Tag Archives: elasticity

Mommy makeover-Breast-Abdomen plastic surgery

Mommy makeover

Mommy surgery before

                                                                                    Mommy surgery after

Cosmetic Plastic surgery of breast and abdomen after childbirth or massive weight loss is often called a Mommy makeover. Recently a patient asked me if in fact it was not a ‘Mummy makeover” since patients are often bandaged up like mummies after this cosmetic surgery duo!


Changes  to body after pregnancy or weight loss

Several distinct but common changes occur to the body after pregnancy or weight gain and loss.

  • Fat Deposits – occur in the flanks, love handles, back and abdomen
  • Loose skin – as a result of stretching of the skin leads to loss of elasticity of skin and its hanging down
  • Breasts become smaller and may also become droopy due to loss of volume and elasticity- in women and men!
  • Arm skin becomes droopy but fat accumulation in the arms may increase
  • Facial  and neck skin may droop giving an older look


Surgery of the abdomen and breasts

Mommy makeovers typically include

Other procedures may include

Mommy makeovers will take between 3.5 to 4.5 hours depending on the type of surgery that needs to be performed. Though some surgeons like to continue to operate on other body areas at the same time, I find that 8 hour cosmetic surgeries are just too much for me. They are also way too much for the patient! I prefer to divide up the surgeries into more reasonable segments, sometimes just by a few days, to allow easier healing for patients.

Recovery from Mommy makeover

After a mommy makeover the recovery will depend on the number and type of procedures performed as well as all the usual reasons for differences in individual healing. Although patients are up and walking the same day as surgery, typically it will take about 10-14 days before patients are back at work. I have had patients return as soon as 3 days after surgery and as long as 14 days.

Here is a link to a patient returning to the office after only 12  hours following mommy surgery;  http://www.youtube.com/watch?v=HCqqri8Yt5M&list=UUGHAP0wTkrkJuRo1yN1CFjg

Full healing though will take about 4 months though their healing is gradual and progressive.

Mommy makeover surgery gives women a new look . A new look for their bodies and a new look on life.

Cosmetic Neck surgery

Throughout history a pleasing and long neck has been one of the most important attributes of “beauty”. In fact, all over the world, native tribes strive to exhibit this area by elongating their necks with jewelry or rings, sometimes to an exaggerated point. Though rings around our necks are not as profuse in this culture, we still appreciate the beauty of a long smooth neck like the girl below.

long neck                                  beautiful neck


A beautiful human neck that is young and healthy is universally known to be

  •  slim (not fat)
  • long (not short)
  • smooth (not wrinkled)

Like all other areas of the body, it can suffer the ravages of time and the environment and come to look less than ideal. Fortunately we now live in a world where repair and improvement of the damage to our necks is possible.


Signs of an old neck

  • Skin of the neck is particularly thin and is one of the first areas to lose its youthful tone. Sun damage will often cause irregular coloring and loosening of the skin in patients as young as 40.
  • Muscle laxity of the underlying “platysma” muscle follows soon after, causing the typical vertical banding that can be seen on either side of the neck midline. Uncorrected, this condition leads to further separation of the muscle and the final result is the “Turkey Neck” with lax muscles and excess skin, and the look of a short wrinkled neck.
  • Fat accumulates in the neck as we grow older

Cosmetic Surgery of the neck

For patients with cosmetic neck problems, a neck surgery can significantly improve their appearance. Surgery is performed each of the problems of skin laxity, muscle separation and fat accumulation, and sometimes all three together.

Neck lift surgery 

Neck lift Surgery consists of incisions behind the ear which allows the skin of the neck to be pulled back and the excess neck skin removed.  A drain is sometimes necessary and is removed in 48 hours.  and return to work is within 5-7 days.


Neck Muscle Surgery

This consists of tightening the platysma muscle  at the same time skin is being removed through hidden incisions behind the ears and extending into the hair of the scalp. There is often an incision made under the chin to allow the platysma muscle to also be tightened in the midline and remove the “turkey neck” separation that occurs.


Neck Fat Removal

Some patients have good skin tone and tight muscles but excess fat in the neck. The neck fat accumulates both above and below the platysma muscle.  This gives the appearance of a short neck as well as a receding chin. The jaw line is non-existent and they have a “thick” neck because of the lack of definition of the face/neckline.

The neck fat can be removed by either liposuction alone, or in cases where there is also skin laxity and muscle separation, during a neck lift surgery.


All these cosmetic neck surgery outpatient procedures can be performed under local 1-2 hours in my office. Use of a turtleneck for a few days to hide the bruising may be required, and at the end of a week most signs have disappeared. Most patients return to normal activities in 2-3 days, and sports in 2 weeks.

When to Have a Face lift Surgery

Age for face lift surgery


I often see patients who want to have a facelift surgery. As a cosmetic plastic surgeon, facelift surgery is one of the more common procedures I perform. Here are some articles I have written about facelift surgery:


https://tavmd.com/2012/10/05/face-lift-surgery-a-modern-approach/                                                   Face lift


One of the questions patients often ask me is, “When to have a face lift surgery?”

The answer to that question is a little more difficult than one would think!


Changes in skin needing facelift

There are a number of changes that make the cosmetic plastic surgery patient see changes in their face that they wish to reverse by facelift surgery. The causes are listed below, but what happens to the face to make the patient see a cosmetic plastic surgeon for a facelift?

  • Brow skin falls, with eyebrow falling under the upper part of the eye socket

  • Eyelid skin droops and fat herniates around the eyelids

  • Cheek skin and fat fall forward, accentuating the lines between the nose and mouth and causing nasolabial lines

  • Jowl skin and fat droop, causing a squaring of the face and marionette lines

  • Neck skin becomes loose and the platysma muscles separate and fall down

  • Skin color changes on the whole face

  • Facial pores become larger

  • Fine wrinkles increase in number and skin becomes rough



Timing of facial aging

How our faces age and needing a facelift depends on a number of factors, some within our control and others outside.


  • Genetics for facelifts

One of the most important factors for determining when to have a facelift surgery is basic genetics. Look at photographs of your mother and father and see when they lost their youthful appearance. You will see that aging occurs in stages. The skin in our faces is like an elastic band that is stretched over the years. Every decade or so, the “elastic band” breaks and we look like we have aged. How often that happens is dictated in part by genetics and hence by how our parents aged.

If by age 45 your mother looked older for her age, it’s a probability that you will, too.


  • Environment and facelifts

The insults you have heaped upon your skin also affect your facial aging. Sun exposure will actually destroy elastin proteins in your skin, making it sag. This also leads to abnormal skin cell maturation, which gives us skin cancers and “old”-looking skin. Wind exposure will dry out the skin, and the resulting dehydration leads to a wrinkled look. Hence the term “a weather-beaten face”! Protecting your skin is an important part of delaying the need for a facelift.


  • Facial skin protection to delay facelift

How you care for your skin will obviously affect the quality of your skin and delay the timing of a facelift. Creams that moisturize your skin, sunblocks that prevent the effects of the sun and creams that help the natural repair mechanisms of the skin can all help improve facial skin quality and delay facelifts.


What age to have a facelift at?

If you have taken the above into consideration, you will see that there is no defined age at which to have a facelift. Everyone is different. The youngest patient I have operated on for a facelift was 38 years old, and the oldest was 80! Still, the majority of the skin changes and drooping of the face skin that requires a facelift seems to occur between the ages of 45 and 60. This is when the greatest changes in our faces seem to occur. When should you have a facelift surgery? When you look in the mirror and are bothered by what you see!


Morad Tavallali, M.D., FACS

After Weight Loss Comes the Surgery; Arm Lifts

After Weight Loss Comes the Surgery; Arm Lifts


Patients who have undergone gastric bypass or gastric stapling, or who have managed to lose weight by other means (diet?), are often left with a body contour that needs significant amounts of surgery for correction. The weight gain will have stretched the skin and caused loss of elasticity. After the weight loss, the skin just hangs; it hangs in the belly area, usually needing a tummy tuck to correct; it hangs in the breasts, needing a breast lift with or without a breast augmentation with breast implants; it hangs in the thighs, where you need a thigh lift; and it hangs in the arms, where you need an arm lift to correct the resultant deformity.

Old arm lift surgery

Traditional arm lifts have included a vertical scar that goes from the elbow directly to the armpit. This unsightly scar makes the arm smaller and removes the “bat wings” of extra skin hanging down, but the cost is, in my opinion, too great. All too often, plastic surgeons perform cosmetic surgery without really thinking about what the patient wants. In the case of arm lifts, the cosmetic patient wants a plastic surgery that will allow him or her to wear a short-sleeved shirt. They do not necessarily want smaller arms; OK, they do, but only to be able to wear the shirt they want. As such, an arm lift surgery that leaves a long scar behind the arm will lead to the patient NOT baring their arms—the whole point of the surgery is lost. It’s the same for vertical scars in a tummy tuck or in a thigh lift: skin is removed in these cosmetic procedures, but the plastic surgeon is not really doing the patient a favor.

My arm lift surgery

The technique I use for an arm lift is a liposuction of the arm to remove any extra fat that is remaining after the weight loss followed by a skin excision in the armpit. The horizontal scar under the arm is well hidden and allows the patient to bare their arms. Look at the junction of your shirt’s body and sleeve; the scar goes in the same position on your body. It is true that maybe a little less skin can be removed in this technique, but the result is well worth it. I sometimes combine a lipo of the skin of the sides and pull that skin up also. The surgery takes about two hours and is performed on an outpatient basis. The patient has to be a little careful in lifting their arms for a few days, but they are up and at it in a couple of days. Full healing can take a month or so. This is the way an arm lift should be done. The vertical scar technique should be banned.


Morad Tavallali, M.D., FACS

Cosmetic Plastic Surgeon


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