Arm Lift, Breast Lift and Hernia Repair All at Once?

I had gastric bypass 4 years ago and lost 200 pounds. I have extra skin on my arms I would like removed and I also would like a Breast lift or Breast implants. Last year, I had emergency bowel obstruction surgery and got a large hernia as a result. I want to get all three procedures done at one time: Arm lift, Breast lift, and hernia repair. Is that possible?

Doctor Answers 14

Combination Cosmetic Surgery

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The combination of breast lift, arm lift and hernia repair can definitely be performed during a single surgical procedure. With that said, the majority of plastic surgeons would prefer staging the hernia repair. Most surgeons would have no problem performing arm lift and breast lift procedures together. In fact, performing these procedures together adds synergy, lowers cost and results in one recovery.

Unfortunately, the presence of a large incisional hernia following complex bowel surgery can represent a wild card. This type of procedure can be complicated and necessitate inpatient hospitalization. In addition, there's the potential for bacterial contamination with this type of procedure. This could significantly increase the potential for complications if combined with breast lift and arm lift surgery. For these reasons, it's reasonable to perform major hernia repair surgery as a preliminary procedure.

If you're considering combination surgery, it's appropriate to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that safely achieves your aesthetic goals.

Combining cosmetic procedures with hernia repair can be done safely depending on the patients health..

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Combining procedures can often be done safely depending on the complexity of the procedures, the health of the patient and the risk factors for complications. Each patient must have a thorough evaluation prior to having longer operations that have a large elective or cosmetic component. It is best to have your surgeons and your medical doctor review your specific situation and health issues to evaluate whether you are a good candidate.

Laurie A. Casas, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 110 reviews

Combined Surgery?

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Thank you for the question.

Combined surgery is very commonly and safely performed.  Whether this can be done in your case  should be based on careful consultation (history, physical examination, and consideration of risks/complications/operating room time).

Based solely on your description,  the breast and arm surgery certainly can be done in one session (assuming you are medically cleared to proceed with surgery).  The “large hernia”  probably should be addressed first.

I hope this helps.

Multiple body procedures

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I think that if you have a complicated hernia to repair, you may be better off fixing that first and then having the other procedures done at a later time. 

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Combination surgery is challenging to coordinate

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No question- the arm and breast lift can be done safely together- this is a combination that makes a lot of sense. Your complex abdominal wall reconstruction should be done in a hospital setting by an experienced general surgeon. I'm a board certified General Surgeon as well as a plastic surgeon, and I would never consider doing these three operations on anyone. Its going to be tough to find two surgeons willing to work simultaneously to pull off these three big operations. Take care of your functional problem first- the hernia- and then think about doing the cosmetic procedures.

Do breast lift and arm lift together, but not hernia repair.

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The breast lift and the arm lift should be done together.  In massive weight loss patients, those incisions have to be coordinated.  But the hernia repair can be a big deal, and I would do that separately.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Arm Lift, Breast lift, and hernia repair in one surgery

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It is really NOT an issue of CAN they all be done at the same time. It IS an issue of SHOULD these three operations be done together generally and then, in you.

As Plastic surgeons were are Surgical Super-Specialists. The vast majority of Plastic surgeons completed and were Board Certified in ANOTHER surgical field BEFORE training in Plastic Surgery -- with the vast majority having trained fully in General Surgery.

As a former General Surgeon, I can tell you that Hernias do not get the "respect" they should be getting. Hernias still kill thousands of people every year and their management can be quite complicated. You often read about hernias recurring despite repairs by good surgeons and of intestine twisting and dying inside hernias.

I would STRONGLY advise you to get your hernia repaired first BEFORE embarking on other repairs. If you wanted to combine the hernia repair with a Tummy Tuck repair (which may be simple or require a COMPONENT SEPARATION TECHNIQUE) I would have no problem with that.

I would save the Breast Lift and Arm lift for a later time once the hernia has healed and does not pose a threat.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Consult with your surgeon.

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Thank you for your question.

It techinically is possible. However, it is important to weigh the benefits vs. the risks. Your hernia repair will definitely take prescedent. It is important to take care of the necessities first. I would schedule a consultation with a board certified plastic surgeon. He/she should consult with your primary doctor and general surgeon and they will figure out what is the best option for you. It may be best to stage the surgeries. It all depends on your medical condition and other factors.

Best regards,

Dr. Speron

Sam Speron, MD
Chicago Plastic Surgeon

Multiple procedures

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The fact that you describe your hernia as large and occured after a complicated bowel obstruction strongly suggests that your first priority should be the hernia repair. Discuss this thoroughly with your general surgeon who will do this repair and may possibly use a mesh. The potential problem is that the general surgeon will likely have to do an extensive dissection to free all of the scarred tissues. Also, if the hernia is so large the compression resulting from a "tight" closure can potentially impair your post op lung function and you need to concentrate on this. The length of time for these multiple procedures and the signifantly increased risks I feel negate considering these together. One consideration would be to do the hernia repair and IF everything went extremely smoothly (better than expected) and if the plastic surgeon is willing to "hang around", then the procedure could possibly by done. But this seems unlikely. Erring on the part of safety for the patient is hardly an error in the end.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

Arm Lift, Breast lift and Hernia Repair at same time

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I have done many body contouring procedures. I have done these procedures at the same time. However, I had to use a plastic surgeon as an assistant in order to speed up the process.

Make sure your surgeon is board certified and that your procedures are being performed at an accredited facility.

John Diaz, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 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.