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THE PROCEDURE

Step 1- Anesthesia 
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you. 
Step 2- Tummy tuck incision 
A tummy tuck involves the surgical removal of excess abdominal fat and skin and includes tightening of the abdominal wall where muscles have weakened.
A full tummy tuck requires a horizontally- oriented incision in the area between the public hairline and belly button. The shape and length of the incision will be determined by the amount of excess skin. 
Once the abdominal skin is lifted, the underlying weakened abdominal muscles are repaired. A second incision around the navel may be necessary to remove excess skin in the upper abdomen. The upper abdominal skin is pulled down like window shade. The excess skin is trimmed and the remaning skin is sutured together. 
A new opening for the belly button is created. The belly button is popped through to the surface and sutured into position. 
When a correction is isolated to the area below the navel, a limited or “mini tummy tuck” with a shorter incision at the pubic bone level may be recommended. Liposuction may be performed with either a full or mini tummy tuck where excess fat is a factor. 
Step 3 – The breast lift incision 
During the breast lift part of the surgery, excess shin is surgically removed to raise the nipple and tighten the breast tissue. Incision patterns vary, depending on degree of excess skin and the amount of lifting required as well as patient and surgeon preference. There are three common incision patterns:
• Around the areola 
(Picture)
• Around t1he areola and vertically down from the areola to the breast crease
(Picture)
• Around the areola, vertically down from the breast crease and horizontally along the breast crease
(Picture)
Step 4- Reshaping your breasts 
After your doctor makes the incisions:
• The underlying breast tissue is lifted and reshaped to improve breast contour and firmness. 
• The nipple and areola are repositioned to a natural, more youthful height.
• If necessary, enlarged areolas are reduced by excising skin at the perimeter. 
• Excess breast skin is removed to compensate for a loss of elasticity. 
Some women may want to consider placement of breast implant in addition to the breast lift. An implant can provide improved upper breast fullness or cleavage. Implants can be placed at the same time or as a second procedure, depending on the experience of the surgeon. 
If you have simply lost breast volume, but the size of the breast skin envelope and the position of the nipple is still good, your surgeon may recommend simply placing a breast implant. Available implants can be filled with silicone or saline. Implants can be placed beneath the breast tissue itself, or under the pectoral muscle. Various incision sites are possible. Depending on your anatomy and personal preference, you surgeon will recommend an implant type and size. 

The Procedure (continues) 
Step 5 – Closing the incisions
Sutures are layered deep within the breast tissue and abdomen to create and support the newly shaped breast and abdomen. After your breasts and abdomen are reshaped and excess skin is removed, the remaining skin is tightened as the incisions are closed with sutures, skin adhesives, tapes or clips. 
Drains may be placed under the skin to remove any weeping blood or serum after the surgery. The drain will remain until this weeping stops, usually one to three weeks. You will be asked to empty and record the volume of drainage so that your surgeon can know when it is safe to remove the drain. You will often be asked to wear a compression garment (girdle) after abdominal surgery, to minimize the bruising and swelling, for a few weeks.
Your surgeon will try to make sure that all of your breast and abdominal scars are hidden beneath your underwear or a bathing suit. However when you are naked, these scars will be visible. While your plastic surgeon will do everything possible to assure you get the best possible scar, scar formation depends on your own genetics and wound healing capabilities. Scars do tend to improve over time, but it may be months to years before the scars fade as much as they will. 
Many women desire the smallest scar possible. However, your plastic surgeon will recommend the incisions which best suit your abdomen. Listen to your surgeon and do not diminish your result by demanding and incision that will not be appropriate for you. 
Step 6- See the results 
The results of your mommy makeover surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal of a more youthful body shape.    
While you may be very pleased with your “perky” breast shape, it is prudent to protect your investment by wearing a supportive bra. 

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