Sharlotte Birkland, a Sacramento nurse, had post-pregnancy surgery last March. A makeover surgery package such as the one advertised below can cost more than $10,000.

THE New York Times / MAX WHITTAKER

Dr. David A. Stoker, a plastic surgeon in Marina Del Rey, Calif., has a surgical cure for the ravages of motherhood. He, like many plastic surgeons nationwide, calls it a “mommy makeover.”

Aimed at mothers, it usually involves a trifecta: a breast lift with or without breast implants, a tummy tuck and some liposuction. The procedures are intended to hoist slackened skin as well as reduce stretch marks and pregnancy fat.

“The severe physical trauma of pregnancy, childbirth and breast-feeding can have profound negative effects that cause women to lose their hourglass figures,” he said. His practice, Marina Plastic Surgery Associates, maintains a Web site, amommymakeover.com, which describes the surgeries required to overhaul a post-pregnancy body.

“Twenty years ago, a woman did not think she could do something about it and she covered up with discreet clothing,” Dr. Stoker said. “But now women don’t have to go on feeling self-conscious or resentful about their appearance.”

In 1970, Our Bodies, Ourselves, the seminal guide to women’s health, described the cosmetic changes that can happen during and after pregnancy simply as phenomena. But now narrowing beauty norms are recasting the transformations of motherhood as stigma.

These unforgiving standards are the offspring of pop culture and technology, a union that treats biological changes as if they were as optional as hair color. Gossip magazines excoriate celebrity moms who don’t immediately lose their “baby weight.” Even Cookie, a luxury parenting magazine, recently ran an article that described post-pregnancy breasts as “the ultimate indignity” and promoted implant surgery; a photo of droopy water-filled balloons accompanied the article.

Many women struggle with the impact of aging and pregnancy on their bodies. But the marketing of the “mommy makeover” seeks to pathologize the postpartum body, characterizing pregnancy and childbirth as maladies with disfiguring aftereffects that can be repaired with the help of scalpels and cannulae.

“The message is that, after having children, women’s bodies change for the worse,” said Diana Zuckerman, the president of the National Research Center for Women and Families, a nonprofit group in Washington. If marketing could turn the post-pregnancy body “into a socially unacceptable thing, think of how big your audience would be and how many surgeries you could sell them,” she said.

Pregnancy affects each woman differently, with age and genetics playing a role in how the body recovers. While many plastic surgeons argue that pregnancy both “deforms” breasts and redistributes fat so that it becomes difficult to exercise away, some obstetricians disagree.

“Some women have stretch marks from pregnancy or weight gain,” said Dr. Erin E. Tracy, an assistant professor in obstetrics, gynecology and reproductive biology at the Harvard Medical School. “But there is no intrinsic abnormality to the breasts or the abdomen.”

Mommy surgery appeals both as a quick fix for stubborn post-pregnancy weight and as a way to control aging itself. Dozens of doctors devote parts of their Web sites to the “mom job,” including Dr. Lloyd M. Krieger, a plastic surgeon in Beverly Hills, Calif., who offers the Rodeo Drive Mommy Makeover for women who want “their tummies and breasts back the way they looked before pregnancy.”

Mommy surgery came to public attention earlier this year after the American Society of Plastic Surgeons reported a rise in cosmetic surgery among women of child-bearing age (not all of whom are necessarily mothers). Last year, doctors nationwide performed more than 325,000 “mommy makeover procedures” on women ages 20 to 39, up 11 percent from 2005, the group said. And this fall, the ABC drama Brothers and Sisters included a playground scene in which one mother asked, “Do you think I should get a mommy job?”

After the birth of her second son in 2000, Katie Helein, a saleswoman for a human resources company in St. Louis, worked out with a personal trainer three times a week for eight months. But Helein, now 37, said she didn’t like her shape.

“I had really badly stretched skin, I lost fullness up top, nothing was where it was supposed to be, even though I was doing sit-ups ’til the cows came home,” she said. “I just wanted my body back.”

In 2001, she had a tummy tuck and liposuction, followed by breast augmentation in 2004, she said. Now her smiling face, and those of her sons, is featured in the “mommy makeover” section of stlcosmeticsurgery.com, the Web site of her plastic surgeon, Dr. William H. Huffaker.

Dr. Huffaker said that several years ago he noticed an increase in mothers who came to his office with concerns about stretched skin and post-pregnancy fat that they could not exercise away.

Now he operates on three to four mothers a week who have breast procedures, tummy tucks and liposuction in one go at a cost of about $12,000 to $15,000, he said.

“Women do have trouble getting back together,” said Dr. Huffaker. “You don’t just do a couple of exercises and get skinny again.”

Mothers of college-age children are also opting for the procedures.

Sharlotte Birkland, a neonatal nurse in Sacramento, has a 20-year-old son. Last March, she went to Dr. Stoker for breast implant surgery, a tummy tuck on her lower abdomen and liposuction of her upper abdomen.

“I had been thin all my life until I had my son and then I got this pouch of overhanging fat on my abdomen that you can’t get rid of,” Birkland said. “And your breasts become deflated sacks.”

There is more pressure on mothers today to look young and sexy than on previous generations, she added. “I don’t think it was an issue for my mother; your husband loved you no matter what,” said Birkland, 39, who recently remarried.

Dr. Stoker said that he performs combination surgeries on mothers at least once a week, at a cost of $10,000 to $30,000.

“It’s comforting to women to know that there are many other mothers out there with a similar cluster of physical issues that are bothering them,” he said.

But other surgeons worry that packaging multiple procedures under a cutesy nickname could induce women to have additional operations, potentially increasing their risk of everything from infections to death.

Various studies published in medical journals have reported death rates from liposuction at one in 5,000 procedures to one in 50,000 procedures.

In Dallas, a father and son who are plastic surgeons, Dr. Harlan Pollock and Dr. Todd Pollock, use the Web site, www.drpollock.com, to expose the “mommy makeover” as a sales tactic.

“Clever marketing may encourage correction of a deformity that was previously of little concern,” the doctors write. “In other words, a woman seeking a tummy tuck, although not particularly concerned about the appearance of her breasts, may be influenced to have breast surgery just because it is part of ‘the package.’ ”

Some health advocates aren’t buying the idea that cosmetic changes from pregnancy merit medical management.

“Some women go back to a pretty flat stomach and some don’t, some go back to their pre-baby weight and some don’t,” said Judy Norsigian, the executive director of Our Bodies Ourselves, a health group in Boston, and an author of the book of the same name. “The question is, does that need to be treated with a surgical makeover?”

On the blog, StrollerDerby, Karen Murphy, a mother of four, lambasted mommy surgery.

“Those badges of motherhood have turned into badges of shame and, if you’re the one caught without a tummy tuck, then you won’t get invited to the party,” she wrote. “It peeves me no end that something as drastic as surgery, as this blatant nonacceptance of one’s own body in whatever shape it happens to be, has become so pervasive.”

In the back pages of New York magazine this fall, among the promotions for mini face-lifts, were two advertisements for cosmetic surgery of the genitalia.

One ad, headlined “Feminine Reconstructive Surgery,” promotes “postpartum recontouring.” Another ad, offering “labioplasty” to reduce the labia and “vaginoplasty” to tighten the vagina, promises an improvement in “sexual satisfaction, cosmetic appearance, and self-esteem.”

Cosmetic operations that promise to make genitals look better or to improve sexual gratification have developed in the wake of the increased availability of pornography. That some young women today remove their pubic hair has also exposed once-hidden parts to greater scrutiny.

In September, the American College of Obstetricians and Gynecologists warned against cosmetic operations for the vagina.

“These procedures are not medically indicated, and the safety and effectiveness of these procedures have not been documented,” the group said in the journal Obstetrics and Gynecology. Potential problems include infection, scarring and sexual pain, they said.

Few Americans are signing up for “vaginal rejuvenation,” but the numbers are marginally increasing. Doctors performed about 1,000 such procedures last year, up from about 800 in 2005, according to the American Society of Plastic Surgeons.

“Even five patients is something to be concerned about,” said Dr. Erin E. Tracy, an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School. “There is a lot of touting of benefit with no studies as to its demonstrable effects while we know there is a real risk of complications.”

— NATASHA SINGER