Unfortunately, even the most rigorous exercise is sometimes not enough to address the sagging appearance especially if the weakened and stretched muscles are the primary cause.  In this case, perhaps tummy tuck or abdominoplasty surgery is the only effective way to aesthetically improve the abdominal area.

Because every woman has a varying degree of sagging, there are many types of tummy tuck which are primarily based on the length and location of the incision sites.  But regardless of which technique is used, plastic surgeons usually place the excisions hidden in the underwear so the scars are unnoticeable, although this may not always be the case especially for patients who need the most correction.

For women who are suffering from severe sagging in the mid-section, the complete tummy tuck is the most recommended approach in which doctors make a horizontal incision that runs across the hipbones, with its middle touching the pubic line while its two sides are curving upward, thus creating a U shape.

Through this incision, plastic surgeons can repair the weakened muscles through deep internal sutures and eliminate the excess fats, skin, and tissue.  And if necessary, they create another excision around the navel in case that there is a significant amount of loose skin in the upper abdomen.

Meanwhile, women with a less noticeable sagging can benefit with a shorter incision which usually leads to faster recovery and minimal scars.  Called as the mini tummy tuck, this also uses the same procedures found in the complete abdominoplasty, although the excision is significantly smaller.

To enjoy the full benefits of mini tummy tuck, patients should have a minimal amount of skin, fats, and tissue which are mainly located below their navel while their upper abdomen should have no obvious sagging appearance.

In case the patients have extra fats in their upper abdomen, mini tummy tuck may be complemented with liposuction surgery to create a smoother appearance.

For patients whose only problem is the weakened muscles and minimal fats, abdominoplasty surgery is usually performed using an endoscope, a fiber-optic camera attached to large screen.  In this way, plastic surgeons can see the underlying muscles through a very small incision which can reduce or even eliminate scars.

Patients who ask for this procedure are usually women who are left with excess skin and weakened muscles after giving birth, and massive weight loss patients who have developed a severe case of panniculus, a hanging tissue and fats which may lead to irritation, breakdown of skin, ulcers, poor hygiene, back problems, difficulty in sitting and walking, and foul odor.

During pregnancy, the growing baby stretches the abdominal tissues and muscles almost to their limit.  Because of this, many women will develop hanging skin and bulging fats which may not respond to exercise and diet.  (The picture below shows Kate Gosselin who admitted to have tummy tuck).

Meanwhile, individuals who undergo weight loss surgery—such as bariatric operation, lap band, and gastric bypass—will most likely develop a significant amount of excess, hanging skin especially in their abdominal area.  This problem occurs since the tissue and skin cannot easily catch up with sudden decrease of body size, according to experts in cosmetic plastic surgery.

Perhaps the most obvious benefit of this surgery is that people can improve their figure which usually has a positive impact on their self-confidence and body image.  But still, plastic surgeons warn patients that they should not treat tummy tuck as an alternative for regular exercise and diet since this is ideal to be performed only once due to the risk of scarring.

Aside from improving the body’s contour, plastic surgeons also use tummy tuck to treat the physical symptoms associated with having panniculus.  Examples of these include ulcers, irritation, breakdown of skin, difficulty in sitting and walking, and foul odor due to poor hygiene.

In some cases, this procedure can also treat back problems due to the weight of panniculus.

People who will have tummy tuck surgery can expect the result to last a lifetime as long as they will maintain a stable, normal weight and will not get pregnant.  For this reason, experts in plastic surgery urge their patients to postpone this treatment if their weight is fluctuating dramatically or they are considering having babies.

As with any surgery, there are risks and possible complications in tummy tuck which must be explained to patients.  To be on the safe side, plastic surgeons always conduct a screening test to determine good candidates from high-risk individuals.

Women with sagging, pendulous breasts are the ones who will benefit the most from breast lift surgery, a procedure that involves several incisions that will allow plastic surgeons to remove any excess skin and tissue and reshape the underlying tissues in order to raise the bust and correct the nipples that are pointing downward.

There are several factors that cause the breasts to droop and one of these is aging.  As women get older, their skin and tissue loose its elasticity and the condition is further aggravated with the effects of gravity.  According to plastic surgery specialists, this aesthetic problem appears earlier for women with larger breasts.  (The picture below shows the stages of breast ptosis/sagging.)

Skin and tissue laxity may also be caused by weight fluctuations.  For this reason, a significant number of patients who have had weight loss surgery such as lap band and gastric bypass will need breast lift at some point in their lives.

These are the other reasons why breast become saggy: hormonal imbalance, several pregnancies, and genetic tendency.

As with any plastic surgery, breast lift has certain risks and complications.  With this, doctors perform a screening test to determine good candidates from high-risk patients.

In general, people who have major health problems and have mental disorders are not a good candidate for breast lift or any cosmetic surgery.  Also, women who are planning to have children and individuals with unstable weight are recommended to postpone the treatment to make sure that its result will not be affected by the physical effects of pregnancy and weight fluctuations.

Because of the use of incisions, patients should expect permanent scars, although these will usually fade over time and become less noticeable.  However, they should not expose the incision sites under the sun for at least six months after their plastic surgery as they may develop unsightly pigmentation.

Aside from the risk of scarring, patients may also experience infection, bleeding, and delayed healing.  Fortunately, such complications can be easily prevented by avoiding certain medications that can increase bleeding, quitting smoking several months before the procedure, and following all the pre- and post-operative care suggested by their plastic surgeons.

To further reduce the risk of complications, patients should also avoid heavy lifting, friction and impact against their breasts, and strenuous activities during their recovery.

To address these problems, plastic surgeons use a procedure called reduction mammaplasty which is more commonly referred as breast reduction.  In this surgery, they use different techniques to provide the most desired result and address a specific anatomical feature.

While this plastic surgery is primarily used to reduce the size of breasts that are too large in proportion to the overall body frame, doctors also use this to correct asymmetrical bust line (one breast is much larger than the other).

Most plastic surgeons agree that breast reduction can be performed at any age, although majority of them recommend patients to wait until the bust development has stopped.  Also, women who are planning to have children are usually advised to postpone the procedure—since it may have a significant effect on the shape and size of the breasts—unless they are suffering from physical discomfort which must be immediately addressed.

As with any plastic surgery, consultation and physical examination are conducted to determine a patient’s health and her anatomical features, expectations and goals, and the right approach which must be utilized.

For women with large breasts that severely droop, plastic surgeons recommend the anchor-incision technique.  As the name suggests, this approach involves incisions shaped like a nautical anchor: a circular cut around the areola or the pigmented part of the breast; a vertical incision starting from the nipple down to the crease; and another cut made horizontally across the breast fold.

Through these incisions, plastic surgery specialists can remove the excess skin and reshape the breast tissue.  And if there is an enlargement of the areola, they may also reduce its size and reposition this to a new location.

Because of the extensiveness of the anchor incision approach, this is not ideal for women who only want to slightly reduce the size of their breasts.  With this consideration, surgeons have come up with different modified breast reduction techniques which usually involve fewer scars and shorter downtime.

For this type of patients, the lollipop incision is usually the most recommended approach.  This technique also uses the same incision sites in the anchor incision, minus the horizontal cut across the breast crease, and as a result, they can expect one less scar and shorter recovery.

I’ve been thinking about getting a “tummy tuck” lately. My six-year-old daughter has smashed up my belly with her little hands, calling my tummy “pizza dough.” And sweetly I reply, “Yes, and you are my little pizza.”

I’ve had three little pizzas. Thanks to my daughter to kindly show me that having a pizza dough belly is the harsh evidence of motherhood, I am thinking about having a tummy tuck.

But having a pizza dough belly has nothing to do with eating pizza. I never eat pizza. I want to, but I think about the doughy belly I have, and gosh I just can’t manage to savor a greasy slice without care. So I schedule all of my exercise classes instead of indulging. My pizza dough belly is the sticky leftover blubber of three pregnancies. Yes, leftovers are good when you have pizza, but when you’ve had babies? Oh, the leftovers of pregnancy are near impossible to remove! Sure, I’m proud of being a mother, and yes, it’s human to have the evidence of motherhood show upon my belly. But when I’m at the spa and the spa attendants ask how many months I am, it’s embarrassing.

No matter how many sit ups I have done, my belly is there. I can do weeks of strenuous core exercises, a multitude of sit-ups, eat a healthy diet all with the intention of shrinking my belly. None of it has worked. I even gave up drinking red wine. I crunched, I pulled it in, and I wore Spanx corsets under my dresses. My jeans fit me nicely, except for the muffin top. I belted, I squeezed, and I fought my belly. I cry in frustration, “no more pizza dough belly!”

The tummy tuck— or abdominoplasty— is fabulous for women who have stretched muscles and skin after pregnancy.

Our plastic surgeons are experts in abdominoplasty, utilizing advanced techniques for natural looking bellies. For best possible results, the surgeons also perform liposuction. It’s a good option for someone like me who has had children and is otherwise at a healthy weight. I don’t have any extra weight to lose, just extra, well, pizza dough.

There are different kinds of tummy tucks available, and a consultation with your board certified plastic surgeon can assist you in learning about what procedure is right for you.

Below is a summary of the different kinds of tummy tuck procedures available:

• Mini Tummy Tuck – If the area giving you the most trouble is below the belly button, you could qualify for a “mini tummy tuck,” or “mini abdominoplasty,” which tightens the skin between the pubic area and your navel. This is generally considered a less complex procedure and will take less time. It will also leave less scarring since the incisions will be much smaller.

• Standard Tummy Tuck – A standard tummy tuck removes excess skin, tightens the center of the abdomen through internal sutures and positions the belly button for a flatter contour.

• Fleur De Lys Tummy Tuck – The best tummy tuck procedure to address concerns with excess skin on the upper portion of is the fleur de lys technique. This technique requires an additional incision through the center of the abdomen and is typically only performed for patients who have lost a significant amount of weight, such as after gastric bypass or lap band surgery.

• Panniculectomy – After your abdominoplasty, you can also get a Panniculectomy, which removes skin and fat below the belly button and around to your lower back area. This technique is also primarily performed on men and women who have experienced massive weight loss.

I have battled my pizza dough belly for years now. I have done everything possible to minimize my tummy, and furthermore, as I approach my 40’s, it becomes increasingly more difficult. Women going through perimenopause like myself, who have had multiple pregnancies like I have, might just consider the extra help in the battle of the pizza dough belly.

Here are what my tired eyes look like in the morning without a touch of cosmetics.

Cosmetic Blepharoplasty Benefits:

• It tightens the skin around the eyes giving a youthful appearance
• It removes sagging skin and the tired-looking under eye bags
• It reduces wrinkles and signs of aging

Blepharoplasty is a solution for many that want to look younger and feel better about their appearance. It can be helpful to reduce the under eye and/or upper eyelid droopiness and sagging. It gives a younger look to the eyes, and who wouldn’t like that?

In fact, my grandmother, now aged 90 years old, admitted that she had an “eye lift” in her younger years, to uplift her “bedroom eyes” and give her more of an awake and refreshed look. I was surprised to learn that my grandmother, in her 60’s, decided to get her eyes done. “Oh yes,” my grandmother purred, “I had my eyes lifted, because my eyelids were so droopy and I looked sleepy all the time. In my day, we called it bedroom eyes when the skin hangs on the top of your eyelids.”

My grandmother lives in West Los Angeles, nearby the hip Whole Foods Market. She walks to get her latte over at Starbucks Coffee, and gathers her groceries at Whole Foods Market in her neighborhood. When she is out in the sunlight, her skin glows with health and her eyes sparkle. She has had her eyes lifted, her nose refined, her face lifted. She loves receiving facials. She told me about her eye lift making a world of difference to her. You would never guess my grandmother was 90 years old.

Well, I thought, since my grandmother had sagging eyelids, perhaps it can be hereditary? For those who have hereditary upper/lower eye sagging, blepharoplasty is an excellent solution. It requires minimal downtime with maximum results.

If you are considering eyelid surgery, you can begin with a surgical consultation. Your board certified plastic surgeon will help you understand all of the details of the procedure and also discuss whether or not this would be a good option for you.

In order to find out if you are a good candidate for an eye lift, consulting your plastic surgeon as well as your ophthalmologist is important. Much depends on your medical history, with a positive evaluation of your current health, and that includes your eye health— information and records from your ophthalmologist are necessary to help weigh the pros and cons of this procedure.

After your evaluation, your plastic surgeon will discuss all of the details of blepharoplasty with you that you may be concerned about, such as techniques done during surgery, anesthesia, and your expectations of the results.

The before and after photos of our patients are inspiring.

Yes, I had several breast implant surgeries, and eventually removed my implants altogether. I had my first set of breast implants put in when I was 19 years old, back in 1989. I was doing a fair amount of lingerie and bikini modeling then. The photographers I worked with mentioned other models that just had their boobs done, and during those photo shoots they raved about how great those models looked. Was it a subtle hint? Then there was my test shoot for Playboy Magazine. I interviewed with Playboy before deciding to get my breasts done. My breasts were perky and lovely on their very own. I was my charming sweet self. But after the test shoot, I didn’t make the grade. A friend of mine who was a photographer mentioned that it might have been my small breasts. I thought that was as ridiculous then as I do now. I didn’t think Playboy Magazine made decisions like that. There were plenty of Playmates with natural B cups like mine. But I found myself considering my B cups in the mirror, wondering what it would be like to have just a little more oomph in my bikini top.

I’d like to say I’m not easily swayed by celebrity culture and boob jobs. I’m a beautiful lady with natural breasts and a lovely physique. I have a healthy outlook and enjoy eating, as well as keeping fit with plenty of exercise. I’ve never had any body image issues. But living in Los Angeles and being a nude dancer during my 20’s had its influence, I must admit. And there’s nothing wrong with that. If one is aware of the influences and comprehends the reasons why women want to get boobs or undergo cosmetic surgery, then, why not? I mean, how gorgeous is Kim Kardashian with or without breast implants? Either way, she’s a beauty.

Of course, at 19 years old, I was young and impressionable. But it was a choice I made not for any other reason as much as my own desire to look even better than I did. I was otherwise of sound mind and good health. I didn’t have unrealistic expectations either. I just wanted a little boost in the bosoms.

I went through my first surgery and all went well. My breasts looked gorgeous and I felt great both naked and in clothes. There was no need for an expensive push-up bra with extra padding. My breasts were full and bouncy all on their very own. I felt feminine and confident. I loved having breast implants!

I did have them redone several times, due to scar tissue that grew around the implants. This seemed to happen to me each time. The scar tissue would form around the implant and become hard. As much as I massaged my breasts in the hot shower to keep the scar tissue from forming, it continued to harden. My breasts still looked good, but the sensation bothered me. I wanted soft breasts, of course.

I remember the days at the strip club, seeing the girls that had just had their breasts done. Everyone was fascinated to see the girl with the new boobs. It caused me to want my own boob job even more. Or have mine redone when I did have them.

The hardening was a factor, even with all the different kinds of implants— smooth outer texture or the rougher texture, which was thought to improve the outcome. I had the “bi-lumen” or silicone bag inside of a saline outer bag. My surgeon had gone through a small incision made along the lower curve of my areolas. I have scars there, but you’d never notice.

Looking back on the three breast jobs I had, I’d consider doing it again. I know what to expect. I’ve also had three children since, which is part of the reason why I would do it again. Nowadays with the improvements in breast augmentation surgery and implants, I am sure the results would be better than ever. My breasts have been through three breast implant surgeries as well as three pregnancies. They still look good, but I must say, I do think about getting boobies all over again! I miss the weight of the bigger breasts, the natural feeling of femininity. And no matter how many men have told me they prefer natural, when it comes down to it, they love boobs no matter what.

What did I learn from my many years as a nude dancer in a strip club? Don’t let anyone tell you that you need boobs. You are the only one to make that decision. If you want them and it’s your choice, then consider the benefits and do it for yourself. Small breasts are also beautiful. I knew one dancer who had the biggest nipples but an otherwise flat chest, and she was just as sexy as the girls with big breasts.

My decision to get my breasts done has always been for my own reasons. And lately, at age 41, I think about doing it again. Perhaps at my age the scar tissue won’t build up as quickly. Maybe I will toss my padded bras aside and go for the breast implants once again? My thinking is, if it makes you feel better about how you look, then go for it. And I just might go for it all over again.

Because breast augmentation is an invasive procedure, most surgeons conduct medical examination to determine if the patients are physically healthy and have no medical conditions such as diabetes, heart problem, autoimmune disorder, high blood pressure, and lung problem which can impede normal healing.

Before the procedure is done, most doctors require their patients to follow these entries:

* Quit smoking at least two months before and after the surgery in order to reduce the risk of skin necrosis or death of the skin tissues.  The reason why smoking can increase the chance of complications is because the nicotine prevents the oxygen from effectively reaching the skin, thus prohibiting the body to heal itself properly.

* Get a medical evaluation including a baseline mammogram (before and after the surgery) in order to detect any changes in the breast tissue which may affect the result of the surgery.

* Avoid certain medications such as anti-inflammatory drugs, aspirin, herbal supplements, and vitamins which can aggravate bleeding.

Meanwhile, there are only two FDA-approved implants used in the market: Silicone implants which are made of a silicone shell filled with plastic gel that can almost simulate the “texture” of the breast tissue; and saline implants which are made of a silicone shell filled with saline (salt and water solution) that is safer than the silicone filling since the body can safely absorb the saline in case of a rupture.

Once the patients have been cleared from any serious medical conditions, the surgery can proceed.  Usually, this is performed under general anesthesia or intravenous sedation in which the patients are asleep during the whole operation.

In most cases, breast augmentation surgery lasts an hour or two, depending on the incision site, the implants used, and the technique adopted.  And soon after the surgery, most patients can go directly to their home to recuperate or stay at least one day at a hospital if they want to have a medical supervision in this most crucial time.

To promote faster healing, patients are advised to stay away from strenuous activities and heavy lifting at least two months after the surgery.  They should also have enough rest and proper diet to ensure faster and normal recovery.

Because of the physical changes brought by pregnancy and childbirth, most women will end up having a sagging abdomen due to skin and tissue laxity.  While this problem may be treated with exercise and diet, there are some cases in which the only effective solution is plastic surgery through a procedure called abdominoplasty or tummy tuck.

In this procedure, plastic surgeons create an incision near or along the pubic hairline that will allow them to remove the excess skin and tissues and reshape the muscles which have become separated due to pregnancy.  The length of the incision greatly depends on the severity of the excess tissues, although the general rule is that patients who need the most correction will need a hipbone-to-hipbone incision while those who have minimal droopiness will benefit more with a shorter cut.

In some cases, tummy tuck surgery can also remove or at least reduce the appearance of stretch marks in the abdominal area.

Another popular “mommy makeover” procedure is breast augmentation in which plastic surgeons use silicone or saline implants to increase the bust size, improve a slightly sagging breast, and make this appear fuller.  (Kate Hudson [see picture below] underwent breast implant surgery on her 31st birthday.)

In this plastic surgery procedure, doctors make incisions below the breast crease, around the circumference of the areola, in the armpit, or within the navel where they can insert the implants.  After the materials have been secured inside the breast pocket, surgeons will then close the incisions using sutures and put compression garments around the chest of their patients.

To prevent or at least postpone sagginess, plastic surgeons generally prefer the under-the-muscle implant placement which provides a reliable bra-like support to the implants.  In addition, this technique creates a gentle slope which makes the breasts appear more natural.

However, breast implant surgery is not the right approach when dealing with moderate to severe sagging of the breasts.  In this problem, breast lift surgery is the best way to correct the drooping bust caused by the skin and tissues becoming less elastic after breastfeeding.

For women who want to have “mommy makeover” plastic surgery, they should postpone this if they are considering having children in later years since pregnancy, childbirth, and breastfeeding will have an effect to the result of the procedure.

Some plastic surgery specialists argue that patients are at higher risk of complications if they remain under general anesthesia for more than five or six hours.  This is where the problem arises since some combination treatments are performed for an extensive length of time.  As a precautionary measure, they recommend a team of plastic surgeons so that one of them can conduct a certain procedure, while another one can treat the other area.

Patients who are considering having combination treatments will enjoy a more convenient recovery compared to getting multiple procedures performed separately.  However, it will take them a longer time to recover and will experience more pain due to the higher levels of surgical trauma.

To reduce the risk of complications, plastic surgeons provide their patients with pre-operative instructions which may include avoiding certain medications and herbal supplements that may aggravate bleeding, staying away from alcohol, and quitting smoking.

To be on the safe side, patients should be honest with their doctors especially about their medical history, previous surgeries, medications and supplements, and other pertinent details which may have an effect on their recovery and the result of the plastic surgery.

In most cases, multiple procedures are performed in a hospital (rather in an outpatient surgical center) and usually require an overnight stay or even longer especially if the operation is extensive.

These are the following surgical procedures which are commonly combined in order to achieve the most desired result:

• facelift and necklift
• forehead and brow lift
• liposuction and abdominal etching
• tummy tuck and breast augmentation

Aside from these procedures, “Mommy Makeover” is also increasingly becoming a popular surgical approach in the US.  This combination of cosmetic surgeries usually includes tummy tuck, breast augmentation or breast lift (whichever is necessary), liposuction, and other treatments used to counter the effects of pregnancy.

However, not all women are a good candidate for “Mommy Makeover” as it involves more risks and higher levels of surgical trauma.  For this reason, doctors perform a strict patient selection method and/or limit the surgical area to prevent exposing individuals from more risks.