if I have multiple skin removal surgeries, do I need to have lower body lift first? Or can I start w/arm lift?

Question

I have a lot of loose skin from weight loss. I plan on having multiple procedures: lower body lift, breast lift with augmentation, Extended arm lift and possibly a thigh lift at some point. My arms bother me the most and I’m not in a financial position to have a body lift at this time. It is necessary (for the best results) to have the body lift first, or can I start with an arm lift and do the more extensive procedures later on?

Scott W. Vann, MD, FACS · Answer

Most massive weight loss patients do correct their waistline first with a tummy tuck or a lower body lift. But they do it because it bothers them the most. However, there is no reason you cannot start with your arms. I have had patients want to start with arms or breasts or both first and then proceed with other areas. Discuss this with a plastic surgeon who does a lot of weight loss patients. Good luck.

J. Timothy Katzen, MD, FACS · Answer

Hello, thank you for your question about what to do with your body after weight loss.  In addition, thank you for your question about whether you can have your arm surgery first, if you are planning multiple skin removal surgeries.  The short answer is "yes, you can have your arm reduction surgery first."  Every plastic surgeon does things a little differently.  I let my patients decide what area bothers them the most and perform that surgery first.  For most weight loss patients, there are 3 sets of surgeries.  During Stage 1, I perform the 360 circumferential lower body lift.  Often, I can combine the 360 circumferential lower body lift with a thigh reduction.   About one to two months after Stage 1, I perform Stage 2.  During Stage 2, I perform a breast lift, breast augmentation, torsoplasty, and arm reduction (upper body lift).  During Stage 3, I perform a face lift and a neck lift.  This is my typical sequence.  However, as I mentioned before, I accommodate my patients wishes, and address the areas that bother them the most FIRST.  I specialize in arm lifts.  IIf you have any more questions regarding reconstructive surgery after massive weight loss, please contact my office. Reconstructive surgeries after massive weight loss include an abdominoplasty, tummy tuck, thigh lift, breast lift, mastopexy, arm lift, brachioplasty, torsoplasty, back lift, buttock augmentation, and buttock lift.  Since these reconstructive surgeries after massive weight loss are big procedures, please seek an experienced, board certified plastic surgeon with significant experience performing these types of lifts. Do your research.  Make sure they have performed at least 100 of each procedure you are considering for reconstructive surgery after massive weight loss.  Make sure they have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon , 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.)

Ajaya Kashyap, MD · Answer

Thank-you for your question. The order of skin excision procedures varies based on your preferences and your surgeon. In my opinion you can certainly have the upper body and smaller procedures done before your Lower body lift. Please find an experienced Board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Kenneth Hughes, MD · Answer

Hello, thank you for your question. Congratulations on your weight loss!! Sagging skin after massive weight loss can be treated by excision procedures. It is not recommended to have multiple procedures at the same time, since longer surgeries have more blood loss and potential complications. An in-person examination is needed. I recommend you to schedule a consultation with a board certified plastic surgeon.

Carmina Cardenas, MD · Answer

The After Weight Loss surgery is very complex and should be done by experts, with a lot of knowledge and experience on these type of procedures.If the surgery you desire the most does not interfere in the future with other, then you may do it safely, or we should not perform on opossite vectors (of pulling) procedures as is: LBL with Upper Body lift.So you may get done the Arm lift safely as separated Procedure.Dr. Cardenas

Daniel Barrett, MD · Answer

Dear Cokienut,
generally speaking, you should be able to address the areas you have the most issues first and later proceed with other surgeries. 
If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

Yes you can begin by addressing your arms.  The lower body lift is often the first procedure only because it is the most involved and generally is the most concerning for patients.  If this is not true for you then you can start with the arms and progress at your own pace.

if I have multiple skin removal surgeries, do I need to have lower body lift first? Or can I start w/arm lift?

Answers (7)

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