In this week’s video edition of #AskDrBirchenough, I answer the question: “Can I get my eyebrows to go up with Botox in my forehead?” For more information, please visit www.birchenoughmd.com/botox.
“Mommy makeover” is a term used generically for a number of different combined surgical procedures. There is no single mommy makeover surgery, but a general concept of helping regain some of the shape you had before pregnancy. The surgeries may be done in combination, or over more than one setting.
Typically, I am addressing concerns women have with changes they have from pregnancy and breast feeding. However, it can extend to facial changes that women go through due to the stresses of raising kids!
For the breasts, one changes that many women see is deflation, or drooping and flattening of the breasts after pregnancy or when breast feeding stops. This occurs because the enlarged breast ducts start to shrink back down, causing the breasts to get smaller. The constant stretching of the breast skin and breast tissue over the many months of pregnancy and breast feeding eventually leave the tissue very lax (stretch marks are one sign of this).
Most of the time the skin and breast tissue won’t have the same elasticity or “snap back” it used to have. For some women, a breast augmentation (implant enlargement of the breast) is enough to restore the lost volume, shape, and contour of the breast. Sometimes a mastopexy, or breast lift, is needed in addition to the implants. A breast lift can mean any one of a number of different specific surgeries and can involve any one of a number of different incisions and approaches, tailored to you. At a minimum, a breast lift will help relocate the nipple-areola to a more aesthetically pleasing location on the breast mound. Typically, a breast lift will also help round out the entire breast and more the breast tissue back up on the chest.
The belly is another area that goes through a lot of changes too. Stretched, lax skin and additional fat deposits can be a long term issue after pregnancy. Also, many women have diastasis recti – a term for stretched muscle and fascia in the lower abdomen. This is the “bulge” or “pot belly” or “beer belly” of the lower abdomen you may see, even if you are very thin and back to your pre-pregnancy weight. These areas can be helped with a mini-abdominoplasty (mini-tummy tuck) or a regular tummy tuck. These surgeries will address the lax muscle and remove the lower abdominal skin and fat (and stretch marks if they are low on your belly). Liposuction of the flanks / love handles can help contour the waist in addition.
Some women only need liposuction to remove the excess fat of lower abdomen, without removing skin, because their skin has enough elasticity to snap back after removing the extra fat.
Facial lines and wrinkles become more prominent and noticeable after pregnancy, long sleepless nights, and many stressed-out days! Botox and Juvederm filler can help restore some of the look of the face, and reduce those lines and wrinkles.
So! What can I do to help “mommy”? Breast implants and/or lift? Tummy tuck or liposuction? Botox? There are many options depending on which areas concern you the most. Come in to discuss what I can help you with!
For additional information, you may also visit birchenoughmd.com/mommy-makeover/.
As well-known and ubiquitous as these products are in the popular press and in my office, there is still a lot of confusion from patients over which injectable to use, when, and where. So here’s a primer!
Botox (and other botulinum toxins like Dysport and Xeomin) works by INHIBITING MUSCLE action.
So, if the wrinkles in between your eye brows (the glabella) or in your forehead or the “crows feet” area are caused by the action of a muscle, then you can decrease the repeated skin creasing by injecting Botox into the muscle. Over about 5-7 days the muscle loses ability to contract, allowing the skin to flatten out and not be so creased. It usually lasts only about 3-5 months before the muscle gets back to full strength and you have to inject it all over again.
However, (and here’s the kicker) the muscle can’t be one that is used for critical facial expressions like smiling or closing your eyes. That’s the reason I avoid injecting Botox around the mouth, cheeks, or into the eyelids – you really need those muscles to work properly to maintain normal facial expressions and functions.
FILLERS (including the hyaluronic acids – Juvederm, Voluma, Restylane, Belotero – and other products like Sculptra and Radiesse) do just that – they FILL! Unlike Botox, the effect is immediately noticeable. They are gels that are injected under the the skin (not into the muscle) to fill in creases, increase volume, and make deeper grooves more shallow. Common places for fillers are in the hollows under the inside part of the lower eyelids (nasojugal grooves), the folds next the nose between the cheeks and lips (nasolabial folds), and the deeper grooves that can form from the corners of the mouth down to the chin (marionette lines).
Fillers can also add volume to the lips and cheeks when used in the right amounts and in the anatomic locations. Just puffing up the lip is easy but looks unnatural. I tend to restore lip symmetry and refine the borders of the lip through very small, precise injections of filler. Very fine lines on the upper lip are difficult to smooth out because of the gel quality of fillers.
So, now that you know the basics, you can come on in to get your injectables! For more information on BOTOX, please visit the skin services section of our website.