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Need Extensive Surgery but Can't Have Them All Done at Once?

I'm 5'3 and 145 pounds with a ton of stretch marks, excess skin, saggy breasts,inverted nipples, flat butt. I've never had any children though it looks like it :( I know I shouldn't get a brazilian butt lift at the same time as a tummy tuck so which should I do first? Also, I like one doctor who does fantastic lipo, tummy tuck, arm lift and brazillian lift but I would like another doctor to do my breasts. It's such a pain lol I don't know which I should do first and how long to wait in between

Doctor Answers (10)

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Make over


Dear newb1,

   Your questions are quite loaded but I will try to be comprehensive. The most important recommendation that I can give you is - safety. Avoid doctors who would want to do too much surgery on you. The common sense approach is 6 hours of surgery. Beyond that you increase your risk of complication significantly. From the information that you submitted, your BMI is 25.6.  A safe combination for you might be tummy tuck and armplasty. As far as the breast, it depends on how much saggyness you have. You can have a mini lift with nipple inversion correction or a full lift (key hole) . This can be combined with buttocks augmentation which should be done with implants and not fat injection because the fat does not last beyond a year. When you choose a surgeon, make sure to see his before and after pictures, either on the internet or in his office. Also choose an experienced board certified plastic surgeon.

           Best of luck,

                                    Dr Widder

Web reference:

Washington DC Plastic Surgeon
5.0 out of 5 stars 41 reviews

Mommy makeover risks and staging of surgery - Los Angeles


There is no simple answer as to what procedure to undergo first.  This depends on your personality and priorities.  I would consider splitting the procedures into stages to maximize safety. Raffy Karamanoukian Los Angeles

Web reference:

Los Angeles Plastic Surgeon
5.0 out of 5 stars 43 reviews

Needing Extensive Surgery


Thank you for your question.

Yes, when many procedures are needed, it must be broken up into multiple surgery (for the safety of the patient and for the best results possible).  I highly recommend choosing a surgeon whom you are comfortable with (in regards to the surgery you are wanting).  

The decision as to what procedure to have done first, it really does depend on what bothers you the most.  Also, you do need to take into consideration recovery of each procedure.  For example, not being able to sit or lay on your back after work on the buttocks but also, not being able to lay on your stomach after tummy tuck / breast surgery.

Best wishes.

Web reference:

San Diego Plastic Surgeon
5.0 out of 5 stars 626 reviews

Limit surgery to 6 hours


You state that you have excessive skin, saggy breasts with inverted areolas.  You would be an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  This technique allows placement of the implant using only a circumareola incision avoiding the vertical scars or boat anchor shaped incisions.  Through this incision it is possible to lift your breast tissue higher, increase cleavage and reshape your breast for maximum anterior projection.  An implant can be placed at the same time.  The preferred implant is silicone gel placed retro-pectoral.  I always recommend the smallest implant possible for the patient.  The larger the implant the faster it will descend and more revisions needed.  In terms of doing multiple surgeries, you should limit your time under anesthesia less than 6 hours and doing what concerns you the most first.

Best Wishes,

Gary Horndeski, M.D.

Web reference:

Texas Plastic Surgeon
5.0 out of 5 stars 109 reviews

Multiple Procedures

Some of the procedures can be combined but it would be a very lengthy anesthesia time and a very difficult recovery period if you did them all at once. I would recommend the liposuction and brazilian lift first and later on the tummy tuck and arms. Always have surgery with a surgeon you are comfortable with and if that means a third procedure to do the breasts with someone else then that is what you should do. The reason I would not recommend combining the brazilian with the tummy tuck or breast surgery is because following fat grafting to the buttocks you shouldn't sit or lay on your back for several weeks so that the grafted fat survives long term. With a tummy tuck or breast surgery you shouldn't lay on your stomach so if you did them both together you could only lay on your sides for several weeks. Not very comfortable for most people. Hope this helps and best of luck to you!
Baltimore Plastic Surgeon
5.0 out of 5 stars 68 reviews

Combined body and breast surgery is common, but you can also have your operations done at two times


Yes, it sounds like you could benefit from a "mommy makeover" even though you are not a mommy!  Did you lose a lot of weight?  Your weight now is not far from ideal.  It is likely that you would benefit from an abdominoplasty and lipo, which is a common combination.  However, every ounce of fat that is obtained by lipo needs to be used to inject your buttocks.  Your surgeon needs to be experienced in buttock fat injection and use high volumes to get the results you want.  Today, almost half of my female patients are having buttock fat injection at the same time as their lipo.  The techniques are very comlementary.


Without seeing photos, my hunch is you will  need a breast lift with implants.  The vertical technique is best.  This can be done by another surgeon at another operation.  However, there are some surgeons who are sufficiently experienced and efficient with operating time to do it simultaneously.  You definitely need to look at before and after photos and make sure you are having the vertical lift, which is simply a better option for minimizing scars while at the same time getting the best lift effect and pleasing breast shape.  I've attached a page from my website for your reference.


Either have the operations the same time and benefit from one recovery period or have them separately, starting with your priority.  I've had patients undergo the second operation as soon as two weeks after the first. 



Web reference:

Kansas City Plastic Surgeon
4.5 out of 5 stars 28 reviews

Timing of Multiple Procedures


Thank you for the question. It is not uncommon for multiple procedures to be done at the same time. I try to keep the operative time to less than 6 hours. The number of procedures and the type of procedures one can perform will be dependent on the overall health of the patient. In other words, do they have any comorbidities (health problems) and if they do how well  are they being controlled?

Since you are looking to "break up" the surgery between 2 surgeons, then look at what it is that bothers you most. It is most common to do an abdominoplasty (tummy tuck) with brachioplasty (arm plasty) together followed by the mastopexy (breast lift) and possible implants with the Brazilian Buttock Lift. The order in which it is done is really not important.

I hope this helps. Good luck.

Tampa Plastic Surgeon
5.0 out of 5 stars 7 reviews

Staging for multiple surgeries


I would recommend you have surgery to the areas that bother you the most.  Some of the surgeries can be combined but you want to limit your surgeries to around 5 - 5.5 hours in the operating room.  If you have too much surgery done at once you increase your risks for serious complications.  Time in between surgeries really depends on the situation.  Give yourself time in between surgeries to fully recover.  Good luck to you!

Orange County Plastic Surgeon
5.0 out of 5 stars 7 reviews

Multiple procedures.


These would be best done in two stages. Other than separating the TT from the BBL, the order doesn't matter too much and should follow your priorities, and I would suggest doing two  at a setting. Pick either the TT or the BBL according to which bothers you more.

I would slightly favor doing the arm with the BBL so that you would not be laying on the freshly lifted (?and enlarged?) breasts while the BBL is done. If you want the breast done separately by another surgeon, you would have to discuss with your surgeon whether the combined TT, BBL, and arm lift is safely done in one setting. 

Thanks for the question, best wishes. 

Seattle Plastic Surgeon
4.5 out of 5 stars 28 reviews

Extensive surgery

  • Start with the area that bothers you the most
  • being patient and doing less at one time is going to be safer
  • The tummy tuck is a bigger surgery with a longer recovery time
  • It is easy to combine breast surgery and arm surgery
  • I try to have patients wait 6 to 12 months between major surgeries
Wichita Plastic Surgeon
4.5 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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