Hello, thank you for your questions prioritizing and combining procedures for body contouring after massive weight loss. Basically, I prioritize based upon what bothers you the most. Since you did not prioritize the areas that bother you the most, I will give you the most common scenario for my weight loss patients. Basically, I divide most significant weight-loss patient’s surgeries into two stages: the lower body and upper body. The lower body in your case would consist of a 360 circumferential lower body lift; this would take care of the abdomen, hips and buttock. I would suggest during your 360 circumferential lower body that a dermal flap be used to reconstruct your buttock. That means your own buttock tissue is used to flip down into the buttock to achieve buttock auto-augmentation. During your 360-circumferential body lift, your hips will be raised and reduced and your abdomen flattened. During your 360-circumferential lower body lift, the rectus abdominis muscles will be sown tightly and excess skin and fat will be removed. If you wish, during a 360-circumferential lower body lift, a medial thigh lift/reduction can be performed. You did not provide pictures of this area so I assume it does not concern you. One month later, I would then suggest a formal brachioplasty which includes arm liposuction and in your case, an incision from the armpit to the elbow. During the second stage with your arms, I would also suggest an anchor breast lift or mastopexy. This would raise your breast. Therefore, I would divide your surgeries into two surgeries. First stage: the 360 circumferential lower body lift with a dermal flap for gluteal or buttock auto-augmentation. Second stage: approximately one month later, an arm lift/reduction (brachioplasty) and a breast lift (mastopexy) . The total time frame for both surgeries would be approximately 2-3 months of healing. I hope this helps to answer your question of how to combine and prioritize procedures after massive weight loss. If you have any more questions regarding reconstructive surgery after massive weight loss, please contact my office. Reconstructive surgeries after massive weight loss include an abdominoplasty, tummy tuck, thigh lift, breast lift, mastopexy, arm lift, brachioplasty, torsoplasty, back lift, buttock augmentation, and buttock lift. Since these reconstructive surgeries after massive weight loss, are big procedures, please seek an experienced, board certified plastic surgeon with significant experience performing these types of lifts. Do your research. Make sure they have performed at least 100 of each procedure you are considering for reconstructive surgery after massive weight loss. Make sure they have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)