Excess skin removal - what is the correct order to get these procedures in?

Thank you for your question regarding the correct order of procedures after a 146 lb weight loss. Congratulations on your weight loss. Great job! There are many scenarios where reconstructive surgery can be ordered after massive weight loss. I've been undergoing reconstructive plastic surgery after massive weight loss for 20 years. I think the best way to address all these areas is in a specific order. I would first suggest a 360 circumferential body lift. This would entail an abdominoplasty (tummy tuck), mons lift, pubic lift, muscle plication, hip lift and reduction, and buttock lift and reduction. Depending on your medical health and your plastic surgeon's team, doing the thigh lift simultaneously with the 360 circumferential body lift is possible. I would then wait one month and proceed with the arm lift or brachioplasty as well as the breast lift or mastopexy. As for pricing in Chicago, I do not know the pricing. However, many patients come to Beverly Hills from Chicago for these procedures. Thank you for the question regarding the correct order of operations after a 146 lb weight loss. Congratulations on your weight loss.

I always begin with the breasts because it pulls up the upper abdominal skin. The breast lift can be done simultaneously with a tummy tuck or you have have the breast lift and thigh. You will need 2 stage surgeries to have all these procedures done.

Best Wishes,

Gary Horndeski, M.D.

In my professional opinion, the correct sequence if lower body lift (this includes a tummy tuck and butt lift combined together), upper body lift (this includes an arm lift and breast lift), followed by a thigh lift performed last. I would highly recommend seeing a board eligible or board certified plastic surgeon for a physical exam and accurate analysis with safe recommendations for potential surgical options. Best of luck!

Dear Unajeva,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

First, congratulations on your weight loss! That is certainly a great accomplishment.
My typical approach is to first do a lower body lift which would combine the tummy tuck and butt lift into one procedure. Usually second would be breast and arms and third would be thighs. Some of this is individualized based on people's priorities and anatomy.
It would be best to see and be examined by a board certified plastic surgeon to help assess your goals and what order of surgeries would be best. Hope this helps!

Congratulations on your weight-loss journey! It's really very impressive what you've accomplished. There really is no correct order in which to perform these procedures and is really up to you to have whatever bothers you the most addressed first. Many surgeons will stage these procedures but how that occurs is very variable between surgeons. With that said, most people see the greatest change/benefit from doing the trunk surgeries first (circumferential body lift). In some situations the breast can be done at the same time as the trunk. I usually save the arms/legs for after the trunk is healed. Pricing and financing options will likely need to be discussed with you after a consultation but you can find the national average pricing on the American Society of Plastic Surgeons website. Hope this helps

1. combine beltectomy (circumferential lower body lift) with brachioplasty to tighten the abdomen, lower flanks, buttocks, lateral thighs, and upper arms. 2. combine upper body lift with inner thigh lift to tighten the upper flanks and inner thighs3. mastopexy to tighten the breastsThere is no "ideal"order. We usually ask the patient what concerns them the most and treat that area first.Pricing varies greatly from surgeon to surgeon. Visit a board certified plastic surgeon for evaluation and discussion.Best wishes...