Plastic surgeon Bob Basu, MD, talks about the evolution of the mommy makeover and what sets his practice apart.

By Steven Martinez

Bob Basu, MD, MBA, MPH, FACS, is the founder and managing partner of Basu Center for Aesthetics and Plastic Surgery in Houston, Texas.

Basu is a nationally recognized expert in plastic surgery. He has been recognized for his work in Newsweek, the Houston Chronicle, and Texas Monthly. He served on the boards of the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) and the American Society of Plastic Surgeons (ASPS).

He is currently the ASPS board vice president of finance and treasurer and has co-written a textbook on breast augmentation.

It’s hard to imagine then that Basu might never have become a plastic surgeon at all.

Attention to Detail

Basu’s first inkling that he might make a good plastic surgeon came during his residency in general surgery. Originally planning on becoming a cardiothoracic surgeon, his chief resident looked over his shoulder one day while Basu was closing up a patient and noticed the unusual amount of care he took.

“He saw that I took pride in how I closed the incisions in general surgery cases, and he told me, ‘You’re going into plastic surgery,’” says Basu. “I looked at him like, ‘what are you talking about? I want to be a cardiothoracic surgeon.’ No, he said, ‘you’re enjoying this closure and making it look good too much. You’re going into plastic surgery.’”

That moment ended up being predictive of the future, and Basu subsequently discovered his love for plastic surgery. He enjoyed the challenge of doing a pristine anatomic procedure that had to be functionally effective and look great.

“What drew me to aesthetic plastic surgery is the additional challenge of seeing your results right away and creating things that are balanced and beautiful,” says Basu. “I really enjoy that every day.”

The Houston Chronicle declared Basu’s practice the best place to get a mommy makeover earlier this year. So, what exactly makes an award-winning mommy makeover?

What Makes an Award-Winning Mommy Makeover

Basu believes that his extensive experience in complex breast surgery, coupled with the sheer number of mommy makeovers he has done in his career, has driven the accolades he’s received.

“It’s the volume of experience, I think, it’s the quality of outcomes, and it’s how we make patients feel that has helped drive some of these recommendations,” says Basu. “Ultimately, it’s all about the patient, that they’re happy with what we’re trying to strive for. I think that’s probably the primary driver.”

A mommy makeover can encompass any number of different procedures, all with the goal of restoring or improving the post-pregnancy body. Pregnancy impacts women in different ways. It changes the shape and size of breasts, leaves them with stretch marks, and causes skin and muscle separation.

Typically including some form of breast augmentation and tummy tuck, Basu has seen the mommy makeover evolve as new techniques and a new ideal aesthetic has emerged over the course of his career.

“When I was in training almost 20 years ago, it was discouraged to do liposuction at the same time as an abdominoplasty; the paradigm has completely changed,” says Basu.

He now regularly incorporates liposuction and fat transfer procedures for sculpting the waist and hips while doing his tummy tucks to accentuate the hourglass figure that women typically want.

“I tell patients that a tummy tuck will help give you a nice flat washboard belly, but we can give you a much better result if we also address the love handles in the waist,” says Basu. “What we don’t want to do is give someone a flat washboard belly, and they’re still left with a muffin top on the side.”

“The American aesthetic has evolved. To put it bluntly, curves are in,” says Basu.

During a tummy tuck, Basu typically does liposuction of the upper and lower waist. While a tummy tuck addresses the front portion of the tummy, liposuction and fat transfers help enhance the curves by taking fat from one area and putting it to good use in another.

“Some people call it the ‘S-curves’ on the waist, and some people call it an ‘hourglass waist’. Now there’s a term that’s used quite frequently in Instagram called a ‘snatched waist,’” says Basu. “I never heard the word snatched in medical school, but it’s a common vernacular now.”

A snatched waist often refers to the exaggerated hip-to-waist ratio that celebrities like the Kardashians and a host of Instagram models made famous. He says that women of all ages, not just younger women, come into his practice asking for a snatched waist.

It speaks to how much the ideal look has changed in America. Basu says it isn’t unusual for a mommy makeover to just include abdominal contouring and a fat transfer procedure without even addressing breasts.

“The American aesthetic has evolved. To put it bluntly, curves are in,” says Basu. “Even on patients that I treat who have had massive weight loss—losing 100-150 pounds through lifestyle modifications or bariatric surgery—part of my body contouring after weight loss plans include solutions that will enhance their curves.”

The Consultation Process

The umbrella term of a mommy makeover is not a one-size-fits-all solution, says Basu. It is ultimately about making mothers feel more confident about their bodies by addressing their individual concerns to achieve patients’ goals.

To that end, the most essential part of a mommy makeover may be the consultation process. Basu says it is important that plastic surgeons understand the patients’ goals and discuss whether that end goal is reasonable and achievable.

“One of the things that I encourage my patients to do is to bring wish pics of results that they would like to emulate,” explains Basu. “These are results, maybe from my website, that they would like to emulate. It can be photos that they see of Instagram models that they would like to emulate.”

The wish pics are a vital part of the communication process for Basu. He says that he can talk to patients for hours about a patient’s goals, but once he’s done a physical examination and seen the wish pics, he knows exactly what results they are trying to achieve.

The process also allows Basu to understand how he will get a patient to their goals and discuss what other procedures might be necessary to achieve it. It also helps him decide if the goal is feasible or safe for a patient to pursue as an outcome.

“At the end of the day, it’s all about patient satisfaction. The patient decides whether they’re happy or not,” says Basu. “My job as a board-certified plastic surgeon is to educate them about whether we can get them there or even if that’s a reasonable goal. In some cases, they bring wish pics that are just not attainable given anatomic limitations.”

Focus on Safety and Comfort

Basu emphasizes patient safety at his practice. He performs his aesthetic surgery cases at his own state-licensed ambulatory surgery center, a facility that meets hospital-grade standards as determined by the Texas Department of Health.

He also has a board-certified anesthesiologist for all of his cases, someone he’s worked with for almost 12 years. In general, Basu maintains a team of colleagues that he has worked with for several years that allows him to offer better continuity of care for his patients.

One aspect of care he has found “revolutionary” for his mommy makeovers is an FDA-approved medicine called Exparel to perform nerve blocks. The use of Exparel has allowed his tummy tuck and mommy makeover patients to recover from surgery without a single narcotic pain pill.

“When my patients compare their experience to a girlfriend’s experience at a different practice, it’s a night and day difference,” says Basu. “Proper utilization of that numbing medicine numbs up the tissue, and I do some special nerve blocks where they’re not feeling any pain for at least 72 hours.”

While there is still a recovery involved with any of these surgeries, the Exparel makes it much more tolerable, he says. Typically, patients can take Tylenol or a non-steroidal anti-inflammatory to manage the pain. In some cases, they may still require some pain medication, but they can more quickly transition off it, says Basu.

“When patients have a smoother recovery, then they become my practice’s champions out in the community,” says Basu.

Perhaps the through line for Basu’s career and what sets him apart in plastic surgery, from fastidious surgery closures in residency to his focus on patient safety, is attention to detail. He is recognized as one of the best plastic surgeons in the country, but there are horror stories in the media all the time about botched plastic surgeries and life-threatening results.

Basu believes that patients should do their homework and remember there is risk involved with any surgery.

“You shouldn’t cut corners on cost. It’s your health and safety,” says Basu. “All human beings love deals. I would love to get my groceries cheaper or maybe buy toilet paper cheaper. If I don’t like that product, I can return it. With discount plastic surgery, there’s no returns. There are only bad outcomes.”

Photo courtesy of Basu Center for Aesthetics and Plastic Surgery

Steven Martinez is associate editor of Plastic Surgery Practice.