J. Timothy Katzen, MD, FACS

Thank you for your question regarding whether a fleur-de-lis abdominoplasty, pubic lift, and crescent breast lift can all be performed in the same surgery. Based on your goals, it sounds like you’re looking to address both the lower and upper parts of your torso in a single surgical session, which can be feasible under the right circumstances. Yes, it is quite common to combine a fleur-de-lis abdominoplasty with a pubic lift, as both procedures are performed through the same lower abdominal incision. A fleur-de-lis tummy tuck is typically used in patients who have undergone massive weight loss and need both vertical and horizontal skin excision to achieve a tighter, flatter abdomen. As part of this procedure, the pubic region is also lifted and reshaped. The lower skin and fat removal naturally improves the appearance of the mons pubis, so a pubic lift is essentially built into a fleur-de-lis tummy tuck. As for combining this with a crescent breast lift, that’s often possible as well—especially when the breast lift is more conservative and does not require extensive skin removal. A crescent lift is a more limited lift that targets mild sagging, and since it's a smaller operation with minimal impact on blood supply and healing, it’s a reasonable addition to a lower body procedure for the right patient. However, whether it is safe and appropriate to combine all three procedures will ultimately depend on your BMI, medical history, and the total length of the surgery. You’ll need a board-certified plastic surgeon with experience in post-weight loss body contouring who can determine whether this combination can be done safely in a single stage or whether staging the procedures is better for your health and healing. If you have any further questions regarding the fleur-de-lis tummy tuck, pubic lift, crescent breast lift, or combination surgeries, please consult an experienced, board-certified plastic surgeon. Make sure they have performed at least 100 major body contouring surgeries and that they can show you before-and-after photos of similar cases. Sincerely, Dr. Katzen (President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame.)

Thank you for your question regarding how long to wait between your arm lift with liposuction and undergoing a mommy makeover. It’s wonderful that you’re thinking strategically about your surgical timeline. Giving your body proper time to heal in between major surgeries is critical not only for safety but also to ensure the best final results. Generally, I recommend waiting at least 3 to 6 months after your arm lift and liposuction before proceeding with a mommy makeover. The exact timing depends on a few key factors, including how smoothly your healing goes, whether you had any complications (such as fluid buildup or scar widening), and how much skin tightening and internal repair will be required during the mommy makeover itself. By the 3-month mark, most of the initial swelling and inflammation from your first surgery should have resolved. Your incisions should be strong and well-healed. If everything looks good at that point and your energy is back, you may be ready to move forward. However, if you had any issues healing or still feel tightness or discomfort, waiting closer to 6 months may be best. Mommy makeover procedures usually involve a tummy tuck, breast lift or augmentation, and sometimes liposuction of other areas. These are bigger procedures, so it’s important to give your body time to fully recover from the first surgery before diving into the next. Staging surgeries also reduces the risk of complications and gives each area the best possible chance to heal optimally. I hope this helps guide your next steps! Please make sure to follow up with your plastic surgeon and discuss your healing progress before scheduling your next procedure. If you have any questions regarding arm lift, arm reduction, mommy makeover, or tummy tuck, please reach out to a board-certified plastic surgeon with experience in staged body contouring after weight loss. Sincerely, Dr. Katzen (President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame.)

Thank you for your question regarding the best approach to safely and effectively stage multiple procedures, including tummy tuck, 360 liposuction, fat grafting to the breasts, buttocks, and face, as well as chin and arm liposuction. You’re in your 30s and in relatively good health, which makes you a strong candidate for combination procedures—but strategy and timing are everything. For patients like you who want to remove fat and use it for grafting while also planning a tummy tuck, I recommend staging the 360 liposuction with fat transfer first. This means starting with 360 lipo to harvest the maximum amount of high-quality fat, then immediately using that fat to perform a Brazilian Butt Lift (BBL) and fat grafting to the breasts and face. This approach allows us to take advantage of all available fat before any is removed with skin during the tummy tuck. Once the fat is transferred and has had time to settle and "take," you can then return for the tummy tuck, which removes the maximum amount of loose skin without wasting valuable fat. If you do the tummy tuck first, you’ll lose a significant amount of usable fat with the excised skin, which could reduce the effectiveness of the fat grafting procedures. That’s why we almost always recommend doing liposuction with fat transfer first, followed by a skin removal procedure like a tummy tuck later. Depending on how extensive your arm and chin lipo needs are, that can often be added to your first stage as well, especially if you’re under the recommended anesthesia time (generally around 6–8 hours). Each patient is different, but this two-stage plan tends to give the best aesthetic outcome with the safest recovery process. Thank you again for your question regarding options for staging surgery and making the most of your fat for grafting. Please be sure to consult with a board-certified plastic surgeon who has significant experience in both body contouring and fat transfer. Look for someone who has performed at least 100+ of these combination cases and can show you before and after photos of real patients with similar goals. If you can’t find someone near you, it’s worth considering travel to see a true specialist. Sincerely, Dr. Katzen (President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame.)

Thank you for your question regarding whether it’s safe to undergo a thigh lift (thighplasty) and an arm lift (brachioplasty) at the same time. You are absolutely right—this can be done, and I have safely performed this combination many times for massive weight loss patients. In fact, I featured a patient case on my YouTube channel where we did exactly this: thighplasty and brachioplasty in one surgery. The results were transformative, and the patient recovered beautifully—but only with the right support system in place. Your second doctor gave you solid advice. Combining these two procedures means that both your upper and lower body will be healing at the same time. That makes even simple movements—like getting out of bed, going to the bathroom, reaching overhead, or pulling yourself up from a seated position—more challenging during the first two to three weeks. Because of this, it’s essential that you have someone with you regularly during that early recovery window. Even if they aren’t medically trained, they need to be able to help with basic daily needs like lifting, mobility, dressing, meal prep, and keeping you comfortable and safe. If you can arrange for support during those first few weeks, combining both surgeries can be an excellent way to reduce overall downtime, limit anesthesia exposure, and complete your body transformation more efficiently. However, if round-the-clock help isn't possible after the first week, it’s worth considering whether to stage the procedures. You could do the thigh lift first and follow up with the arms in December as you mentioned. That said, many of my patients are able to make it work with a strong recovery plan, a dedicated helper (or two), and the right mindset. If you do proceed with both surgeries at once, I strongly recommend you prep your space ahead of time: stock up on pillows, pre-made meals, step stools, slip-on clothes, and anything else that makes recovery easier. A hands-free bathroom setup, shower chair, and plenty of wound care supplies are also a must. Thank you again for your thoughtful question. Yes, you can absolutely have a thigh and arm lift at the same time—as long as you are medically healthy and prepared with the support needed for recovery. I hope I’ve helped clarify your options and what to expect. For more insight, be sure to look at before-and-after photos of patients who had both procedures and watch video case studies to see what recovery really looks like. Sincerely, Dr. Katzen (President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Thank you for your question about how to stop painful thigh chafing. I’m so sorry to hear how much this has affected your day-to-day life. Thigh chafing is a very real and frustrating problem, and you're not alone in dealing with it. Many people—regardless of size—experience inner thigh rubbing that can lead to raw skin, open wounds, and eventually scarring. Thankfully, there are both non-surgical and surgical options that can help you enjoy daily activities more comfortably. From a non-surgical standpoint, some patients find relief using anti-chafing balms like Body Glide or Monistat's Chafing Relief Powder Gel. Compression-style undergarments or slip shorts (such as those from Thigh Society or Skims) can also reduce friction and are a favorite among many of my patients. However, these solutions are temporary and may not address the core of your concern. If your chafing is caused by excess skin and/or fat on the inner thighs—often a result of genetics, prior weight loss, or stubborn fat deposits—you may be a candidate for a medial thigh lift (also called a thighplasty). A medial thigh lift removes excess skin and fat along the inner thigh and tightens the area to minimize rubbing. This procedure can dramatically improve comfort and reduce chafing, especially for patients who have tried everything else without relief. Liposuction alone may also be an option if your skin has good elasticity and the primary concern is excess fat rather than loose skin. However, if you do have excess, sagging skin, liposuction alone could worsen the issue. If you’re considering a surgical solution, please consult with an experienced, board-certified plastic surgeon who specializes in post-weight loss body contouring. Ask to see before-and-after photos of their thigh lift patients, especially those with similar concerns. Make sure your surgeon has performed at least 150 thigh lifts and is comfortable guiding you through recovery, scar care, and post-op maintenance. I hope I’ve answered your question about surgical and non-surgical options to stop thigh chafing. You deserve to wear what you love without pain or worry. Please review before-and-after pictures, check reviews on RealSelf, and don’t hesitate to travel to find a qualified surgeon who can help. Sincerely, Dr. Katzen (President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)