Once a secret treatment only afforded by the wealthy few, the demand for post-baby cosmetic surgery has increased "significantly" in recent years. From school teachers, nurses and farmers to women in the corporate world, Rebecca Blithe reveals a growing trend among Kiwi mums.
Monica*'s friends think she's lost weight recently. They're impressed and they want to know how the mother-of-two's done it - which diet? What kind of work outs?
But the results are not in exercise and healthy eating. In truth, Monica, 32, underwent a "mummy makeover" to achieve her new look: it's an umbrella term for various surgeries "typically on the abdomen and breasts" to resolve issues that can arise following childbirth or become worse after menopause and can't be remedied by diet and exercise.
Although Monica is thrilled with the results of a tummy tuck and breast augmentation and wants to speak out about her life-changing operation, she tells the Herald a lingering taboo around cosmetic surgeries in New Zealand prevents her from putting her face to her work, as she doubts "[her] community would understand".
But she hopes sharing her journey anonymously might shed some light on an alternative for others like her who have found themselves feeling bereft of the body they used to have.
"Having a baby just changed everything," she says. "You know how they say old ladies' breasts hang down to their knees? Honestly, that was me."
Monica wanted to lose weight following pregnancy but found it "a real challenge".
"Especially when you've got all those stubborn fat pockets in all those odd places. I had a kangaroo pouch, I'd call it, that used to hang down.
"I used to feel so uncomfortable about going out and putting clothes on. My clothes still fit, but they looked ugly. It was a really big deal for me. It was something that used to really pull me down and take my confidence down."
Monica works in a corporate setting, "standing in front of people all day" and says returning to her job and a wardrobe of suiting and dresses was also tough.
"All those pretty dresses I used to wear - you want to look nice and hot and presentable. But that never happened for me. It was really, really challenging. I'd been trying diets but this area around my stomach just wouldn't go away. Losing weight is fine but that skin that stays and hangs around your belly felt disgusting."
Around this time, Monica was also embarking on a new relationship. She tells the Herald she felt insecure about her naked body too.
"I didn't want anyone to see me. Exposing myself, I was like, 'I feel disgusting'. The thought of being with someone new, are they going to judge you?"
While Monica says her partner told her she didn't need surgery, he was supportive of her decision to pursue it.
She also shared her intentions with her mother, who offered some alternatives: "She's quite old school," says Monica. "She was just like, exercise and drink warm water and you'll be fine. I tried to explain to her that it's the saggy skin that's there to stay, even if I lose lots of weight, it's the muscle that's torn apart in my belly. There's no exercise that can lift my boobs up magically."
Adamant about undergoing surgery, Monica says her mum eventually came round in support too. After consultations with three Auckland-based surgeons, where one quoted $56,000 and insisted Monica had had a hernia, which was later cleared by her GP, she settled on Dr Katarzyna Mackenzie.
Monica paid $34,000 for a tummy tuck and a breast lift with Mackenzie. This included her hospital stay and post-op garments.
Of the surgery and recovery, Monica describes it as "pretty straightforward".
"It was really sore for the first week but the medication helped and the recovery was quite smooth. It took me around six weeks to be able to drive again but I didn't have any complications. There was a garment I was recommended that kept everything compressed and helped with the swelling - which can stay for around eight to 12 months for some people."
Seeing her before-and-after pictures, Monica says she's "blown away every time I look at them. It's definitely a confidence booster for me."
Despite her delight in her new body, the busy mum "hasn't told a soul" beyond her partner and mother.
"People would just think ... she's a lazy person. She could have just gone to the gym.
"I still think it's a big thing here that people think it's just a Hollywood thing and plastic surgery just means lots and lots of Botox and you're just fake. That it's not a natural process like losing weight and it's not a healthy way.
"People also think the only people who are getting plastic surgery are people who have money. That's another problem. It means so much to somebody who's middle-class like me and I've separated from my husband and I've got my kids to myself."
But according to a staff member at Dr Mark Gittos' clinic in Auckland's Herne Bay, the tendency to keep treatments under wraps is changing – as is the demographic seeking them.
"We have seen a bit of shift in people being secretive about it and it only being for the discreet, discerning patient to patients from a wide range of demographic," said a practice manager from Dr Gittos' clinic.
"From school teachers, nurses, everyday office workers to farmers – they are finding money for procedures and they are not only lovely to work with, they are referring their friends and widely sharing their experience," they said, adding patients were coming to them from as far afield as Invercargill.
When it comes to mummy makeovers specifically, they say the surgeries pertaining to this term are now "extremely common, usually after the birth of the last child. This is often given as a push present or it's something the woman has chosen to do for herself."
Interest has grown so "significantly" in the past two to three years that Gittos' clinic has bookings almost 12 months in advance just for consultations.
"An estimated increase would currently sit at 600 per cent compared to that of three years ago. We have two full operating days per week and these are always full. [We do] eight to 10 of these procedures per week."
Mackenzie has also seen "at least a 50 per cent uptake in mummy makeover patients" coming to her since she returned to New Zealand in 2019, following a fellowship in London.
She points to the proliferation of coverage on social media and advancements in plastic surgery which has increased the safety of these particular surgeries.
"Social media has helped bring the many benefits of mummy makeovers to the cultural forefront ..." says Mackenzie, noting her position as one of just a handful of female plastic surgeons in New Zealand makes her a popular choice for these procedures.
While mummy makeovers may be becoming more common, according to one plastic surgery insider, there remains a group who will go to some lengths to keep their work under wraps: those with a lot of money.
What you would deem New Zealand's upper crust will "pretend they've had nothing done".
"They keep it very secret. They come in the back door. It's all very hush-hush. Then they'll disappear off the scene for a month."
Or, with more people working parts of their week from home, they'll say, "Can I come in on a Wednesday for my boob job? Then I can take the weekend off then I'll go back to work next week and no one will even know."
Mackenzie says she has also observed a lingering taboo in New Zealand around plastic surgery, sharing that "people have a lot of procedures done and deny it", but she does see it as becoming "generally more acceptable".
"Twenty years ago, it was for the rich and famous. Now that's changing and the attitudes are changing as well as more people than ever feel comfortable about going to see a surgeon."
The majority of Mackenzie's mummy makeovers are women in their early 30s.
"They have had children a little bit later because they have focused on their career and then they can afford to have it done. That bracket goes up to mid-50s," she says noting women can also experience changes to their body after menopause.
"Some can restore the body with exercise and diet but then they hit menopause and hormone changes can affect the body.
"I have patients who come to see me - especially ones who have been through menopause quite early - with extra skin and lose tummy muscles. So they come to deal with that. The breast is often affected by pregnancy and breastfeeding and they can become empty and flat or sometimes they get bigger. Or smaller. Breast lift or augmentation or a combination of both, or even reduction, are common."
Mackenzie currently conducts, every month, an average of two to three "full mummy makeovers", which involve "at least" a tummy tuck and breast augmentation at the same time.
These procedures completed in one go will take "around seven hours", says Mackenzie. "So it's almost a full day, I may add up another two-hour case.
"Sometimes I stage them, when there is a clinical indication and I don't want a patient under general anaesthetic for more than four hours - that means I may do tummy first and breast a few months later."
She explains that women who have experienced significant weight gain can find their skin stretches but, despite losing weight, doesn't revert back.
"As we get older the skin ages and its ability to snap back decreases and some [women] end up with folds of skin under their tummy and extra skin where they develop skin infections or dermatitis or sweating which accumulates under the folds above the pubis area," she says, adding this makes participation in sport and physical activities challenging "because they've got extra skin around the tummy which makes it difficult to fit into active wear. They can really feel self-conscious."
Just as her patient Monica shared, Mackenzie finds many patients who are "mothers from the corporate world" place a high value on their appearance.
"The way they look is important. You feel more confident when you look good and they lose that after pregnancy and just want to go back. They want to capture the aspects of their pre-pregnancy bodies, which can be beyond any diet and exercise. They feel really self-conscious and that motivates them to seek surgery."
*Monica's name has been changed to protect her identity