Groundwork: breast surgery & mommy makeover

• Breast surgery alone: about $7,000–$12,500 all-in in DFW from published practice pricing; roughly $9,000–$10,000+ if a lift is added. Tabbal posts the fullest breakdown.
• Mommy makeover (usually tummy tuck + breast surgery, often liposuction): published DFW figures run $8,000 to $30,000+ depending on practice and scope. Most clustered around $12,000–$20,000. Insurance usually doesn’t cover it.
• After five pregnancies, implants add volume but don’t lift. Whether she needs a lift, and whether a tummy tuck with muscle repair is worth discussing, can only be decided in person.
• Safety: combined surgery is common but raises clot and complication risk as it gets longer. ASPS guidance is to aim for 6 hours or less and to stage if needed.
• Timing: surgeons here say to wait at least 6 months after breastfeeding ends (Angobaldo’s practice says 6 to 12 months).
• Shortlist to consult first: Tabbal, Setty, Stiles. Add Angobaldo or Anderson for comparison.
• First step for any finalist: verify ABPS board certification yourselves.

• Silicone vs saline: silicone feels more natural and ripples less, but a rupture can be silent. Saline is firmer and a rupture is obvious. UTSW
• Smooth vs textured: nearly all BIA-ALCL cases involve textured implants, and many surgeons now use smooth. FDA
• Placement: “dual plane” (top half under the muscle) is the most common modern choice. Tabbal
• Size: chosen to fit her chest width, not a cup size. Surgeons cite roughly 250–450 cc for most women. Oversized implants raise the chance of stretching and sagging. 3D imaging is a simulation, not a promise. Tabbal

• Implants add volume and don’t reliably lift. ASPS says augmentation “does not correct severely drooping breasts. A breast lift may be required.” ASPS
• One surgeon’s rule of thumb: if nipple-to-fold distance is over 9–10 cm on stretch, strongly consider a lift. Without one there can be a “double bubble.” Tabbal
• A lift adds scars and cost, and a lift with implants is a more complex operation than either alone. Only an in-person exam decides.
• A new pregnancy can undo results. She is finished having children, which surgeons list as a key candidate factor. ASPS

• Silicone implants: first ultrasound or MRI at 5–6 years, then every 2–3 years. Insurance may not cover it. Saline: no routine imaging. FDA
• Since Oct 2021, a boxed warning and a patient decision checklist she signs before surgery are required. FDA bulletin
• She still needs mammograms. Tell the center about implants so they use extra views. ACS

Plan on $7,000–$12,500, or about $10,000+ with a lift, plus future imaging and possible revision.

A mommy makeover is a customized combination, usually done in one operation. ASPS lists the possible parts. ASPS Most common: a tummy tuck plus breast surgery. ASPS

No source ranks combos by number of births, so this is from how surgeons describe the common pattern. Pregnancy stretches abdominal skin and muscle, and the breasts lose volume and sag. NTPS

• Tummy tuck + breast lift ± implants + liposuction: the “traditional” makeover. NTPS
• Tummy tuck with muscle repair + liposuction: when the abdomen is the main concern. Tabbal
• Breast augmentation and/or lift alone: if she wants breast changes only, with no abdominal surgery. NavMDs

Which one fits her depends on exam findings, and some surgeons will advise staging it in two operations.

National

• ASPS: “typically between $15,000–$20,000,” higher with more procedures (undated blog; ASPS publishes no average on its cost page). ASPS · cost page
• RealSelf patient-reported: $18,716 average (798 reviews), range $8,000–$35,000 (updated July 4, 2024). RealSelf
• RealSelf guide page: $17,464 average, $7,900–$30,195. RealSelf

DFW and Texas

• RealSelf DFW average $17,891; Texas $16,764 (as quoted by Dr. Hill, Sept 2025). Hill blog
• NavMDs (published prices from Texas surgeons, Oct 2026): Texas typical about $15,000, most $13,000–$20,000. Frisco typical $16,250 (2 surgeons), Plano $17,501 (4 surgeons), Dallas $13,000 (12). Aggregator data, so use as a rough guide. NavMDs
• One Dallas practice (Dauwe) says $22,000–$30,000+ in DFW. Dauwe

Practices on the shortlist

Setty’s and Angobaldo’s ranges don’t say what’s included, so ask for an all-in number.

*ASPS “latest statistics” average surgeon’s fee only. Excludes anesthesia, facility and related costs. The ASPS pages don’t state the data year.

RealSelf patient-reported component averages (all-in, from a search snapshot of its makeover guide since RealSelf blocks direct reads): tummy tuck $11,659, breast aug $7,503, liposuction $8,570, perineoplasty $4,657, vaginoplasty $7,442. RealSelf

NavMDs Texas typical prices: tummy tuck $9,000, aug + lift $8,999, aug $6,256, lift $8,000, liposuction $6,000. NavMDs

• ASPS cost components: surgeon, facility, anesthesia, prescriptions, implants, garments, medical tests. ASPS
• Anesthesia: hourly. NTPS cites $400–$1,800. Facility: about $1,200 in a surgeon’s clinic up to about $10,000 for a hospital with an overnight stay. Pre-op tests up to $500, garment up to $350. These are from a 2017 blog, updated 2023. NTPS
• Tabbal’s breast breakdown: surgeon $5,000–$8,000, anesthesia $800–$1,500, facility $1,000–$2,000, implants $1,000–$2,000, garments $100–$300. Tabbal
• Tabbal’s makeover quotes can include private-duty nursing the first night. A physician anesthesiologist costs more than a CRNA. Tabbal
• Combining saves one anesthesia and facility bill, but staging into two operations means paying both twice. Hill · NavMDs
• Also ask about revision policy and cost. RealSelf

• Who offers what: Tabbal: CareCredit, PatientFi, Cherry. Setty: CareCredit, Alphaeon, PatientFi. Angobaldo: CareCredit, Alphaeon, Cherry, PatientFi. Hill: CareCredit, Alphaeon, PatientFi. Hubbard: PatientFi, Cherry. Tabbal · Setty · Angobaldo · Hill · Hubbard
• CareCredit: “no interest if paid in full” plans of 6, 12, 18 or 24 months are deferred interest. If even $1 remains at the end, all interest back to the purchase date is added. Its page cites a 32.99% purchase APR for accounts opened since 5/30/2024. CareCredit
• Alphaeon: its rate sheet lists no-interest-if-paid-in-full plans of 6, 12, 18 and 24 months and equal-pay plans of 24–60 months at 17.90%–20.90% APR. Terms depend on credit, so confirm what she’d be offered. Alphaeon
• NavMDs says most practices offer 6–24 month plans. NavMDs

• Wait after the last baby: Tabbal says at least 6 months after childbirth, and 6 months after breastfeeding stops. Stiles: at least 6 months after breastfeeding stops. Angobaldo’s practice: 6 months to 1 year after childbirth and after finishing breastfeeding. Tabbal · Stiles · Angobaldo
• Before surgery: stable weight, close to ideal. ASPS says BMI ideally under 30. No smoking. ASPS
• Time off: about 2 weeks off work is standard, with help from another adult. ASPS says no heavy lifting, including children. ASPS
• Activity: at least 4–6 weeks before gym or strenuous lifting. Normal activities around 3 months. Final results 6–12 months. ASPS · ASPS
• Tabbal timeline: week 1 flexed at the hips, drains out by week 2, light activity and driving about week 3, exercise gradually weeks 4–6, about 80% of swelling gone by 3 months. Tabbal
• Setty: upright is hard for the first couple of weeks, exercise held about 2 months, healing around 6 months. Setty
• Stiles: no lifting over 5 lb for 6 weeks. Stiles
• RealSelf lists 2–4 weeks of downtime. RealSelf
• With five kids, plan childcare and help for at least the first two weeks.

1. Are you certified by the American Board of Plastic Surgery? Where would surgery be done, who accredits it, and who gives anesthesia (physician anesthesiologist or CRNA)?
2. How many breast augmentations and lifts after multiple pregnancies do you do a year? What is your own reoperation rate, and what is your revision policy and cost?
3. Given five pregnancies, do I need a lift now? What if I choose implants alone, and what is the risk of a “double bubble” or bottoming out?
4. Which implant, placement and incision do you recommend, and why? What will it look like in 5–10 years?
5. Can I see photos of patients like me with results at a year or more? Can I speak to a past patient?
6. Do you use Vectra or Crisalix 3D? Can I try sizers in a bra? (It’s a simulation.)
7. Do I have muscle separation (diastasis) or a hernia? Is a tummy tuck worth discussing, and is it a good fit with breast surgery?
8. If we combine procedures, how long would the operation be? What is your time limit, and when do you stage?
9. What is your clot-prevention plan (risk score, leg compression, walking, any blood thinners)? Overnight stay or nursing support?
10. Give me an itemized all-in quote: surgeon, facility, anesthesia, implants, garments, meds, follow-ups, revisions. What are the deposit and cancellation terms and the financing APR?
11. Follow-up visits, after-hours contact, and the plan for ultrasound or MRI at 5–6 years and for mammograms.
12. When can she drive, lift the kids and exercise? How much help is needed, and for how long?
13. Will you review and sign the FDA patient decision checklist with her? FDA