Tummy Tuck, Arm Lift, Thigh Lift and Breast Implants... at the Same Time?

Question

I Am a 42 Yr. Old Mom of 3 Children Who Has Lost 107 Pounds with Exercise & Clean Eating. As a Result of the Weight Loss, I Have no fat tissue left in my breasts, loose abdominal skin,(but hardcore abs underneath), loose skin on thighs & arms Is it safe for me to undergo a tummy tuck, brachioplasty,thigh lift and breast implants all at the same time? I am 5'1", and weight 120 pounds and in excellent health, no meds or illnesses. Alternatively, I am considering the tummy tuck done first. Since I am a personal trainer, how long can I expect to be out of work after just the tummy tuck?

Young R. Cho, MD, PhD · Answer

Thank you for your question and congrats on the weight loss. It is definitely too much to combine all procedures in one setting. However, combining two procedures such as tummy tuck and breast augmentation/lift are great as they address some of big changes that happen after pregnancy and/or weight changes. It is often referred to as a mommy makeover. It is a bigger procedure and may often require a night in the hospital. Alternatively, you can combine the arms/tummy together and then stage the breasts/thighs together. A lot of this will depend on your priorities.I would consult with a board certified plastic surgeon in your area to discuss your options in more detail, review if there are any medical reasons to stage the procedure.  If they deem you are healthy to have have the combined procedure, then you will only have one recovery.

Jed H. Horowitz, MD, FACS · Answer

The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.    Healing after a  #tummytuck will require time. Some patients are out of bed and walking the night of surgery and every hour while awake. I allow my patients to return to work at one to two weeks with 14 days preferred.  However, no lifting or straining.  At three weeks, increased level of activity and full with no restrictions, at 6 weeks. #MummyTummy is a term given to modified tummy tucks which can use liposuction and skin tightening with radiofrequency such Vanquish, Vela3, thermage, thermiRF and others.  The actual fat contouring can be done non-surgically as well with #UltraShape or Cool-Sculpting.As I advise my patients, if your work keeps you sedentary, you may return whenever you feel up to it. If your work is strenuous, wait until your work activity does not cause any superficial pain. Some employers will modify a person’s job duties so they can back sooner, but without physical activity. Our office can provide our patients with a note stating they are not to engage in strenuous activity for a specified period of time. The note will not disclose what procedure they have underwent. Therefore, you may have to request a similar note from your surgeon if you are not independently employed. I recommend avoiding heavy lifting and strenuous #activity for six weeks following your surgery. With that said, it may help you plan your return to work accordingly.As for heavy lifting and other #strenuous #activities, it should be avoided for until you have clearance from your surgeon. You may, however, do normal activities at any time if they cause no pain or #discomfort. Let your body tell you what you can or cannot do. Aerobic exercise will raise your blood pressure, which could cause late bleeding and harm your result. Once you begin exercising again, start gently and let your body tell you what it can tolerate. Don’t rush!!  If you have concerns about your healing, or pain that you question to be unusual, it is important to call your plastic surgeon to discuss these further asked to be examined.

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question!  The breasts and tummy tuck are commonly performed together, often referred to as the "mommy makeover". If you are healthy and your surgeon decides that a/he could perform the procedures in a safe time for you, these procedures certainly can be done in one stage. However, these are challenging and lengthy procedures that will take several hours each to perform.  It is your decision as to whether you have your procedures performed in one or multiple stages, but your surgeon will give his/her recommendations.  But, I would consider staging these into at least 2 settings. I would consult with a plastic surgeon well-versed in these procedures and discuss your concerns with your surgeon and see what your options are as well as have an examination.  Your safety is ultimately the most important factor and is always on the mind of your surgeon when making such decisions. Hope that this helps! Best wishes for a wonderful result!

Jeffrey E. Schreiber, MD, FACS · Answer

Congratulations on your weight loss! Combining plastic surgery procedures is great when it's done right as this helps with recovery times, anesthesia exposure, and costs. However, it's important to be safe. Doing too many things all at once can increase your operative risks. As everyone is different, check with your plastic surgeon to see how many of the procedures can be done at the same time safely. If you don't have a lot of extra skin, then you may be able to do everything. Yet, you may want to anticipate having to stage your procedures into 2 or even 3 stages. Good luck!

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Congratulations on your weight loss!  That's awesome!  Plastic surgery certainly can address you areas of concern but to perform all these procedures is not advisable!  In patient's who have had massive weight loss a definitive plan needs to be formulated.  Sometimes two procedures that are close in proximity can be performed or it is okay to perform procedures individually.  If you have your tummy tuck done first then expect 4-6 weeks before vigorous activity can be performed.  Good Luck!!

	Dr. ES

Lawrence Iteld, MD · Answer

Congratulations on your weight loss! It is very tempting to combine surgical procedures, and is commonly done, at some point it becomes unsafe to do too much in one setting. I would recommend breaking up your makeover in two surgical settings. Good luck.

Otto Joseph Placik, MD · Answer

Congratulations on your success, You look great! These are multiple procedures and the combination is rarely performed together unless their are multiple surgeons and/or in a few select centers across the USA. I would probably advise and lower/upper approach with the tummy/thighs first and the breast/arms second,

Kris M. Reddy, MD, FACS · Answer

Generally, you will be better off to have the Tummy Tuck, Arm Lift, Thigh Lift and Breast Implants performed in stages. The tummy tuck and breast implants can be performed first. The arm lift and thigh lift can follow - generally four to six months later. If you have just the tummy tuck, you can resume light activities within a week to 2 weeks with more strenuous activities 4 - 6 weeks after surgery.

Steven Wallach, MD · Answer

Combining all those procedures sounds like a lot. You  may be better off staging some of them to decrease you overall OR time and potential blood loss.

Peter A. Aldea, MD · Answer

Regarding: "Tummy Tuck, Arm Lift, Thigh Lift and Breast Implants... at the Same Time?
	
	I Am a 42 Yr. Old Mom of 3 Children Who Has Lost 107 Pounds with Exercise & Clean Eating. As a Result of the Weight Loss, I Have no fat tissue left in my breasts, loose abdominal skin,(but hardcore abs underneath), loose skin on thighs & arms Is it safe for me to undergo a tummy tuck, brachioplasty,thigh lift and breast implants all at the same time? I am 5'1", and weight 120 pounds and in excellent health, no meds or illnesses. Alternatively, I am considering the tummy tuck done first. Since I am a personal trainer, how long can I expect to be out of work after just the tummy tuck?"

	Physically speaking, a Tummy Tuck, Arm Lift, Thigh Lift and Breast Implants CAN be done at the the same time. But, just because such a marathon surgery can be done (and is profitable for the surgeon) does not mean you should have it done this way.

	Separating large Plastic Surgery projects into smaller surgery parcels, or staging the procedures, is much more comfortable to the patient and is associated with a much faster recovery. It allows the surgeon to do touch up corrections, if needed, on the areas previously operated. But MOST importantly, it greatly reduces the risk of complications, especially infection and blood clot formation (DVT and PE) seen with longer procedures.

	I would suggest you think about having the Tummy Tuck and Breast lift/Augmentation as the first procedure and allow it to heal. you can then have the other procedures done in the order that best suites you.

	Dr. Peter Aldea

Tummy Tuck, Arm Lift, Thigh Lift and Breast Implants... at the Same Time?

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