1967 · Pitanguy; F.M. Grazer
Abdominoplasty with diastasis repair
Area. Lower abdominal skin and fat removed; anterior rectus sheath plicated with sutures
The surgeon removes skin and fat of the lower abdomen and sews the separated rectus muscles together by folding the anterior rectus sheath (plication). Pitanguy popularized abdominoplasty in 1967. Nahas type A deformity, rectus diastasis after pregnancy, is treated by plication alone.[1][2][3]
Suits. Women who have finished having children, with loose skin and a rectus diastasis.
Trade-offs. Abdominoplasty had a 4.0% major complication rate in 25,478 insured cases, against 1.4% for other cosmetic operations. With absorbable suture, 40% of 40 women had residual or recurrent diastasis at a mean of 64 months; with nylon (28 women) or PDS (12 women), no recurrence was found at 12 to 48 months.
1991 · A. Matarasso; O.R. Saldanha
Lipoabdominoplasty
Area. Liposuction of the flap and flanks, with limited undermining
Liposuction is done in the same operation as the tummy tuck. Matarasso classified combined abdominoplasty and liposuction in four types in 1991. Saldanha described lipoabdominoplasty without undermining in 2001, keeping a thin fat layer with its vessels and lymphatics.[1][2][3]
Suits. A loose lower abdomen with fat of the upper abdomen, waist and flanks.
Trade-offs. Florida limits liposuction to 1000 cc of supernatant fat when it is combined with abdominoplasty in an office operation. In CosmetAssure data, abdominoplasty with liposuction had a 3.8% major complication rate, against 3.1% alone.
1995 · T. Lockwood
High-lateral-tension abdominoplasty
Area. Superficial fascial system repaired with permanent sutures, tension placed at the sides
Lockwood resected as much skin at the sides as in the center and closed the superficial fascial system with permanent sutures along the whole incision. Undermining was limited to the area near the midline to keep blood vessels to the flap.[1]
Suits. Moderate to severe laxity of abdominal skin and muscle, with or without fat of the trunk.
Trade-offs. In Lockwood's 50 patients followed 4 to 16 months, complication rates were equal to or lower than historical controls and did not rise with added liposuction.
1961 · Thomas Cronin, Frank Gerow
Breast augmentation
Area. Implant placed behind the breast or partly behind the pectoral muscle
A silicone or saline implant adds volume. Cronin and Gerow of Houston introduced the silicone gel implant with Dow Corning in the early 1960s. Augmentation was the most common cosmetic breast operation in women in CosmetAssure data, 41,651 of the breast cases.[1][2][3]
Suits. Breasts that lost volume after pregnancy, without much sagging.
Trade-offs. Major complications after cosmetic breast surgery were 1.46%, mostly hematoma (0.99%).
1976 · P. Regnault
Breast lift (mastopexy)
Area. Skin of the breast removed and the nipple raised; gland reshaped
A breast lift removes breast skin and raises the nipple. Regnault defined pseudoptosis, partial ptosis and three degrees of true ptosis by the nipple's position against the fold under the breast. The degree sets the technique.[1][2]
Suits. Sagging breasts with enough volume.
Trade-offs. Scars on the breast. In 28 mastopexies combined with abdominoplasty, complications did not differ from abdominoplasty alone.
2003 · S. Spear
Augmentation mastopexy
Area. Lift and implant in one operation
The lift and the implant are done together. The two goals conflict: the lift tightens the skin and the implant expands it. Spear titled his 2003 paper on the operation 'Surgeon, Beware'.[1][2][3]
Suits. Sagging breasts that also lost volume.
Trade-offs. Revision rates after one-stage augmentation mastopexy range from 8.7 to 23.2%. Augmentation-mastopexy had a higher risk of major complications, mainly infection (relative risk 1.74), than single breast operations.
1949
Breast reduction
Area. Breast tissue and skin removed; nipple moved up
Tissue and skin are removed to make the breast smaller and higher. The Wise pattern, introduced in 1949, is used to plan the cuts.[1][2]
Suits. Large, heavy breasts.
Trade-offs. In 738 breast reductions, adding abdominoplasty (44 women) did not raise breast or total complications, but total revisions rose (odds ratio 6.6).
Labiaplasty
Area. Labia minora trimmed or wedge resected
Labiaplasty reduces the labia minora. ASPS lists it among the procedures in a mommy makeover.[1][2]
Suits. Women who want the labia minora reduced in the same operation.
Trade-offs. In 46 studies with 3,804 patients, pooled satisfaction was 99%. Wound separation was most common after laser (5%) and wedge resection (3%), and hematoma after W-shape resection (8%).
2006 · W.G. Stevens
Single-stage or staged operations
Area. All parts in one operation, or split over two
ASPS says a mommy makeover is typically single-stage. Splitting the parts into two operations shortens each one. Matarasso names length of surgery as a main factor in planning the combination.[1][2][3]
Suits. Single-stage: healthy patients whose combined plan fits a safe operating time. Staged: longer plans or higher-risk patients.
Trade-offs. In 1,753 cases, each added hour raised the odds of complications by 21%, with higher risk after 3.1 hours. Florida caps planned office surgery for elective cosmetic procedures at 8 hours combined.
2026 · M. Tettamanzi
Tumescent local with spinal anesthesia
Area. Dilute lidocaine and epinephrine in the tissue, with spinal ropivacaine at L1-L2
Combined abdominal and breast operations are traditionally done under general anesthesia. One Italian series of 62 patients from 2011 to 2023 used tumescent local anesthesia with spinal anesthesia instead.[1][2]
Suits. Patients and surgeons who want to avoid general anesthesia.
Trade-offs. Major complications occurred in 14.5% of the 62 patients, including 5 hematomas and 3 seromas. Florida caps tumescent lidocaine at 50 mg/kg in the office.