Mommy Makeover Season 1: Episode 6

Types of Mastopexy

There are two major different types of Mastopexy. (Breast Lift) The first one is a skin only mastopexy which is able to remove excess skin and lift some of the tissue. This is only appropriate when the amount of breast tissue is minimal and the main problem is the excess skin. The more common case is when the whole breast itself needs to be lifted by re-shaping and repositioning. Especially if the breast is larger in size. These two surgeries are substantially different.

A Major mastopexy takes longer to perform and is more risky. It is more likely to harm nerves and blood vessels. The blood flow to the nipple has to be considered in these cases to keep it safe and prevent necrosis. If the measurement from the inframammary crease to the nipple, is greater than 15 cm then a free nipple graft should be considered. This allows for a more powerful reshaping of the breast to be performed. The following are some examples of skin only Mastopexy‘s versus a Major Mastopexy.

Next week we will show discuss free nipple graft in in more detail..

Mommy Makeover: Season 1 Episode 5

Breast Lift

So far we have focused on the nipple and its Postpartum changes. The same changes that affect the nipple may affect the entire breast.  Sometimes, breast size will increase 2 or 3 cup sizes during pregnancy.  Most of the time this excess volume, and even some of the original breast tissue will disappear after breastfeeding.  This is called “involutional hypomastia.  Often the remaining skin and nipple drops below its original position. The following is an example:

One of the most common questions that I get in regards to Mommy Makeovers is, “Will I look good with implants alone or do I need a lift”

A good rule of thumb is that if the nipple has descended beneath the inframammary crease, then a lift will be necessary.  Sometimes, subtle differences between people’s breasts can make it so that one person may be able to look good with implants alone and another may need a lift.

Am I a Good Candidate?

One of the big considerations when deciding whether or not to do a mastopexy (which is just another name for a Breast Lift) is the age of the patient and their history of scarring. Younger patients with a history of hypertrophic or keloid scars are not good candidates for breast lifts.  Older patients typically heal more slowly with scars that are thinner and less noticeable, due to their immune systems not being quite as vigorous as a younger person. 

Also, when somebody is greater than 40 years of age, the aesthetic quality and shape of the breasts may have deteriorated to the point where the improvement in shape is worth the scars. Whereas, a younger person may have experienced some negative changes to the shape of appearance of their breast from the pregnancy but it’s not bad enough to justify the scars.

I believe that in order for a mastopexy to be worth it, the end result has to be better, not just different.  In other words if we get the shape perfect and the scars are excessive, then the surgery may not be worth it.  A slightly imperfect breast with implants alone may still look better than the scars of a Mastopexy. 

Next time we will discuss the different types of Mastopexy. 

Mommy Makeover: Season 1 Episode 4

Changing the Position of the Areola

Last time we discussed making the areola smaller and more round. Today I will discuss 2 major techniques for moving the nipples. After pregnancy, if the breast becomes deflated and sags then the nipple can be repositioned higher with a technique that is similar to the one previously described. An oval is drawn around the inner circle that is marked. As these patterns are brought together the nipple will move up to 3 cm in the direction that the oval is oriented. The following is the markings of the pattern described and a one week result in a patient that I performed it on.


Free Nipple Graft

If during pregnancy the breast increases massively in size and never returns to normal the nipple may need to move so far that it can’t be done without detaching it. This is called a free nipple graft. The nipple areola are marked with the cookie cutter and the nipple is removed with a scalpel. Next the nipple is thinned to the perfect thickness and it is sewn back on in a spot that has been deepithelialized in a shape that matches. The following is an example of nipples that have been removed and thinned.

Patients are warned that sensation will be lost after this technique. However, some patients have told me that it eventually did come back for them.

Mommy Makeover: Season 1 Episode 3

The Areola

We have discussed altering the shape and size of the center of the nipple. Today’s discussion will focus on the areola. When we refer to the nipple in common speech it includes the areola. However, for surgical treatment, we tend to focus on the nipple as that central portion of the breast that protrudes above the level of the skin. The rest of the nipple is the darker, larger, flat area around the base of the nipple referred to as the areola. There really is no "normal" for its size and color. We rely on the “eye of the beholder” to decide what the best sized nipple is for each breast.

As surgeons we use “cookie cutters” to outline the center of the areola when we are making surgical alterations. The above is a photo of a couple of those circular tools. They come in all sizes but a rule of thumb is that a 38-40 mm areola looks good on a B-C cup breast, 40-42mm looks right for a breast in the D cup range. A breast that is DD or larger may require a 45mm areola or bigger. Most of the time people getting plastic surgery for their breasts have an A-B cup and are looking to be bigger or a DD or bigger and are looking to be smaller. Therefore most of the time an areola that is 38-42mm in diameter is used.

The mark that is made with the cookie cutter is the new outside of the nipple. All of the extra pigmented skin around this is then removed. A “purse string” suture is used to pull the two circles together as seen below.

This is the technique that is used to reduce the size of the areola and make it a perfect circle. Next time I will discuss one of the 2 different ways of moving the nipple to a new spot.

Mommy Makeover: Season 1 Episode 2

Nipple Inversion

With pregnancy and breast-feeding sometimes the opposite of enlarged nipples can happen. This is termed “inverted nipples.” This happens when the ducts of the breast do not stretch to keep up with the breast growth. Oftentimes, this becomes a permanent problem especially if the breast does not return to its original size.

There is a simple solution for this. After breast-feeding is finished, the nipple can be recovered by dividing the ducts.

Step 1


This office procedure involves numbing the nipple first with ointment and then with an injection. If this is done with patience there is no pain involved.

Step 2

After the nipple is numb an 11 blade scalpel is used to divide the ducts.

Step 3

Then a device is used to hold the nipple in its new position so that it will heal properly. When done correctly the new appearance of the nipple will be maintained long term.

After the procedure it is possible for normal sensation to return. However, sometimes nerves are injured and sensation may be reduced. After this procedure it will not be possible to breastfeed again. If an unplanned pregnancy occurs then when the milk comes in it will go away similar to when you quit breastfeeding as there is no outlet for the milk.

Next episode we will talk more about changes to the nipple from pregnancy. Specifically the size shape and color of the areola and what can be done to improve it.

Multi-Part Series: Mommy Makeover Season 1 Episode 1

👋 Dr. Bruggeman here.  I will be writing all the content for this blog myself.  This will give me a chance to offer mini-consults through the internet. There will be photos involved so that you can compare the things discussed here to yourself or someone you know.  All of the photos are mine unless otherwise specified.  There’s no substitute for an in person consult but this will be an effective way to help you decide if a consult is worth it.

What is a Mommy Makeover?

I’ll begin with a multi-part series that covers Mommy Makeover . A mommy makeover can be a confusing term because it covers a lot of different things.  Basically the term applies to the correction of any of the negative changes that happen to your body after having a baby.  Mostly this involves the change in size and or drooping of the breasts.  Another major body area of concern is the abdomen.  It experiences a lot negative effects from the increase in overall size and stretching of the skin.  Also, with childbearing there is weight gain that is healthy for you, and the baby as well, but sometimes it can be difficult to lose the unwanted weight after pregnancy.  These areas are often good targets for liposuction and skin tightening modalities.

Starting From the Top Down- The Nipple

Let’s start from the top down.  Today’s topic will begin with the nipple.  It is usually positioned on the top and in the center of the breast.  It may be the first thing that is noticed when you look at your breast.  With breast feeding the nipple can change.  It may change positions, usually to a lower part of the breast, this contributes to the droopy appearance referred to as “ptosis.”  Also, the size of the areola and the nipple itself can change.  If the nipple maintains a disproportionately large size after the breast’s volume has gone away it can be fixed.  Often times the size or shape off the nipple is a topic that gets overlooked in consults because patients may not be aware that anything can be done safely, or the doctor may assume that if the patient doesn’t bring it up then they must be happy with it.


The above photos are examples of enlarged nipples that detract from the overall aesthetic appearance of the breast.  The procedure used to reduce the height of the nipple is safe and can be done in the office with local anesthetic.  As you can see here nothing is amputated and no nerves or ducts are severed, because the reduction comes from excising the excess skin around the nipple.  Sutures are placed to bring the height of the nipple down. Any size can be selected for your desired end result.


Here are examples of two different heights resulting from the same procedure.  The sutures are left in place for 1-2 weeks.  The sensation and the ability to breast feed in the future remain intact.

Season 1 Episode 2- COMING SOON!

Natural Results with Morpheus8 from InMode Aesthetic Solutions

Morpheus8 from InMode Aesthetic Solutions provides a noninvasive way of chin tightening and jowl reduction. This radio frequency fat reduction method tightens the skin in just one or two treatments using microneedles, fine frequencies and heat. The results? Natural, smoother, younger-looking skin with a noticeable reduction in jowls and sagging skin near the chin.

About Radio Frequency Fat Reduction – Non-Invasive Aesthetics

Morpheus8 is a radiofrequency subdermal adipose remodeling device (SARD). This means it uses radiofrequency waves to work below the skin (subdermal) on your fat tissue (adipose tissue). The radio waves penetrate deep into the skin and remodel the fat tissue, tightening and smoothing it to wipe away signs of aging.

The benefits of Morpheus8 treatments include:

  • Natural, uniform effect
  • Little to no thermal damage to the skin (any thermal damage is temporary and fades in days)
  • Safe for most skin types
  • Little to no post-treatment pigmentation

Radio frequency fat reduction makes a noticeable difference, but friends may assume you’ve just gotten more sleep or have that special ‘glow’ because it doesn’t look over-tight or sculpted. Instead, the radio frequency waves smooth your skin back to its natural, youthful appearance.

Watch a Morpheus8 Procedure Completed at Bruggeman Plastic Surgery & Aesthetics

Dr. Bruggeman filmed a video demonstrating how he used the Morpheus8 procedure on one patient to tighten her skin and firm her jawline. You can watch these videos on our Facebook page or here. [link].

As you can see from the videos, the woman is smiling throughout the procedure! Dr. Bruggeman takes great care to ensure his patients are comfortable and relaxed during treatment. A Morpheus8 session can be completed in our convenient Peoria, Arizona office,

The patient herself couldn’t believe the results. “My significant other noticed a difference immediately,” she beamed. “And I could see in just one treatment how my skin looked younger, firmer. It’s amazing what can be done with non-invasive aesthetic treatments like Morpheus8.”

Is Morpheus 8 Just for Non-Invasive Chin Tightening and Jowl Reduction?

Radio frequency fat reduction such as Morpheus8 offers more than chin tightening and jowl reduction. It can be used as a spot treatment on other areas of the body where fat accumulation does not respond to diet or exercise. The leg and stomach areas, for example, can be reduced using radio frequency fat reduction.

Other Non-Invasive Aesthetics Available in Our Peoria MedSpa Office

Bruggeman Plastic Surgery & Aesthetics offers more than Morpheus8 radiofrequency fat reduction. We offer a full complement of non-invasive aesthetic solutions in our Peoria, Arizona MedSpa office.

  • Laser hair removal to remove leg, chest, arm, bikini and other hairs
  • IPL, the “photo facial,” that reduces the signs of sun damage to the skin
  • Skin tightening
  • Feminine rejuvenation
  • Chemical peels
  • Injectable fillers
  • Dermalinfusion
  • Environ Professional Skin Care

We offer a FREE 30-minute skin consultation in our private, comfortable office. During your consultation, we’ll discuss your goals and desires and develop a plan to achieve them.

Make an Appointment with Bruggeman Plastic Surgery & Aesthetics

Bruggeman Plastic Surgery & Aesthetics in Peoria, Arizona offers non-invasive aesthetic treatments right in our office, and we’re only minutes from Sun City, Glendale, Surprise, Sun City West, Avondale, and Litchfield Park.

Please call for an appointment today: 623-233-5709. We’ll discuss your goals and create a treatment plan to help you look and feel beautiful! Morpheus8 from InMode Aesthetic Solutions is just one of the many procedures we offer in our private, comfortable Peoria office. Let us help you decide the right treatment to achieve your goals.

Bruggeman Plastic Surgery & Aesthetics Offers Medspa Office in Peoria, Arizona

Bruggeman Plastic Surgery & Aesthetics Offers Medspa Office in Peoria, Arizona

What do Bruggeman Plastic Surgery & Aesthetics and “famous name” day spas have in common? A beautifully appointed, modern medspa office that invites you to sit back and relax during treatments.

Take a moment now to enjoy a virtual tour of our Peoria, Arizona office.

From the modern decor to the cozy treatment couches and chairs, you’ll feel cradled in comfort as you experience the benefits of non-invasive aesthetic treatments.

An Inviting Space for Plastic Surgery and Aesthetics

The spacious picture windows invite natural light into the waiting room and treatment areas. White on white, punctuated by sharp bursts of peony and poppy pink flower murals, emphasize the fresh, new look you’ll experience after non-invasive aesthetics.

Privacy Is Paramount

Each consultation room offers a cozy, private space in which you can discuss your goals and treatment plan with Dr. Bruggeman or one of our medical aestheticians. Individual treatment rooms ensure privacy, comfort, and cleanliness. All rooms are equipped with soft, natural light as well as treatment lights, comfortable adjustable padded treatment chairs, and more to put you at ease.

The Medspa Environment – Like a Luxury Spa, but Better

If medical offices make you anxious and nervous, you’ll be delighted with Bruggeman Plastic Surgery & Aesthetics. No ugly medical charts on the walls or anatomical drawings. No crowds in the common waiting area.

Instead, serene off-white walls adorned with colorful flower murals lead you deeper into the network of small, private consultation and treatment rooms. The waiting area includes several small yet interconnected areas with inviting couches, chairs, refreshment area, and flat-screen televisions. The entire atmosphere is relaxed, elegant, and distinctly spa-like.

Medspa Treatment Rooms for Non-Invasive Aesthetics

Our medspa environment offers a clean design that harkens to the top interior design trends found in glossy magazines. Yet it is also a professional medical space where we transform your appearance using the latest non-invasive aesthetic techniques.

Some of the aesthetic techniques provided in our Peoria office include:

  • Morpheus8, radio frequency microneedling that smoothes skin, tightens jowls, and reduces bra fat rolls. The results are natural yet effective, shaving years off of your appearance.
  • IPL, or the “photo facial,” that provides sun damage repair for your skin.
  • Laser hair removal with Diolaze XL from Inmode Aesthetics, reducing unwanted hair from legs, bikini area, chin, underarms

These are just a small sample of the minimally invasive treatments available in our office. Review the complete list of non-invasive aesthetics and call for an appointment now.

Bruggeman Plastic Surgery & Aesthetics: Free Consultations Available

Bruggeman Plastic Surgery & Aesthetics in Peoria, Arizona, opened in 2019 to offer the latest non-invasive aesthetic treatments and plastic surgery to both men and women. We’re only minutes from Sun City, Glendale, Surprise, Sun City West, Avondale, and Litchfield Park.

Call for an appointment today: 623-230-2200. We’ll discuss your goals and create a treatment plan to help you feel rejuvenated and youthful. From in-office facials and peels to breast augmentation plastic surgery, Bruggeman Plastic Surgery & Aesthetics satisfies the need for all to look and feel their best.

Complimentary 30-Minute Skin Analysis is Now Available at Bruggeman Plastic Surgery & Aesthetics


First-Time Patients will Receive a Skin Analysis that Addresses Common Skin Concerns

PEORIA, Arizona — Uneven skin tone? Adult acne? Rosacea? Spots that just won’t go away? Bring those troublesome skin care problems to Lyda Moore, Lead Aesthetician at Bruggeman Plastic Surgery & Aesthetics, for a free skin analysis and recommendations to restore the skin to its natural beauty.

For more information about Bruggeman Plastic Surgery & Aesthetics, please visit

Lyda, working under the direction of Board Certified Plastic Surgeon Dr. Brian Bruggeman, M.D., is a Licensed Aesthetician, Certified Laser Technician and Laser Safety Officer and she offers numerous non-invasive treatments to help people address common skin concerns.

“I love problem solving and helping people feel better about their appearance and themselves. Our Free Skin Analysis allows me to investigate any external surface issues, and also identify internal factors that may be contributing to a patient’s skin concerns,” Lyda said.

The complimentary skin analysis also provides each patient with the opportunity to explain and identify their perceived areas of concern. Lyda personalizes an individual treatment plan to address each with the latest, medically advanced modalities available.

With all these state-of-the-art treatments under one roof, each of which was hand-picked by both Lyda and Dr. Bruggeman, there really isn’t any skin concern that can’t be addressed.

“Working under a plastic surgeon adds extra levels of knowledge, experience and comfort for our patients. By law, an aesthetician’s scope of practice is limited. However, if I come across concerns such as possible skin cancer or suspicious-looking moles, I can defer to Dr. Bruggeman’s medical expertise. He can examine the area and refer people to a dermatologist, if necessary,” explained Lyda.

Some of the more popular, non-invasive treatments offered by Bruggeman Plastic Surgery & Aesthetics are IPL (by Lumecca), Dermalinfusion, Morpheus8, Microneedling, and laser hair removal.

“We can address everything from sun damage, hyperpigmentation, aging skin, acne scarring, skin tightening, fine lines, rosacea, and so much more,” said Lyda. “Best of all, each treatment can be done in the comfort of our beautiful, custom designed office.”

Bruggeman Plastic Surgery & Aesthetics opened in 2019 and offers comprehensive MedSpa treatments and plastic surgery to residents of the Peoria, Arizona area. The office welcomes new patients and encourages those interested in plastic surgery and aesthetic solutions to call (623) 230-2200 to schedule a free plastic surgery consultation and aesthetic skin analysis. Bruggeman Plastic Surgery & Aesthetics is located at 14155 N. 83rd Avenue, Suite 147, Peoria, Arizona.

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About Bruggeman Plastic Surgery & Aesthetics

Bruggeman Plastic Surgery & Aesthetics, located in Peoria, Arizona, offers plastic and reconstructive surgery as well as medical aesthetics for men and women. Innovative services include Crisalix® virtual reality 3D/4D software that enables patients to visualize before and after images, BodyTite® and FaceTite® from Inmode Aesthetic Solutions, and many more services. The relaxing, spa-like environment, medically trained aestheticians, and excellent care from Dr. Bruggeman and his staff provide patients with procedures that enhance their appearance and help them feel good about themselves.

Bruggeman Plastic Surgery & Aesthetics Opens Office in Peoria, Arizona


Medical Day Spa and Plastic Surgery Office Brings Latest Facial, Body Enhancement Techniques to Peoria-Area Residents

PEORIA, Arizona — Dr. Brian Bruggeman, M.D., announced today the opening of his new practice in Peoria, Arizona. Bruggeman Plastic Surgery & Aesthetics brings cutting-edge medical aesthetics, plastic surgery, body enhancements and more to the Western Salt River Valley where fun in the sun often leads to premature wrinkling, uneven skin pigmentation, and other signs of aging.

“Our office provides a luxurious, day-spa feeling while under the care of a licensed plastic surgeon or medically-trained aestheticians” said Dr. Bruggeman. “We provide both the latest beauty treatments as well as plastic and reconstructive surgery to correct and enhance a patient’s appearance.”

Bruggeman Plastic Surgery & Aesthetics provides an array of plastic surgery and aesthetic services for a healthier, more youthful appearance. Patients may select from IPL, laser hair removal, skin tightening, Dermalinfusion®, feminine rejuvenation, Botox® and more. Medically-trained aestheticians analyze patients’ skin and recommend products and procedures to enhance and correct common skin problems.

Among the innovative offerings is Crisalix®, a virtual reality system that enables patients to visualize in 3D and 4D what they will look like before and after a procedure.

Learn More About Crisalix

“It’s revolutionary,” Dr. Bruggeman said. “It answers the common question many patients have: ‘What will I look like after the procedure?’”

Dr. Bruggeman also performs plastic surgery services including reconstructive surgery after mastectomy, rhinoplasty (nose jobs), face lifts, breast implants and breast reduction surgery, tummy and chin tuck,  “Mommy Makeover” procedures, and liposuction. Less invasive services that can be performed in the office include BodyTite® and FaceTite® from InMode Aesthetic Solutions, liposuction, body contouring, and skin tightening.

Dr. Bruggeman earned his medical degree from the University of Utah and completed his residency in Plastic and Reconstructive Surgery at Albany Medical Center, New York. He has worked with burn victims at the Westchester Burn Center in Valhalla, New York, and volunteered his time in Santiago, Dominican Republic, repairing cleft lips and palates.

The office welcomes new patients and encourages those interested in plastic surgery and aesthetic solutions to call (623) 233-5709 to schedule a plastic surgery consultation and aesthetic skin analysis. Bruggeman Plastic Surgery & Aesthetics is located at 14155 N. 83rd Avenue, Suite 147, Peoria, Arizona.

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About Bruggeman Plastic Surgery & Aesthetics

Bruggeman Plastic Surgery & Aesthetics, located in Peoria, Arizona, offers plastic and reconstructive surgery as well as medical aesthetics for men and women. Innovative services include Crisalix® virtual reality 3D/4D software that enables patients to visualize before and after images, BodyTite® and FaceTite® from Inmode Aesthetic Solutions, and many more services. The relaxing, spa-like environment, medically trained aestheticians, and excellent care from Dr. Bruggeman and his staff provide patients with procedures that enhance their appearance and help them feel good about themselves.