"Kimple is having a tummy tuck and liposuction around her hips, part of the package plastic surgeons call a "mommy makeover." "

""It's expensive, about the cost of an economy car, but it will be worth it," said Kimple. "

"More than 325,000 tummy tucks, breast augmentations and breast lifts were performed on women ages 20-39 in 2006. That's an increase of about 11 percent from 2005, according to data released Thursday by the American Society of Plastic Surgeons. "

"The breast and tummy procedures are most commonly requested by mothers after their last childbirth, plastic surgeons said. Bay Area surgeons are seeing more of these clients, especially mothers of twins and women who wait until their late 30s to have children and might not bounce back as easily from pregnancy. Those mothers also tend to have more money for surgery. "

""I've had patients come in while they are still pregnant, saying, 'This going to be my last child, so I want to get on your surgery schedule,' " said Dr. Gary Friedman, a San Francisco surgeon. "

"Some sociologists say the mommy makeover trend is driven by the plastic surgery industry and by unrealistic expectations society holds of mothers, including the entertainment industry's obsession with how quickly actresses regain their pre-baby bodies after delivery. "

""This is a major extension of the rejection of the maternal body and (the) obsession with the adolescent, nubile body," said Rita Freedman, a clinical psychologist in Harrison, N.Y., who has written two books on body image. "Nature intended us to nurse our children for several years. And the nursing body is very different." "

""This is commercially driven," she added. "People make money off of this, and that's important to bear in mind. If it takes you an extra four or six months to do it on your own, you haven't spent any money." "

"Friedman said his patients, who complain about sagging breasts, stretched-out belly skin and fat deposits on their thighs, often have tried and can't sculpt their bodies on their own. They just want to shave off a couple of years and undo what he called the damage from pregnancy; they're not necessarily looking for a "Bay Watch" body. "

""I think women when they are pregnant are not feeling very sexy, they don't think their husbands find them sexy and they are anxious to return to a more attractive image," he said of his clients. "

"Dr. James Anthony, who also practices in San Francisco, said he sees a subset of moms who do like one physical impact of pregnancy and lactation: They want him to re-create the larger breasts they had while nursing. "

"According to the American Society of Plastic Surgeons, which surveys its 6,000 members annually, breast augmentation is by far the most popular procedure among all women -- 329,000 were performed in 2006. "

"About 11 million cosmetic procedures were performed last year , 7 percent more than in 2005 and 48 percent more than 2000. "

"The society's new data also show
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