Arm lift, tummy tuck. What should I do first? Help (photo)

Question

I want an arm lift for my arms But I also need a tummy tuck. Doctor said he can't do both at the same time so he suggested I do tummy tuck with fat transfer to buttocks and arm lipo to use that fat to buttocks as well and gave me a good price; I really want an arm lift because my arms is filled with stretch marks ; But what will my arms with stretch marks look like after the arm lipo ; He said for me not to worry that my arms will retract, HELP ME DECIDE please!!!!!!!

J. Timothy Katzen, MD, FACS · Answer

Hi Jessica, Thank you for your question regarding whether you should have an arm lift or a tummy tuck done first. Every plastic surgeon is different and every plastic surgeon does things a little bit differently.  In my Beverly Hills plastic surgery practice, I have been combining arm lifts and tummy tucks in the same procedure for the past 20 years.  I see no reason to stage your arm lift and your tummy tuck.  Your recovery should be fine.  If your arm lift and your tummy tuck cannot be performed together for some reason, then you have to ask yourself which area bothers you the most.  I would perform surgery on the area that bothers you the most.  One month later, I would perform your second surgery.  In regards to your arm stretch marks, there is no liposuction machine, whether it is the VASER, SmartLipo, etc. that will remove your arm stretch marks.  The only way to remove arm stretch marks is with an arm lift.  Based on the arm pictures you provided, many of your arm stretch marks would be removed with an arm lift.  Good luck!  I hope that I have answered your questions regarding an arm lift and tummy tuck. If you have any more questions rearing the arm lift, arm reduction, arm liposuction, or a tummy tuck, please call my office.  Sincerely, Dr. Katzen.

Kenneth Hughes, MD · Answer

Thank you for your question and pictures, I do these 2 procedures at the same time in my practice and have excellent results, always see a board certified PS.

Reza Rod, MD · Answer

Every doctor is different and plans his or her surgeries differently.  However, it is common to combine both an arm lift and tummy tuck together.  As a patient, it is in your best interest because it is less expensive and allows you to recover once rather than twice.  There may be reasons why this two step approach is being recommended.  Talk to your board certified plastic surgeon before undergoing any procedure. If you had to do one before the other, I would do the tummy tuck first because it has a longer recovery and has more health benefits.

Harry T. Haramis, MD, FACS · Answer

Personally, many of my patients avoid arm lift scars with Vaser ultrasound liposuction and/or Smart Lipo laser which tightens the skin. Stretch marks may improve but are not removed.You can do this with tummy tuck, but I do not like to add fat transfer as recovery is more difficult.An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, it is difficult to determine if you would benefit from an arm lift or liposuction alone of your arms.  A tummy tuck and BBL can be performed together if you are in good health.  If you are an appropriate candidate for a tummy tuck, this can be done through a
low and short incision, all completely below the bikini line.  The belly button can be designed to look
natural and have no scars on the exterior.  
Your muscles can also be plicated resulting in a flat
abdomen.  A BBL can be performed at the same time for improved
buttock and waist contour.     Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Christopher S. Jones, MD · Answer

I usually ask my patients to prioritize their problem areas so that we can focus on number one. In that way, we do not, for any reason, operate on number two first. That outcome, however good, leaves the patient with their number one problem. So first, decide which is worse in your mind: your arms, or your abdomen. Focus on ridding yourself of the number one problem and you will have a joyous experience. A patient who, understandably, wants to combine as many procedures as possible must understand the tradeoffs which can come from a lack of focus on quality for the sake of quantity. Ask yourself and your surgeon for focus on your main problem. I know this answer did not address the technical aspects of your question, but somehow felt that this might help. Good luck with your surgery and congratulations!

Gary L. Ross, MBChB, FRCS · Answer

Risks of anaesthesia increase with increased operative time and your surgeon is considering this when he/she advises you. With any lipo of the arms there is a chance that the skin will not retract and you may need an arm lift as a second stage. It sounds like your surgeons plan is appropriate.

David L. Abramson, MD · Answer

the amount of surgery that can be performed is usually based on what can safely be done within 4-6 hours. Every surgeon is aware of how long certain procedures take but safety always should take priority

Giovanna Ghafoori, MD · Answer

Hi, JessicaHumble.  I can understand your quandary!  Every surgeon has his/her preferred combinations vs. staged procedures, and there are pros and cons to each option.  Your surgeon's training, experience, and level of comfort or degree of conservationism goes into the recommendation.Some things to consider:  Both a tummy tuck and an arm lift are each a relatively large surgery, with a good amount of surface area to heal and a good amount of incision length to heal, and each will result in a certain degree of blood and fluid loss.  Depending on the amount of liposuction performed, liposuction may also be a relatively large surgery in terms of surface area to heal and blood/fluid loss, but the incisions length is negligible.  Combing large surgeries will tax your body's nutritional stores, increase the likelihood of post-operative anemia, and possibly tax your body's fluid and electrolyte status due to the combined swelling and fluid shifts of each of the procedures.  However, doing the procedures individually means a complete recovery period and a completely new set of risks with each procedure.Pulling up a girdle and caring for drains and lower abdominal incisions (of a tummy tuck) is a challenge if your arms are out of commission (due to the brachioplasty).If you have optimal skin retraction following arm liposuction, at the same time as the tummy tuck, you may be able to avoid a second surgery (the staged brachioplasty) all together.Combining a Brazilian Butt Lift (i.e. transferring  the fat removed with liposuction to the buttocks/hips) with a tummy tuck is also combining two relatively large surgeries, as mentioned above.  Post-operative care can be more challenging as pressure on the transferred fat must be avoided at all costs, yet the optimal position following a tummy tuck is on one's back with some flexion.  However, and especially if your surgeon generally performs some supplemental liposuction with a tummy tuck, doing a tummy tuck without the Brazilian Butt Lift results in a waste of the fat removed in the tummy tuck for a future butt augmentation.In many cases, there is just no getting around the need for an arm lift.  However, the risk of poorer scar quality with an arm lift is much higher than with most other surgeries and may be visible.  I hope some of the points help in making your decision or in making you more comfortable with your final decision.  And hopefully they won't add to your angst :) Best of luck, and I hope you have an uneventful recovery and the results you were hoping for!  Dr. Ghafoori

Alexander M. Sailon, MD · Answer

Generally speaking, it is best to work from the core (the belly and chest) outwards. This way if you are unhappy with the liposuction of the arms, you can always progress to the arm lift in the future. It is difficult to tell without an exam which is a better procedure suited for you. Best of luck!

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