-feeling and looking breast. Each patient is assessed to determine which implant type and which placement position is best for her anatomy and desired outcome.

General Procedure

The surgery is commonly performed in an outpatient setting at a hospital or surgical facility while the patient is asleep with general anesthesia. Breast augmentation involves making a small incision into the breast to be able to insert a breast implant. There are several possible locations for the small incision that will be used for inserting the breast implant. The most frequent technique utilizes an incision made in the lower portion of the breast. Another technique, though less frequently used, involves making an incision in the armpit. A third technique makes an incision around the areola (the darker skin surrounding the nipple). A newer technique uses an incision in the belly button, thus reducing the chance of scarring in the breast area. The best technique will be decided between the patient and the surgeon during the consultation.

During surgery, the breast tissue is raised to create an open pocket. Inserting an implant behind each breast can increase a woman’s breast size by one or more bra cup sizes. In some circumstances, particularly those in which there is breast asymmetry (uneven breast size), an inflatable implant may be used to allow the surgeon to adjust the level of inflation to attain breast symmetry and balance. Surgery typically lasts from 1 to 3 hours.

Recovery Process

Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and recovery time. A special, supportive bra is place after surgery to minimize movement of the breasts and will need to be worn for several weeks. Patients sometimes report minor pain associated with the surgery. This pain can be treated effectively with oral medication. While complications are rare, patients can minimize potential problems by carefully following the directions given by the physician after surgery.

500cc High Profile Saline sub-muscular breast implants

Saline submuscular breast augmentation

before saline sub-muscular breast implant

after saline sub-muscular breast implant

Tummy Tuck - Abdominoplasty - Before

Reasons for considering an Abdominoplasty

• Inability of dieting and exercise to improve the abdomen area.
• Excessive accumulation of skin following weight loss.
• Loss of skin elasticity or diastases (loose abdomen muscles) due to pregnancy or weight gain.
• The removal of unsightly skin and fat deposits as well as the proper alignment of the abdomen muscles to produce a more flattering look.

General Procedure

Abdominoplasty surgery can last from one to five hours, depending on the desired look and the patient’s unique anatomy. To begin the procedure, an incision is made just above the pubic bone area. This incision goes horizontally across the lower abdomen and sometimes around to the back. The skin is then stretched away from the muscle tissue, and excess skin is removed. The abdomen muscles can be tightened to provide a firmly contoured stomach and well-defined waistline. Finally, the incision is closed; and the skin is stitched back into place. Sometimes the procedure requires an additional incision around the navel in order to provide the best results.

Tummy Tuck - Abdominoplasty - After

Recovery Process

Post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and recovery time. As the body recuperates, the patient can expect some swelling, pain, and discomfort. . Medication can be prescribed to relieve any pain caused by the procedure. Drains are necessary for about a week to ensure excellent healing. A compression garment is usually required for about three weeks after surgery. Normal activities can generally be resumed within two weeks. It may take up to a year for the body to completely adapt to the new abdominal configuration. With proper diet and exercise the striking results of the surgery will be long lasting.

Before Brachioplasty

After Brachioplasty

Before Arm Lift (Brachioplasty)

After brachioplasty (arm lift)

With aging, weight loss, or a combination of the two, the skin of the upper arm often becomes loose and flabby. Patients are often self-conscious about raising their arms or wearing short sleeves. An upper arm lift, or brachioplasty, is a procedure that removes excess skin and fat so that the upper arm is more smooth and contoured. The procedure involves making an incision along the inner aspect of the upper arm from near the elbow to the armpit. The excess skin is trimmed and the incision closed so that the scars are hidden when the arms are down. The procedure is often combined with liposuction. Alternatively, liposuction may be used alone if no skin removal is required. If a patient has some excess but not enough to warrant a full brachioplasty, he or she may be a candidate for the minor brachioplasty procedure. The incision is placed in the axilla (armpit) and does not run the entire length down the arm to the elbow. It will not be as dramatic as the full procedure but is a nice alternative for someone with more modest skin laxity.

The thigh lift procedure usually involves both liposuction and the removal of excessive skin from either the inner or outer thigh or both.

Liposuction is a cooperative effort. The surgeon does her part and you (the patient) must do yours. We encourage you to lose weight after the surgery: usually about 10% of your pre-operative weight. If we eliminate your problem areas with liposuction then you will lose the weight in other areas and the end result exponentially improves. Traditionally, it’s much easier to lose weight after the surgery as we have reduced your fat to lean body mass ratio. This makes you into a more effective “fat burner.”

We utilize the “gold standard” method of liposuction called “Tumescent Technique.” This is performed by putting “tumescent” solution into the fat before the liposuction begins. This technique allows for smoother, more comfortable results after the procedure.

Finally, we utilize a 636 nm red light laser. Studies have shown that exposure to laser light of this wavelength will cause a cell membrane reaction that will make liposuction more efficient and provide for significant subjective improvements in post-operative pain management.

Liposuction is not a replacement for proper exercise and diet. Instead, liposuction is a reduction procedure for stubborn areas where fat accumulates. Used in combination with several areas of the body, liposuction can provide a well proportioned body appearance. Ideal surgical candidates are those already in good physical condition but having stubborn areas that do not respond to diet and exercise.

General Procedure

Liposuction can be done under general anesthesia with the patient asleep or under local anesthesia where the area is numbed and the patient remains awake. Through a tiny incision, a narrow tube or “cannula” is inserted and used to vacuum out the fatty tissue beneath the skin. The surgeon determines the amount of fat to be removed by massaging the skin and squeezing the tissue. After eliminating the excess fat, the incisions are closed by applying a compression dressing or bandage to the area in order to prevent bleeding, reduce swelling, and support the affected area.

Liposuction can last from thirty minutes to several hours depending upon the amount of fat to be removed. Liposuction surgery is an excellent procedure that can benefit those who want to remove unattractive fatty deposits.

Recovery Process

New techniques allow for faster recovery from liposuction procedures. The length of the recovery will depend on how extensive of an operation the patient undergoes. Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and reduce the recovery time. A support garment may need to be worn for several weeks after the surgery, depending upon which area(s) are selected to be treated. Patients sometimes report minor pain associated with surgery which can be treated effectively with oral medication. While complications are rare, patients can minimize the risk for potential problems by carefully following the directions given after surgery.

But clothing fit is not the worst of the problems that women with large chests face. Carrying around extra weight can cause stress and pain to the neck, upper back and shoulders. Some women have grooves in the shoulders where the bra strap sits, holding up all the extra weight. Infections between and under the breasts are quite common as well.

Often women with large breasts are not as physically active as they would like to be because the extra tissue “gets in the way” or makes running or jumping sports impossible because of uncomfortable or painful bouncing.

Breast reduction surgery is a wonderful option to improve back and neck pain, re-establish a more proportionate figure and restore self-confidence. The surgery is a same-day procedure, so the patient goes home after surgery and usually feels less neck and back pain and can stand up straighter almost immediately. Breast reduction patients are very happy with their new shape and regret not having done the surgery sooner.

Breast reduction (or reduction mammaplasty) is an enhancement procedure that reshapes the breasts in order to make them smaller, lighter, and firmer. Reduction is accomplished by removing excess fat, glandular tissue, and skin. Large breasts can cause physical pain as well as emotional and social anxiety. Women who take advantage of the breast reduction procedure find that they are able to lead a healthier, more comfortable life, in addition to enjoying a beautiful, more proportionate appearance.

Reasons for considering a Breast Reduction

• Back, neck or shoulder pain caused by heavy breasts.
• Sagging breasts produced by their large size.
• Disproportionate body frame attributed to oversized breasts.
• Restriction of physical activity due to the size and weight of the breasts.
• Painful bra strap marks and/or rashes as a result of large breasts.

General Procedure

Techniques for breast reduction vary; however, the most common procedure involves an incision that circles the areola. From the areola, the incision goes down and follows the natural curve under the breast. The surgeon then removes excess breast tissue, fat, and skin. Next, the nipple and areola are repositioned to a higher position and held in place by stitches. Occasionally, liposuction alone can be used to reduce breast size. The best procedure can be determined during the initial consultation visit.

Of all cosmetic surgery procedures, breast reduction results in the quickest body-image changes. Patients are pleased with the elimination of physical pain caused by large breasts as well as a better proportioned body, an enhanced appearance, and better fitting clothes.

Recovery Process

Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and reduce the recovery time.  A special, supportive bra is placed immediately following surgery to aid the healing process and to minimize movement of the breasts.  This surgical bra will need to be worn for several weeks post operatively.  Patients sometimes report minor pain associated with surgery.  Any pain can be treated with oral medication.  While complications are rare, patients can minimize potential problems by carefully following the instructions given after surgery.

Breast Lift - Abdominal Liposuction - Before

A breast lift, also known as a mastopexy, is a procedure to raise and reshape ptotic or “sagging” breasts. This may be associated with pregnancy, breast feeding, weight loss or as part of the natural aging process. As a woman ages, skin loses some elasticity which can cause the breasts to lose their natural shape and firmness. This procedure is designed to elevate the breasts and give them a more youthful appearance. A breast lift may also be completed in conjunction with breast enlargement surgery (augmentation).

There are several different breast lift (mastopexy) techniques depending upon the degree of breast ptosis (sagging). The goal of surgery is to tighten the skin envelope of the breast and to reposition the nipple-areolar complex to a more natural, youthful position.

Sometimes breast augmentation is utilized in conjunction with breast uplifting procedures. And some surgeons who don’t have experience with breast lifts will try to compensate by incorrectly using very large implants to “fill out” the breast when only a mastopexy will accomplish the goal.

Reasons for considering a Breast Lift

• Elevate the breasts due to sagging caused by the effects of aging and gravity.
• Firm the breasts if they have lost substance due to pregnancy and subsequent breast-feeding.
• Re-align your nipples/areolas if they point down or to the side.
• Bring back natural suppleness after weight loss.

General Procedure

Breast Lift - Abdominal Liposuction - After

The breast lift surgical procedure usually takes one and a half to three hours. There are several techniques for performing a mastopexy, each of which involves a different incision on the breast. Some patients, especially those with relatively small breasts and minimal sagging, may be candidates for modified procedures requiring less extensive incisions. Two such procedures are the “crescent lift” and “doughnut (or concentric) mastopexy” in which circular incisions are made in part of or around the areola. But the most common procedure involves a vertical or “lollipop” incision or an anchor-like incision along the underside of the breast.

If the patient is having an implant inserted along with the breast lift, the implant will be placed in a pocket directly under the breast tissue or under the muscle of the chest wall.

Recovery Process

Generally, post-operative instructions call for plenty rest and limited movement in order to speed up the healing process and recovery time. Bandages and a supportive bra are placed right after surgery to aid the healing process and to minimize movement of the breasts. The patient will need to wear the supportive bra for several weeks after surgery. Patients sometimes report minor pain associated with surgery which can be treated with oral medication. While complications are rare, patients can minimize potential problems by carefully following the post-operative directions given by the surgeon.