Is this safe to have a 360 belt tummy tuck, lower back liposuction, male breast reduction, nipple graft, & back lift at once?

Question

Hello, I have loose skin on my upper body and have had a consultation with an experienced, reputable surgeon at a JCI accredited hospital in Bangkok, Thailand. The surgeon has given me various options, one of which is to have a 360 belt tummy tuck, lower back liposuction, male breast reduction, nipple graft, and backlift. These would all be completed in one procedure. I am in my mid forties, have eczema which is controlled with 12.5mg of methotrexate each week, and asthma which is controlled with ventolin. The surgeon's before and after photos were excellent and I trusted that he had my best interests at heart. He estimated that the surgery would take 7 hours to complete. I would like to get a few more opinions on whether all of these procedures are safe to be combined in one operation? P.S. I am an ex smoker who has used a vape since 2020. I stopped using the vape two days ago, to allow myself 4 weeks of not smoking before this potential procedure. Thanks everyone.

Camille Cash, MD · Answer

Combining procedures is common and considered safe, but there is a limit.  Generally it is recommended that elective plastic surgery be limited to six hours of surgical time.  This is for safety and also to allow the surgeon to optimize your results.  Based on your health history, current nicotine user, and procedures you are considering, it would be best to break them into two stages.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the safety of combining a 360 belt tummy tuck (also known as a lower body lift), lower back liposuction, male breast reduction with nipple grafting, and a back lift in a single surgery. I appreciate your detailed history and applaud your commitment to stopping vaping ahead of surgery—this is an important step toward safer healing.

While your goals are absolutely valid, the proposed surgical plan includes too many procedures to safely and effectively perform in one session. The biggest concern is the conflict between the lower body lift and the back lift. These two procedures involve incisions that pull the tissue in opposite directions—the lower body lift pulls upward while the back lift pulls downward. Performing both at the same time places excessive tension on the skin, dramatically increasing your risk of wound healing complications, scar separation, tissue necrosis, and compromised results.

A much safer and more effective approach would be to stage the procedures. One option is to perform the 360 lower body lift with or without the male chest reduction and nipple grafting as your first procedure. Then, in a second stage, you could undergo the back lift and any remaining chest contouring. These two procedures should be spaced out by at least 2 months to allow your body adequate time to heal and reduce your risk of complications.

Although 7 hours is within the safe range for many combined plastic surgeries, this estimate may be too optimistic for such an extensive procedure. Your controlled eczema and asthma are additional factors that make it even more important to avoid excessive surgical stress. Safety, healing, and optimal results all rely on minimizing tension, blood loss, and anesthesia time.

You are doing the right thing by getting second opinions. Please consult with a board-certified plastic surgeon who specializes in post-weight loss surgery and understands the staging process. You deserve the safest path to the best possible outcome.

Sincerely,
Dr. Katzen

Is this safe to have a 360 belt tummy tuck, lower back liposuction, male breast reduction, nipple graft, & back lift at once?

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Is this safe to have a 360 belt tummy tuck, lower back liposuction, male breast reduction, nipple graft, & back lift at once?

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Everything you need to know about Body Lift

Our mission is to create a world where every investment in modern beauty is Worth It.