Mommy Makeover- History of Smoking Calls for Caution*

Mommy makeover is the procedure which will address the problems that result after pregnancies such as sagging breasts and protuberant abdomen with skin excess. This usually involves abdominoplasty with either breast reduction, breast lifting or breast augmentation and often liposuction but it can be a number of combinations of the above. This is a significant surgical undertaking and patients have to be healthy. Contraindications to the surgery include smoking, underlying health problems such as diabetes, heart disease or obesity. Smoking interferes with the circulation of the rearranged tissues of the breast and abdomen and it is not advised to proceed with the surgery while actively smoking. This 39-year-old woman had been an active smoker when she requested surgery. He was advised that she quit smoking for at least 6 weeks prior to surgery. Even in patients who have quit smoking there are permanent changes from the years of smoking that have to be accounted for during surgery. A more conservative approach is necessary and limiting liposuction and less extensive manipulation of tissues is recommended to avoid skin necrosis. This patient had a conservative breast reduction and abdominoplasty. She did very well during the surgery with no wound healing problems and was very happy with her outcome. Safe surgery involves proper patient preparation and intraoperative decision making to avoid overly aggressive procedures which could lead to unfavorable outcomes.