The young mother interviewed for this story has asked us to conceal her identity. She says her two pregnancies have taken a toll on her body, that's both uncomfortable and embarrassing.
The patient said, "Every day to have to wear these thick pads so that you stay dry. Going down the steps, picking up your child from the car seat, a little bit of exertion you get wet."
She said her bladder issues trace back to the stretching of her abdominal muscles during delivery. And rather than have it fixed with conventional surgery, she's decided on a combination procedure. Two surgeries that promise to fix not just the bladder issue, but the cosmetic side effects of that stretching as well.
The patient said, "You have this loose skin, so wearing your jeans is not going to be the same."
"You're doing a surgery that you want with a surgery that you medically need and that makes having surgery in general much more palatable," said plastic surgeon Carolyn Chang, M.D., FACS.
In an operating room at California Pacific Medical Center in San Francisco, Chang teamed up with Alexandra Haessler, M.D., an OBGYN. First Haessler will perform a pelvic sling procedure -- a common surgery designed to support the bladder.
"When women experience urinary leakage with activity, such as movement or exercise or cough, we stabilize the urethra by placing a thin, small, but permanent mesh sling," said Haessler.
The procedure, considered medically necessary, takes about half an hour. When she's done, Haessler hands off to Chang, who will spend the next several hours performing a tummy tuck. After making an incision, the surgeon clears away excess fat, and sutures the muscles into a firmer shape.
"I like to call this the ultimate mommy make over," said Chang.
Chang points to several advantages of the combination procedure including cost. While the cosmetic portion of the surgery isn't covered by insurance, some shared expenses such as anesthesia and the recovery room may be.
Of course any surgery carries risks, but the downside of combining multiple procedures a longer time on the operating table, as well as the potentially more complicated recovery if there are problems with either surgery.
"If someone is doing a little more extensive procedure, then the second procedure needs to be a much smaller procedure," said Chang.
But the patient in this procedure will have the advantage of a single recovery time and she believes there may be psychological benefits to the combination surgery.
The patient said, "I know you'll never be the same as before I had the children, but I think it will be spirit lifting."
As for costs, a tummy tuck by itself typically runs between $11,000 to $13,000 and is not covered by insurance.
Written and produced Tim Didion