Breast Reduction and Tummy Tuck

1. What Is Mommy Makeover?

Mommy makeover is a combined aesthetic surgery plan that aims to correct shape changes in the breasts and abdomen after pregnancy and breastfeeding. In this context:

• Breast volume, shape and nipple position,
• Sagging, stretch marks, muscle separation (diastasis) and fat accumulation in the abdominal area

are evaluated together and are addressed in a single session when possible.

The combination described on this page is a mommy makeover approach in which breast reduction and tummy tuck are planned together. The goal is to restore the patient’s body to a form that is as balanced, natural and functional as possible.

2. In Which Situations Is the Breast Reduction and Tummy Tuck Combination Preferred?

This combination is generally preferred when:

• After pregnancy and breastfeeding, the breasts have enlarged, sagged and cause complaints such as neck and back pain,
• There is looseness, stretch marks, excess skin and forward bulging in the abdominal area,
• Clothing choices are difficult due to the size and shape of the breasts and abdomen,
• The patient wishes to address both breasts and abdomen under a single anaesthesia and experience one recovery period,
• Problems such as breast heaviness, rash in the folds and posture disorders are also affecting quality of daily life.

In some patients these procedures may be planned in separate sessions. The decision to combine them is made by the surgeon, taking into account the patient’s overall condition, expectations and safe operative time.

3. Who Is a Suitable Candidate for Mommy Makeover?

In general, suitable candidates are those who:

• Have an overall state of health that is appropriate for surgery,
• Have, where possible, completed their pregnancy and breastfeeding period,
• Have a relatively stable weight and do not plan frequent weight gain and loss,
• Have realistic expectations regarding long term results and scars,
• Can comply with postoperative care, use of compression garments bras and activity restrictions.

In patients who plan another pregnancy in the near future, the timing of breast and abdominal surgery should be carefully evaluated with the surgeon. In some cases, considering the planned pregnancy, surgery may be postponed.

4. Preoperative Evaluation and Planning Process

Before surgery:

• The patient’s medical history, chronic diseases, medications and allergies are reviewed in detail.
• A breast examination is performed and, if needed according to age and risk profile, breast ultrasound or mammography may be requested.
• The abdominal area is assessed for abdominal muscles, excess skin, stretch marks and areas of fat accumulation.
• For the breasts, the current volume, desired size and new nipple position are evaluated; for the abdomen, the condition of the skin below the navel and the likely incision line are explained to the patient with visual aids where possible.
• Necessary blood tests, anaesthesia evaluation and additional investigations are completed.
• Recommendations are given regarding discontinuation or reduction of blood thinning medications, certain supplements and smoking before surgery.

At this stage, the expected degree of change in each area is explained clearly, simply and realistically. The aim is for the patient to understand all aspects of the process before making a decision.

5. How Is Breast Reduction Performed in a Mommy Makeover?

During breast reduction:

• Excess fat, breast tissue and skin are removed from the breasts,
• The nipple and areola are moved to a higher position appropriate to the new breast size,
• The breast shape is recreated to be as natural as possible and in harmony with the rib cage.

The technique used may vary depending on breast size, degree of sagging and skin quality. Most commonly:

• An inverted T (anchor) scar,
• An L shaped scar,
• Or, in some cases, techniques using more limited incisions may be applied.

Breast reduction not only improves aesthetic appearance but can also help reduce complaints such as neck and back pain, shoulder grooving, bra strap marks, rashes and fungal infections caused by breast heaviness.

Note on breastfeeding

Breast reduction surgery may affect some of the milk ducts depending on the technique used and the amount of tissue removed. For this reason, patients who wish to breastfeed in the future should discuss this in detail with their surgeon before surgery.

6. How Is Tummy Tuck Performed in a Mommy Makeover?

With a tummy tuck (abdominoplasty):

• Excess skin and the underlying fat tissue below the navel are removed,
• In suitable patients separation between the abdominal muscles (diastasis) is repaired,
• The abdominal wall is given a flatter, firmer appearance.

In general:

• A horizontal incision is made near the bikini or underwear line,
• The navel is freed and the abdominal skin is pulled down from the upper abdomen,
• Excess skin is removed and the navel is repositioned,
• The incision is closed with aesthetic suturing techniques.

In most patients, the tummy tuck scar is planned to run within or close to the bikini line to keep it as hidden as possible in daily life. In patients with a previous caesarean scar, this is often incorporated into the tummy tuck incision.

7. The First Postoperative Days: Pain, Drains and Hospital Stay

The first hours after surgery are spent in recovery and in the patient’s room while overall condition stabilises. Because this is a combined procedure:

• The patient’s position, pain control and fluid balance are closely monitored.
• Drains may be placed in the abdominal area and breasts to help remove fluid that may accumulate for a limited period.

In the first days:

• Tightness in the breasts and abdomen,
• A pulling sensation when trying to stand fully upright (especially in the abdominal area),
• Fatigue and mild to moderate pain

are considered normal.

Patients usually stay in hospital for one night (sometimes two) after combined surgery in order to safely manage pain control, start walking, perform the first dressings and monitor the drains.

8. Staying in Istanbul, Follow Ups and Returning Home

For patients coming from abroad or from another city, after surgery:

• It is generally safe to stay in Istanbul for 7–10 days so that the first dressings, removal of drains and the first follow up examination can be performed.

During this period the patient receives detailed information on:

• Use of compression garment and bra,
• Walking level,
• Showering, wound care and medication use.

For the journey home, especially on long flights, the surgeon evaluates the risk of blood clots and limitations in sitting and positioning. If needed, additional recommendations such as compression stockings, walking breaks and fluid intake are given.

9. Returning to Social Life, Work and Sports

At home

• In the first days it is very helpful to have assistance; in patients with small children, activities such as lifting children and standing for long periods should be restricted for a while.
• Getting support while changing position in bed can make recovery after tummy tuck more comfortable.

Return to work

• For desk based jobs, a return to work is usually possible after 10–14 days.
• For physically demanding jobs, a plan of around 3–4 weeks may be required depending on the nature of the work.

Return to sports

• Light walking is encouraged during the first weeks.
• For exercises that strain the abdominal muscles and for weight training, a waiting period of 6–8 weeks is generally recommended.
• Exact timing is determined individually by the surgeon during follow up visits.

10. Scars, Compression Garment and Bra Use, Breastfeeding

Scars

• In breast reduction there will be scars around the areola and on the lower part of the breast.
• In tummy tuck there will be a horizontal scar parallel to the bikini line.

The colour of the scars fades over time but does not disappear completely; they generally become paler and more mature over 6–12 months.

Compression garment and bra

• An abdominal compression garment is recommended for 4–6 weeks to support the new abdominal contour and help reduce swelling.
• A supportive or sports bra helps control swelling and supports the new breast shape; regular use is usually advised for 4–6 weeks.

Breastfeeding

• In breast reduction performed after pregnancy and breastfeeding, some of the milk ducts may be affected.
• This does not necessarily mean that breastfeeding will be completely impossible, but in some patients breastfeeding capacity may be reduced.

Patients who plan another pregnancy and breastfeeding in the near future should carefully discuss this with their surgeon, taking their individual situation into account.

11. Possible Risks and Complications

As with any surgical procedure, mommy makeover also carries certain risks:

• Bleeding, infection
• Delayed wound healing, wound breakdown
• Asymmetry in breast shape and size
• Contour irregularities in the abdomen or a scar appearance different from what was expected
• Temporary or, rarely, permanent changes in sensation (especially around the nipple and abdominal skin)
• General surgical risks such as blood clot formation

These risks are minimised as far as possible through careful patient selection, good preoperative preparation, an experienced surgeon and adherence to postoperative instructions. All potential situations are discussed with the patient in a transparent way before surgery.

12. Results and Expectation Management

When breast reduction and tummy tuck are combined, the aims are to:

• Reduce breast volume to a size that is both comfortable and in harmony with the body,
• Achieve a flatter, firmer and more toned appearance of the abdomen,
• Help reduce the physical and psychological burden of body changes after pregnancy.

In the first weeks, results may look different due to swelling and a feeling of tightness.

• The general shape becomes apparent to a large extent within 6–8 weeks.
• Patience is needed over the following months for the final form and scars to mature.

The most satisfying results are seen in patients who have realistic expectations, maintain weight control and follow medical recommendations consistently.