First of all, I do recommend and have performed more combination procedures of breast and abdomen than isolated procedures alone when addressing the “mommy makeover.” There are several advantages to this - one anesthesia, one recovery, and usually financially advantageous (e.g. discount on second procedures).
When I am performing a combined breast lift/augmentation and abdominoplasty procedure, the recovery is about 2 weeks before going back to work. 6 weeks before any heavy lifting. When an augmentation procedure is performed, the pain is more from the breasts than the abdomen. The reason is because I place most implants in the submuscular position. Any time you perform surgery on muscle or bone, this is more painful than dealing with surgery involving skin and fat. When you elevate the pectoralis muscle for placement of the implant, this can cause the initial soreness moreso than the abdominoplasty procedure. In the abdominoplasty, I do tighten the muscle with permanent sutures, but the muscles are not transected in any way. As a matter of fact, most of my patients when recovering from an abdominoplasty procedure complain more about back soreness from the inability to get in a comfortable position when they are sleeping due to being hunched over – this resolves in about a week when most patients can stand upright at this time.
In contrast, if the abdominoplasty procedure is performed with a breast reduction or a mastopexy alone (WITHOUT an implant), then most
patients will feel more soreness from the abdominoplasty. This is because a mastopexy or breast reduction does not involve operating on the pectoralis muscle. Breast reduction and mastopexy procedures alone are much less painful than a breast augmentation procedure.
One of the most important issues is that of safety. If multiple procedures are performed in one setting, it is important for the patient to be healthy and to be properly medically cleared for surgery. A very lengthy surgery can increase risks, however, a combined breast procedure and an abdominoplasty should be relatively safe, as long as the patient is healthy without medical risk factors.
Edward Park, M.D.
Board Certified by the American Board of Plastic Surgery