Dr. WorldWide | Frank Agullo, MD

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Let me say the quiet part first. “Mommy makeover” is a marketing name, not a single operation. It is a label that bundles several procedures under one friendly phrase, and the phrase sells better than the parts.

That is fine, as long as we are honest about what is happening underneath it. When someone books that consult with me, my first job is not to schedule the longest list. It is to figure out which procedures actually serve their goals and which ones they can skip.

Sometimes the most useful thing I do all day is talk someone out of part of it.

What “Mommy Makeover” Actually Bundles

It is a menu we combine, not a fixed package. It can include a breast augmentation or whatever your breasts need, the liposuction 360, the BBL (fat injections to the buttocks), and the tummy tuck. We pick from that list based on you. You do not have to do all of it, and most patients should not.

Being Scared of Part of It Is Normal

Almost everyone walks in certain about one thing and nervous about another. Sure about the tummy tuck, anxious about implants. Or the exact reverse. That is not a reason to rush, and it is not a reason to skip.

It is a reason to slow down and go through each piece on its own. We talk through the parts you are unsure about, one at a time, and you are completely allowed to leave my office undecided. The decision keeps until you are ready.

Implant, Lift, or Both?

This depends entirely on what dropped. If you mostly lost volume, an implant can be enough. If the nipple and tissue have descended, an implant alone can actually make it look worse, and a lift enters the conversation.

Often the answer sits in between. A donut lift, a small circle of skin removed around the areola, raises the nipple about an inch and re-centers it, and I can place a modest implant through that same incision to restore the upper fullness. You get a perkier, natural result without the longer scars of a full lift, and the scar hides at the edge of the areola.

Liposuction or Tummy Tuck? The Key Conversation

This is the one I never let a patient gloss over. Liposuction removes the fat we can pinch. But if your abdominal muscles separated during pregnancy, you will still see a bulge when you relax, and the only thing that fixes that is a tummy tuck.

A tummy tuck makes everything flat and tight and repairs the muscle, like a built-in corset. It is significantly more improvement than lipo alone, but it comes with a scar. I would rather you choose with that clearly in front of you than feel cheated later.

Should You Lose Weight First?

Stable matters more than low. If your weight is still swinging a lot, settling it first usually gives a better, longer-lasting contour.

But a tummy tuck removes loose skin and repairs separated muscle, and no amount of dieting fixes either of those. So the answer depends on what is actually bothering you, and we sort that out at the exam, not by a rule.

What Belongs on Your List vs. What Doesn’t

Can It All Be Done at Once?

Often yes, and it is usually the smarter choice. One anesthesia, one recovery, one block of time off work. When I plan combined surgery I am weighing your overall health and the total operative time, not just stacking a wish list. Adding something small, like the breast portion, frequently does not add much to your recovery.

There is a ceiling, though, and I respect it. Operative time has a relationship to safety, and at some point a longer list stops being convenient and starts being a risk I am not willing to take. When a wish list runs past that line, I stage it. Two calmer surgeries beat one marathon, every time, and I will tell you honestly when that is the smarter plan for your body.

The Recovery You Are Actually Signing Up For

People focus on the surgery and underestimate the recovery, so let me set expectations. The tummy tuck is the dominant part of the recovery in most mommy makeovers. It is the one that asks the most of you, with a real adjustment for the first week or two as the repaired muscle settles.

The breast portion and the liposuction ride alongside it without adding much. Lymphatic massage, the compression garment, and patience carry you the rest of the way. Most patients are back to normal daily life faster than they feared, with full exercise coming later. The point of planning it together is that you do this recovery once, not three separate times.

When Is the Right Time to Do This?

There is no universal answer, but there are good signals. You are finished having children, or confident that you are. Your weight has settled. You have help lined up at home for the first week, because you will genuinely need it. And the reasons are yours, not a date someone else circled on a calendar.

I will not rush a patient into a permanent decision to make an event. If the timing is wrong, I will say so, and we will plan for when it is right. The body you are restoring took years to change, and getting the timing right is worth more than getting it fast.

The Credential Behind the Plan

Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, Mayo Clinic plastic surgery fellowship, Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, and Castle Connolly Top Doctor for thirteen consecutive years. The best mommy makeover is not the longest list. It is the right list for your body and your goals, planned safely.

Ready to Talk?

Let us build the plan that fits you, not a template. For the patient-facing walkthrough, see the companion post on agulloplasticsurgery.com. For the practice’s mommy makeover overview, see the version on swplasticsurgery.com.

Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.

@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

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I have an unpopular opinion about the filler-everything era. I see the cleanup.

More and more of the people who book with me are not asking for volume. They are asking me to take something out. Migrated filler that drifted off the cheekbone. Old filler that puffed up under the eyes and simply never left. Permanent lip biopolymers, injected years ago by someone who is no longer in the picture, now causing asymmetry and firmness that will not resolve on its own.

When someone tells me “I want it out,” that is often exactly the right instinct, and I want to explain why.

Permanent Biopolymers in the Lips

Yes, I can remove them. Over time the skin stretches around permanent material and you get those little bags. I make an incision right where the wet and dry parts of the lip meet, then remove the affected tissue and whatever I find inside.

The incision goes all the way across, because doing it in spots leaves little dog ears (puckered bunches of tissue at the edges). Placed where it is, you will not see it. It heals fast, around five days, and the scar keeps improving for about two months. Look closely and you will find the line. No one else will.

No, I Will Not Cut the Muscle

Some biopolymer sits deeper, down in the muscle. I do not remove muscle, because I am not willing to compromise your motion or your expression. Your own body is already working to push the material toward the surface, which is part of why you see those bumps in the first place.

The Honest Part: It Can Come Back

I tell every patient this up front. Once I remove what has surfaced, your body may keep pushing more up, and sometimes about six months later you notice it again and we go back in to remove more.

That happens roughly forty percent of the time. We apply a discount when it does. I would rather give you an honest number than a perfect-sounding promise I cannot keep, because honesty is the entire point of the people coming to me for cleanup work.

Placement vs. Removal, Side by Side

Migrated Filler in the Face

Old filler often does not fully dissolve. It migrates. If you are already having a facelift, I can place medication during the procedure to dissolve some of it, so we end up working with your natural tissues instead of over-inflating an area like the high cheekbones.

I am genuinely cautious about stacking more filler on top of filler. That is not a marketing position. It is what I see when I open these faces up.

Under-Eye Filler That Has Been Puffy for Years

This is one of the most common complaints I hear. Filler placed under the eyes can hold water and stay swollen for a very long time. Dissolving it is usually the first step, and it can take more than one treatment, especially if it has been there a while or if earlier attempts to dissolve it did not work.

Once your own tissue is back to baseline, fat grafting is a safer way to address true hollowing than chasing it with more product.

Why Removal Is More Delicate Than Placement

People assume that if filler went in easily, it must come out easily. The opposite is usually true. Putting material in takes minutes through a needle. Taking it out, especially permanent biopolymers, is more delicate work and is sometimes staged across more than one visit.

The reason is simple. Injected material does not stay in a neat pocket. It spreads, it scars into the surrounding tissue, and with permanent products it bonds to structures I want to protect, like nerves and muscle. So removal is not the same procedure run in reverse. It is its own operation, with its own planning, and I will be straight with you about what can be fully reversed and what cannot.

What I Want the Filler-Everything Era to Learn

I am not anti-filler. Used in small amounts, in the right person, by careful hands, it has a place. My objection is to the reflex of treating every concern with more product, because the cleanup lands on my table years later.

The pattern I see most is volume chasing volume. A little filler softens a line, the face adapts, more goes in to keep up, and eventually the proportions drift away from the person’s actual features. By the time someone sits across from me asking to look like themselves again, the honest answer is rarely another syringe. It is usually subtraction, patience, and letting their own tissue come back to baseline before we decide anything.

And when volume truly is missing, I would rather replace it with your own fat than with a product that migrates and holds water for years. Fat grafting uses your tissue, settles into your face, and does not leave me a cleanup to do down the road. That is the whole philosophy in one sentence: restore with what is yours, and stop renting volume by the syringe.

The Credential Behind the Caution

Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, American College of Surgeons Fellow, Mayo Clinic plastic surgery fellowship, and Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine. Removing material thoughtfully, and being straight about recurrence, is its own skill, and I take it as seriously as any operation I do.

Ready to Talk?

If you are tired of chasing one filler with another, or you want a biopolymer out, come talk to me. For the patient-facing walkthrough, see the companion post on agulloplasticsurgery.com. For the facial-aesthetics menu, see the version on swplasticsurgery.com.

Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.

@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.