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Not everyone is rushing to the operating table, however.
Dr. Casas estimates the breasts of one-third of the mothers she's seen during her 18 years of practice return to normal after pregnancy—if their weight does. Another third suffer from stretched skin and less breast tissue. The final third, which often includes those who do not lose the baby weight, have larger breasts after their deliveries.
She also recommends that patients try to tighten up their abdominal area first through diet and exercise, which in many cases allow them to bypass a tummy tuck.
"Some women bounce back like nothing ever happened," Dr. Mackenzie says. "Some women's bodies are ravaged after pregnancy."
For other mothers, it's an issue of priorities—and a woman's well-being.
Jennifer's younger sister, Joanna Duke, a 28-year-old public relations representative and mother of two in Decatur, Georgia, is opposed to mommy makeovers. She believes many women are trying to solve emotional problems with the surgeries.
"It's like putting a Band-Aid on a larger issue that you're not willing to work on," she says. "You need to fix those issues first. Then, if you still have a self-esteem problem—or whatever is driving you to have elective surgery—get it done. But go to counseling first, because nine times out of 10, the people that I know also have emotional issues going on."
Kathryn Probasco, 38, of Sacramento, California, shares that view. Currently pregnant with her third child, the attorney and physician's wife admits that while she occasionally misses her prepregnancy body, she won't ever undergo postpartum plastic surgery.
"Looking old doesn't concern me—not especially," she says. "Part of self-acceptance is accepting the changes that occur in life when you become a parent, and I mean mentally, physically, emotionally and spiritually. If your biggest concern after you give birth is whether your boobs sag, then your priorities are in the wrong place."
Dr. Casas is also concerned about her patients' overall health. She prefers the term "restoration" to "mommy makeovers," and unlike many plastic surgeons, refuses to operate on anyone who isn't willing to practice self-discipline.
"Liposuction, yes, but I won't perform invasive plastic surgery on someone who is 30 pounds overweight," she says. "I require all my patients to exercise and have good nutrition. If you want me to artificially suture your [abdominal] muscles, that's fine. But you can blow it out again by overeating or overdoing it. So why not just work on it before the surgery?"
