A Plastic Surgery Primer for Our Pandemic Times
Odds are good that you’ve looked at your own face more this past year and a half than ever before, thanks to the ubiquity of video conferencing options like Zoom during the pandemic as a way for workers (and friends and families) to connect remotely. With said “Zoom boom,” there have been news reports about a rise in plastic surgery, suggesting that all the hours logged on video calls have made people more attuned to the things about their appearance they’d like to change.
So, if you too have found this page by Googling what exactly a mommy makeover consists of, or just what fillers are the most popular, rest assured—you’re not alone. We asked Yale Medicine plastic surgeons Tito Vasquez, MD, and Melissa Mastroianni, MD, to help explain, in user-friendly language, the basics of some of the most popular procedures: mommy makeovers, facelifts, breast augmentation, no-drain tummy tucks, and injectables.
One key point to remember is that surgery is still surgery. “There can be scars and, generally, recovery times. With any procedure, there will be an initial phase of swelling,” Dr. Mastroianni says. “No one wakes up from the operating room ready to show off their new bodies. If you have any events or trips coming up, make sure you discuss timing with your surgeon.”
It’s also extremely important to do your research and select a well-vetted, board-certified plastic surgeon for these and any other procedures as well—including non-invasive procedures such as fillers. Sometimes you will come across ads promoting a cosmetic surgeon, but you should know this is not the same as a plastic surgeon.
Make sure to see a board-certified plastic surgeon with certification from the American Board of Plastic Surgery, because these doctors have spent far more time receiving the specialized training needed to ensure safety and optimal results. “There are a number of other agencies that will offer board certification and they can sound very legitimate, but they will not ensure adequate training,” Dr. Mastroianni says.
And keep in mind, “It is very tempting to look at Instagram on a provider’s page to see stunning ‘before and afters,’ but doctors showcase their best work,” Dr. Mastroianni says. Therefore, know that, as a consumer, it’s always appropriate to ask to see a doctor’s “before and after” photos so you have an idea of what to expect.
What is usually included in a Mommy Makeover?
“Mommy makeover” is a catch-all phrase that describes a combination of procedures aimed at restoring a mother’s body to her pre-pregnancy state, Dr. Vasquez explains. Most commonly, the combination of surgeries in a mommy makeover includes some type of breast rejuvenation or enhancement, as well as an abdominoplasty and/or liposuction, Dr. Vasquez adds.
One of the things that makes mommy makeovers popular is that they are a combination of procedures customizable to the patient’s needs. “Mommy makeovers aren’t cookie-cutter operations. Not every woman will need extensive breast surgery or implants—it is still considered a mommy makeover even with less-involved procedures,” Dr. Mastroianni says.
How much does a Mommy Makeover cost?
A mommy makeover that includes two surgeries will cost between $16,000–$20,000, says Dr. Vasquez. Each procedure will likely cost around $10,000.
How long does a Mommy Makeover surgery take and how long is recovery?
If you’re doing a breast rejuvenation surgery and abdominoplasty, the outpatient surgery will take anywhere from four to six hours, with a one- to two-week at-home recovery time, according to Dr. Vasquez.
What is a facelift?
“Facelift is a general term for tightening and lifting facial tissues that, over time, become droopy,” explains Dr. Vasquez. This involves not only a surgical lifting of the face, but usually also a combination of rejuvenating the tissues beneath the skin, as well as the skin itself—either through lifting or tightening.
While traditionally facelifts have been done on patients older than 60, Dr. Vasquez says that modern techniques, such as the minimal or limited skin-incision facelifts that he commonly performs, can be done on patients in their 40s. Doing so can result in a natural look, and is also less complex, which means long-lasting results with fewer potential complications.
How much does a facelift cost?
A facelift will cost between $7,000–$25,000, according to Dr. Vasquez. The wide range is because a facelift often has many “à la carte” procedures added to it, like an eyelid lift, resurfacing of the face, fat-grafting, or implants. Like a mommy makeover, a facelift can be tailored to meet the patient’s needs.
One interesting fact about facelifts is that in many cases, over time, they end up costing less than non-invasive types of facial rejuvenation, Dr. Vasquez notes. Fillers, Botox®, threadlifts, or energy-based devices often give less noticeable results and, frequently, at a high cost. “If you take that into account, five to ten years after those surgical procedures, a facelift actually can end up being much more cost-effective,” he says, adding that “In the right candidates, facelifts are very safe and have very low complication rates.”
How long is the surgery and how long is recovery?
Depending on how many additional rejuvenation procedures you might have with your facelift surgery, it can take from two and a half hours all the way up to seven hours. As for recovery time, Dr. Vasquez notes that if you work a sedentary job, it may be realistic to resume work in a week.
How long does a facelift last?
The effects of a facelift can last for eight to 12 years, but results vary based on how well you care for your skin and if you avoid sunburns, Dr. Vasquez notes. This longevity is one of the major benefits of facelifts, along with a natural-looking appearance. If done correctly, a facelift should be imperceptible to the casual observer.
What is breast augmentation?
Breast augmentation generally involves some type of implant that increases the volume and projection of your breasts, Dr. Vasquez says. Nowadays, an increasing number of breast augmentations are being done via fat-grafting, but the majority of cases still involve an implant. One benefit of breast augmentation, Dr. Vasquez says, is immediate results.
How much does breast augmentation cost?
You can expect a breast augmentation to cost about $8,000, according to Dr. Vasquez. Factors, such as whether you choose silicone or saline implants, or how large you want the implants to be, don’t typically affect cost.
How long is the surgery and how long is recovery?
A breast augmentation usually takes around an hour and a half, and recovery takes about one to two weeks, depending on your job or activity level, Dr. Vasquez says.
How long does breast augmentation last?
You should plan to have your breast implants examined periodically, preferably every year. Though breast implants can sometimes last a patient’s entire lifetime, the American Society of Plastic Surgeons (ASPS) recommends that women have their implants changed every ten years, Dr. Vasquez says.
The reason, he explains, is that implants are subject to rupture, wrinkling, and weakness of the wall of the implant. Changing the implants helps prevent future problems like rupture or even very rare conditions such as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).
It’s important to become informed about all the potential risks and benefits of breast implant surgery. “If a young woman is getting implants, chances are they are not the only implants she will have in her lifetime,” Dr. Mastroianni adds.
No-Drain Tummy Tuck
What is a no-drain tummy tuck?
A tummy tuck (also called abdominoplasty) is a common procedure. But a different type of abdominoplasty, called a “no-drain tummy tuck” offers some important advantages.
Whereas a traditional tummy tuck uses surgical drains to prevent fluid accumulation and requires patients to regularly empty their drains while recovering from the procedure at home, as its name suggests, the no-drain tummy tuck simplifies recovery by eliminating that somewhat unpleasant step. Dr. Vasquez explains that this is because the modified procedure allows for less tension on the final incision. No-drain tummy tucks also potentially lead to less prominent scars.
Dr. Vasquez was one of the first plastic surgeons to perform the no-drain tummy tuck here in Connecticut almost a decade ago. The ASPS has endorsed the use of this technique for people who are deemed to be the “right surgical candidates.”
How much does a no-drain tummy tuck cost?
A tummy tuck (including both no-drain and traditional tummy tucks) usually costs in the area of $12,000. This price includes some liposuction as well, Dr. Vasquez says.
How long is the surgery and how long is recovery?
An abdominoplasty can take three to four hours, according to Dr. Vasquez, and recovery is generally one to two weeks, depending on a person’s work requirements and activity.
How long does a no-drain tummy tuck last?
If you maintain a stable weight and don't get pregnant, a no-drain tummy tuck may never need to be performed again, says Dr. Vasquez.
What are injectables?
The term “injectables” refers to treatments (i.e., a medication, drug, or tissue) that are delivered under the skin by a very small needle or tiny tube (microcannula), either to provide lift and volume, or to relax muscles and wrinkles. Dr. Vasquez says the most common types of injectables are Botox and fillers, like Juvéderm® or Restylane®, to name a few.
“Botox is a neuromodulator and is probably the most commonly used injectable. It’s considered the gold standard to which other neuromodulators, such as Dysport®, Xeomin®, and Jeuveau®, are compared,” says Dr. Vasquez. Botox is commonly used in the upper third of the face, though it may be used in the neck and lower face as well. Dr. Vasquez says that his typical Botox patient gets 30-50 units, which are dispersed in very targeted injections in the upper face or forehead, the brows, the area between the eyebrows, and around the nose or eyes.
Botox is administered by extremely fine needles that are nearly as small as acupuncture needles. Typically no anesthetic is needed. After the procedure, however, vibration tools, ice packs, and topical anesthetics are often used to minimize discomfort, says Dr. Vasquez.
Fillers include products like Juvéderm and Restylane. Dr. Vasquez explains that these fillers are made of synthetically produced hyaluronic acid, which “is basically a complex sugar that’s derived from the same compounds seen in joint fluid and other tissues of the body.” One benefit of hyaluronic acid is that there’s virtually no chance of an allergic reaction or rejection of the product—and it’s reversible, says Dr. Vasquez. “Thus, this type of filler is both popular and safe,” he says.
Dr. Vasquez says the most common areas where patients receive fillers are the “parenthesis lines” or nasolabial folds, along with the cheeks and/or lips (which have become especially popular in the last several years).
“While many types of physicians or other providers perform these procedures, people should strongly consider board-certified plastic surgeons, dermatologists, or facial plastic surgeons, who are specifically trained in these aesthetic treatments,” says Dr. Vasquez.
How much do injectables cost?
Fillers are priced not by unit, but by the vial, and can cost anywhere from $300 to $1,000.
It’s important to note that the price for injectables can vary widely and you may often see coupons or special offers that bring the price down to a level that may seem surprisingly affordable. However, while the price in these cases may seem attractive, it may not turn out to be a bargain. Dr. Vasquez says that patients should remember the extensive training that aesthetic surgeons and dermatologists undergo to perform these procedures effectively and safely.
How long do injectables take and how long is recovery?
Botox can take as little as five to ten minutes, whereas fillers typically can take somewhat longer, Dr. Vasquez says. Recovery is minimal and usually can take 24 hours to several days.
How long do injectables last?
All neuromodulators should be repeated every three to four months. It takes about three to five days for Botox to start showing its effect, with full benefits visible at about two weeks, Dr. Vasquez says.
The lifetime of fillers depends on how deep the injection is placed, the specific product used, and the molecular size of the compound, Dr. Vasquez says. The thicker the product, the longer-lasting the results. Thicker products can last up to two years or more, while smaller or thinner injectables can last several months but result in softer, more natural effects.
“I recommend that patients try to communicate their goals and trust in their provider to choose the most appropriate product for their needs,” says Dr. Vasquez.