After Massive Weight Loss, Safe To Have Breast and Lower Body Surgery At Once? What Are My Best Options?

I had gastric bypass and have lost 135lbs. I am only 32, I'd like to wear a bikini.I've received 3 different opinions.One told me he would not do my breasts in one surgery. He would do a lift then implants because he did not want the blood supply to my nipple to die. The 2 other doctors said they would do everything at once. I want to have a lower body lift, "build a but",breast lift w/ silicone implants. Is this safe to do in one surgery? Also,is fat grafting going to give me a decent rear end? If I Get a Butt Through Fat Grafting Will the Results Be Permanent? Is a Brazilian Butt Lift the Same Thing As Fat Grafting?

Doctor Answers 6

Multiple procedures are safe after massive weight loss

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Doing multiply proceedures after massive weight loss can safely be done in most patients.  Obviously your current medical problems will influence a surgeons decision.  A common procedure done in my office is a " Total Body Lift" with/without breast lift/reduction +/- implants.  Patients will commonly add an arm lift.  The thigh lift is done in a month or so later.  The Total Body Lift comprises of a beltectomy(lifts up the butt and outer thighs) Bra roll excision, Axilla excison, Abdominalplasty, Corsetplasty +/- a reverse Abdominalplasty.  I do not transfuse blood and this is done in a hosptial setting as out patient surgery.  Obviously you need to pick a surgeon who is well versed in these proceedures.  Also a medical clearance is a must. You will need to have a special nutritional supplementation prior to surgery to maximize a good outcome. Good luck with your surgery. 




Anire Okpaku MD

Miami Plastic Surgeon

Mommy Makeover Following Massive Weight Loss

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Congratulations on your weight loss success! It is best to undergo #MommyMakeover procedures when your weight has been stable for at least one year. 

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.  #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. 

In addition to a one-on-one consultations with a board certified Plastic Surgeon, patients always need to be seen by their primary care doctor prior to such procedures.  We screen every patient and their medical records for risks of blood clots (DVT) and then take appropriate measures.  MWL (massive weight loss patients of  75 lbs or more) tend to have poor skin elasticity and will frequently need additional tightening even afte 6 -12 months regardless of who or how their surgery is performed. This is simply the nature of such body tissues and the ability to heal with the lack or limited elasticity. 

After Massive Weight Loss -Plastic Surgery Options

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It is always better to try to correct everything you would like in one surgery as long as it can be done safely.  The state limits the amount of fat that can be liposuction when combined with other cosmetic procedures.  For this reason, it may be in your best interest to have the Butt Augmentation done with fat grafting (fat transfer) done separately at a later date so that you can really achieve the optimal projection and look you desire. As far as a Breast Lift with implants and a lower body lift completed in one procedure that is a perfect combination and falls in the category of a “Mommy Makeover” type of surgery which is done together (safely) quite often.

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Multiple Procedures at Once following Masive Weight Loss

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Having a body lift at the same time as a breast lift and augmentation is a standard surgery to go through after massive weight loss, as long as the patient is in good health. The surgeon who wants to wait to do your augmentation at a second stage is being as conservative as he can possibly be.   We normally do not delay the placement of the implants unless there is a health issue.   It is very important that you see your primary care physician for clearance before undergoing surgery.  Fat grafting to the buttocks may help you achieve a better look.  The results vary depending on how much fat is harvested and what amount your body absorbs.  The amount of fat that your body maintains after about 10 weeks should be permanent. 


M. Mark Mofid, MD
La Jolla Plastic Surgeon

Body Contouring After Large Weight Loss Often Requires Multiple Procedures for Safety

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Hi there-

With regard to the varying opinions you have received, I would not let this cause you anxiety- especially as it pertains to breast lifting when implants are to be placed. Some surgeons are comfortable doing this at once, and some think that safety and the outcome are better in their hands when the two procedures occur separately. This does not mean that either approach is necessarily "right" or "wrong".

With regard to the procedures you are considering, and the timing of these, you should understand that decisions about what might be possible to do all at once can be very complex, especially with regard to some of the larger body contouring procedures and in weight loss patients. Variables that need to be considered include the health and nutritional state of the patient, the anticipated length of the procedure(s), the positioning necessary to complete the procedures, and even the bandages and garments planned...

It is also important to realize that your experience will be different depending on who does your surgery and where they do it, and that these variables may affect what you can safely combine... In other words, the most commonly limiting factor in terms of combining procedures is the length of the procedure. But some surgeons are able to do combo procedures in less time than others, making it safe to combine them, while other surgeons take longer (without being better or worse- just longer) and therefore would not want to combine the procedures.

The most important thing is having a safe experience.

Therefore, I think the best advice I could give you is for you to find a surgeon you like and feel you can trust, and allow them to guide you.

How to go about this? Please read this:

Breast lift/augmentation

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The combination of beast lift and insertion of implant at the same time increases the risk of interfering with nipple areola circulation. That risk is small and many surgeons will do it togwther. However that also depend on the individual case, and the amount of ptosis. There are many techniques that can be used to minimize the risk.

Lower body lift can be a long surgery

Fat transfer to the buttocks is the same as Brazilian Buttock Lift. The fat will stay, about 60-80% of the transferred fat will stay. That is very technique dependant

Samir Shureih, MD
Baltimore Plastic Surgeon

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.