The cost of mommy makeover procedures varies by geographic area, said Murphy, who practices outside Philadelphia. He charges about $9,000 for 31/2 hours of plastic surgery, including breast and tummy work. Lickstein said his patients typically pay about $18,000 for mommy makeovers that may also include work on love handles.

Studies on the effects of cosmetic surgery on body image and self-esteem have shown mixed results.

Blankenship and others said cosmetic surgery has helped them feel better about their bodies. Their clothes fit better and they no longer obsess over flaws. They said it was something they wanted for themselves and nothing their husbands, or anyone else, encouraged.

“For me, it was about feeling comfortable in my own skin,” Blankenship said. She noted that she still has stretch marks, which she considers a badge of honor.

Some critics said mommy makeovers have fed into a culture that puts pressure on women to live up to unrealistic expectations of beauty,  rather than age naturally. Images of celebrities who are slim and trim weeks after giving birth worsen the issue, some say.

Diana Zuckerman, a psychologist and president of the National Research Center for Women & Families Cancer Prevention and Treatment Fund, said studies have found that cosmetic enhancements don’t necessarily improve the overall way people feel about themselves. Some women find themselves looking for the next fix and getting additional surgeries.

“It can be quite disappointing when people fix the body part and they find out they are still the same person,” Zuckerman said.

Harriet Lerner, a psychologist specializing in women’s issues, said women should “say no to the surgeon’s knife and to the impossible pursuit of perfection prescribed for women.”

“Regrettably, women are taught to feel shame, alienation and disconnection from our ‘imperfect’ bodies as we move through the life cycle” she said.

Pre-surgery counseling can help women better understand what to expect from the surgery, said Dr. Michele Manahan, an assistant professor of plastic surgery at the Johns Hopkins University School of Medicine.

People don’t think about the scarring that may occur with the surgery or the typical six-week recovery time it involves. If a mom has young children, she won’t be able to pick them up for days, and sometimes weeks, after the procedure.

“We want to make sure the patients are happy with the end result and will choose a surgery that accomplishes what they want,” Manahan said.

Cosmetic surgeons said they wouldn’t take patients who have unrealistic expectations or have health problems that might make surgery dangerous.

“If there’s someone who wants to look like a 20-year-old Farrah Fawcett, we’re going to have to get a little perspective,” Murphy said. 

It is unfair to negatively judge women who take the cosmetic surgery route, he said.

Some moms are waiting to get mommy makeovers later in life, after they are done raising children and they have fewer financial obligations.

Nancy Teasley, 60, decided to turn to plastic surgery after the last of her three children finished college “to get back in pre-baby form as much as possible.” Exercise and diet kept her in fairly good shape, but sagging skin left her stomach and breasts shapeless and floppy.

“It comes to a point where healthy eating and exercise just don’t work anymore,” said the Clarksville woman. “You’re just fighting against it all.”

Teasley had her breasts enlarged, liposuction on her love handles and a tummy tuck.

“I feel a lot more confident and happy with my body,” she said.