Combined Abdominoplasty and Mastopexy in a Single Surgical Session for a 34-Year-Old Mother of Two
A 34-year-old homemaker from Hyderabad had returned to her pre-pregnancy weight after two children but her body had not returned to its pre-pregnancy shape. The abdomen carried loose overhanging skin and a separated muscle wall that no exercise could correct. The breasts had lost upper pole volume and developed significant ptosis through two rounds of breastfeeding. She wanted to address both concerns in a single procedure rather than face two separate surgeries and two recoveries. After researching her options, she consulted Dr. Harikiran Chekuri at Redefine Clinic. A carefully planned combined abdominoplasty and mastopexy performed in a single session restored her abdominal contour, repaired the muscle wall, and repositioned the breasts to a natural, youthful position without implants.
PATIENT PROFILE
| PARAMETER | DETAIL |
| Age | 34 years |
| Gender | Female |
| Occupation | Homemaker |
| City | Hyderabad, India |
| Presenting Complaint | Loose abdominal skin with overhang, breast ptosis, loss of upper breast volume |
| Diagnosis | Post-partum abdominal skin laxity with diastasis recti, Grade II breast ptosis |
| Number of Pregnancies | Two (children aged 4 and 7) |
| Breastfeeding History | Both children breastfed for 12 to 18 months each |
| Current Weight | At pre-pregnancy baseline |
| BMI | 23.4 (within normal range, stable for 14 months) |
| Previous Treatments | None surgical. Exercise and diet maintained for 2 years without resolution |
| Date of Surgery | January 2026 |
| Outcome | Excellent |
THE PROBLEM
She had done everything right. The weight came off. She exercised consistently, watched her diet, and gave herself time. Two years after her second child, she was back to the weight she had been before either pregnancy. But the body in the mirror was not the same body. The lower abdomen had a fold of loose skin that sat over the waistband of every pair of trousers she owned. Planks and crunches made no difference. Her core felt weaker than it should for the amount of effort she put in.
The breasts were a separate but equally frustrating story. Both children had breastfed for over a year. By the time the second was weaned, the upper pole had deflated and the nipple had dropped well below where it used to sit. She was not unhappy with the size. She wanted position and shape back, not volume.
She had researched plastic surgery options in Hyderabad for over a year, carefully weighing whether to address the abdomen and breasts separately or together. The idea of two separate general anaesthetics and two separate recovery periods was not something she wanted to put her family through. She consulted Dr. Harikiran Chekuri at Redefine to understand whether a combined procedure was a safe and realistic option for her.
CONSULTATION & TREATMENT PLAN
WHAT WAS ASSESSED DURING THE CONSULTATION
A comprehensive physical and photographic assessment was conducted across both anatomical areas before any surgical plan was formulated:
- Abdominal assessment: Moderate skin excess with overhanging pannus at lower abdomen, diastasis recti confirmed at approximately 3.5cm separation at the umbilical level, adequate subcutaneous fat for contouring
- Breast assessment: Grade II ptosis confirmed with nipple positioned 2cm below the inframammary fold, adequate glandular tissue volume, no implant required, skin envelope lax at upper pole
- General health evaluation: No active medical conditions, non-smoker, BMI stable for 14 months, cleared for general anaesthesia
- Surgical risk for combined procedure: Discussed in full. Operating time, fluid balance, and post-operative monitoring requirements reviewed. Patient assessed as a suitable candidate for combined session
- Patient goals confirmed: Flat abdominal contour, functional core improvement, natural breast position without implants, single recovery period
- Scar placement discussed: Low transverse abdominal scar within the bikini line, periareolar and vertical breast scars reviewed with photographs
- Post-operative support: Availability of family help during recovery confirmed as a prerequisite for combined procedure clearance
SURGICAL PLAN
- Full abdominoplasty with complete skin excision from umbilicus to pubic hairline
- Diastasis recti repair via midline plication of the rectus abdominis fascia
- Umbilicoplasty to reposition the navel in the correct anatomical position
- Liposuction to flanks for additional waist definition if intraoperative assessment supports it
- Mastopexy using the Lejour vertical scar technique to reposition the nipple-areola complex and reshape the breast mound
- No implants. Native breast tissue repositioned and tightened to restore upper pole fullness
- Procedures performed in sequence under a single general anaesthetic with a planned operative time of four hours
PRE-OPERATIVE PHOTOS
Baseline photographs were taken from the front, lateral, and oblique angles under standardised lighting to document the abdominal skin excess, breast ptosis, nipple position, and overall body contour before surgery.
Pre-operative photographs: frontal view | lateral view | oblique view
PROCEDURE DETAILS
PROCEDURE DETAILS
- Patient positioned supine under general anaesthesia. Safety checks completed by anaesthesia and surgical team
- Abdominoplasty commenced first. Low transverse incision marked within bikini line from hip to hip
- Abdominal skin and fat elevated from the pubic hairline to the costal margins
- Diastasis recti repaired with a series of interrupted and running absorbable sutures along the midline fascia, restoring a single functional abdominal wall
- Umbilicus detached, preserved on its stalk, and set aside for repositioning
- Excess abdominal skin excised. Wound edges brought together under appropriate tension
- Umbilicus repositioned through a new opening and sutured into place
- Liposuction to bilateral flanks performed with 150ml removed each side for waist definition
- Abdominal drains placed. Wound closed in layers
- Patient repositioned. Mastopexy commenced using the Lejour vertical scar technique
- New nipple-areola position marked and de-epithelialised
- Breast glandular tissue reshaped and sutured into an elevated, projecting mound
- Nipple-areola complex transposed to the new position
- Vertical breast scar closed in layers. No implants used
- Compression garments and supportive dressings applied to both areas
- Total operative time approximately four hours. Procedure completed without complication
PROCEDURE FACTS
| PARAMETER | DETAIL |
| Procedure 1 | Full Abdominoplasty with Diastasis Recti Repair and Umbilicoplasty |
| Procedure 2 | Mastopexy (Breast Lift) using Lejour Vertical Scar Technique |
| Combined Session | Both procedures performed under a single general anaesthetic |
| Duration | Approximately 4 hours |
| Anaesthesia | General anaesthesia |
| Abdominal Scar | Low transverse, within bikini line |
| Breast Scar | Periareolar and vertical (Lejour pattern) |
| Implants | None |
| Drains | Two abdominal drains removed at 48 hours |
| Hospital Stay | One night observation, discharged day two |
| Complications | None |
POST-OPERATIVE RESULTS
The recovery was staged carefully. The first two weeks were the most demanding, with mobility restricted and family support essential for daily tasks. Abdominal drains were removed at 48 hours. At the two-week review, both wounds were healing cleanly with no signs of complication. By week six, the patient had returned to light activity and was able to manage the household independently. At the three-month review, the abdominal contour was flat and well-defined, the diastasis repair had held, and core function had noticeably improved. The breasts had settled into a natural position with the nipple-areola complex in the correct anatomical location. At the six-month review, scars were softening and fading within the planned positions and the patient confirmed the result met every goal discussed at consultation.
Post-operative photographs at 6 months: frontal view | lateral view | oblique view
OUTCOMES AT A GLANCE
| OUTCOME METRIC | RESULT |
| Abdominal Contour | Flat, well-defined. Skin overhang fully resolved |
| Diastasis Recti | Repaired. Midline fascia restored. Core function improved |
| Umbilicus | Repositioned naturally. No distortion |
| Waist Definition | Improved with flank liposuction. Clothing fit significantly changed |
| Breast Position | Nipple-areola complex elevated to correct anatomical position |
| Upper Pole Fullness | Restored using native tissue. Natural appearance without implants |
| Scar Position | Abdominal scar within bikini line. Breast scars softening at 6 months |
| Complications | None |
| Patient Satisfaction | Excellent at 6-month review |
PATIENT FEEDBACK
Feedback recorded at the 6-month follow-up visit at Redefine, Hyderabad.
Google Review ★★★★★ 5.0 Verified Patient (Name withheld for privacy) “I had thought about this for almost three years. Two children, two recoveries, and a body that no longer reflected how I felt about myself. The abdominal skin just would not go away no matter what I did. The same with my breasts. I was nervous about having two procedures at once but Dr. Harikiran explained the planning thoroughly and I trusted the process. The recovery was harder than I expected the first two weeks. But by week six I was back to normal activity. At six months I could see the full result. My abdomen is flat. My breasts sit where they used to. My clothes fit differently. I feel like myself again. I would not change a single thing about the decision.” |
Patient identity withheld per confidentiality guidelines. Review published with written consent.
POST-OPERATIVE CARE & RECOVERY
Complete bed rest for the first 48 hours with compression garments worn continuously
Head and knees elevated in a flexed position for the first week to reduce tension on the abdominal wound
Abdominal drains managed at home after discharge and removed at the 48-hour review
No lifting of any object heavier than half a kilogram for the first three weeks
Light walking encouraged from day three to reduce the risk of deep vein thrombosis
Compression abdominal garment worn for six weeks continuously, then for a further six weeks during the day
Supportive bra worn continuously for six weeks post-mastopexy
Scar massage to begin at six weeks once wounds are fully closed
No strenuous exercise, swimming, or any activity that loads the abdominal wall for eight weeks
Follow-up appointments at 48 hours, two weeks, six weeks, three months, and six months
RECOVERY TIMELINE
| TIMEFRAME | WHAT TO EXPECT |
| Day 1 to 3 | Moderate discomfort, drains in situ, limited mobility. Full rest at home with support. |
| Day 4 to 14 | Drains removed. Mobility improving. Wound checks ongoing. No unsupported activity. |
| Week 2 to 6 | Swelling and bruising reducing. Light activity from week three. Compression garments worn. |
| Month 2 to 3 | Return to normal household activity. Abdominal shape becoming visible as swelling resolves. |
| Month 3 to 6 | Scars softening. Final breast shape establishing. Core strength returning. |
| Month 6 to 12 | Near-final result. Scars continue to fade. Full activity permitted from month two onwards. |
DISCLAIMER
This case study is for informational purposes only and does not constitute medical advice. Individual results may vary based on body composition, skin elasticity, healing response, and individual anatomy. Combined surgical procedures carry specific risks that are discussed thoroughly during consultation. Results take six to twelve months to fully mature. Consult a qualified plastic surgeon to understand what is achievable for your specific anatomy and medical history. Patient identity withheld per confidentiality guidelines. Feedback published with written consent.