Which surgery should I have first ? Arm lift/breast reduction then BBL/lipo or vice versa?

Question

I'm getting an arm lift breast reduction combo. As well as, bbl/lipo of stomach, sides & inner thighs. My breasts are heavy but they don't cause me pain. According to my research bbl/lipo is more painful (although not unbearable) & requires extensive recovery compared to arm lift/breast reduction. To my surprise all women who've had AL & BR didn't experience pain post op, just discomfort lots of itching. Which surgery should I have first? How long should I wait ?

J. Timothy Katzen, MD, FACS · Answer

Hi Makemeover879,

Thank you for your question regarding arm lift, breast reduction, Brazilian Buttock Lift (BBL), and liposuction.  In general, you can do either procedure first.  However, I would suggest doing the BBL and abdominal liposuction first. The main reason that I would recommend this sequence is that during your first surgery, the shape and foundation of the buttock can be established.  During your second surgery, you can further augment the buttock with arm fat removed during the arm lift.  During the arm lift, arm liposuction should be performed followed by arm skin and fat removal.  The arm fat is healthy and tolerates transfer to the buttock well.  The fat from the arm will not be much, but every drop counts!  I would wait for one to two months between the BBL and the arm lift with breast reduction.

The itching after an arm lift is usually due to the dressing.  Usually, the itching passes quickly.

I agree.  Most patients do not have much pain associated with an arm lift and breast reduction.  In general, liposuction is a blunt surgery.  During liposuction, the cannula bumps blindly against muscle and fascia.  The localized trauma is what causes pain after liposuction.

Good luck.  If you have any further questions regarding arm lift or fat transfer, please contact my office.

Sincerely,

Dr. J. Timothy Katzen

Owen Reid, MD · Answer

Although these procedures could be done in either order, I would recommend booking the breast reduction and arm lift first and the BBL second. One potential benefits of this case order is that it gives your surgeon a chance to revise or improve the breast reduction and/or arm lift either by liposuction or scar revision during the BBL.

Amy Simon, MD, FACS · Answer

Planning your surgical procedures is purely a matter of personal
preference.  You certainly could do these in whichever order you prefer
depending on your top priorities.  I have found that Melbourne, Florida,
body contouring patients generally appreciate a full discussion about all of
the procedures, options, and considerations during the pre- and postop period
prior to making a definitive decision as to combinations of procedures and in
which order to proceed.  We make these decisions together after
considering all of the patient’s thoughts on the issue, as well as, of course,
the input of the board-certified plastic surgeon.  I recommend you discuss
this in detail with your board-certified plastic surgeon.  I hope this
information is helpful.  Best of luck!

Lissa Bootstaylor, MD · Answer

Choosing which set of surgeries to have is often a difficult decision but I always ask my clients to prioritize their combo surgeries  by determining which procedures will make them  look better in their clothes. If you look better, you feel better and you will be content even if you have to postpone your second surgery. If you examine your wardrobe  carefully and focus on your favorite pieces in your closet the surgery you should have first will be obvious.  Now, when considering the timing of the second surgery, a waiting period of 3-6 months is always ideal because if the first surgery needs "tweaking" it can be done during the second surgery! All of the surgeries that you are considering can always look better with a little touch up..;;;;;

Zachary Farris, MD, FACS · Answer

Thank you for your question. In terms of an arm lift/breast reduction versus BBL/lipo, either order would be fine. It really depends on what you want addressed sooner. In my practice, I would recommend waiting at least 3 months after surgery before moving on to the next. Be sure to consult with an experienced board certified plastic surgeon. Good luck!

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