Full tummy tuck w/ MR; thigh, arm, & breast lift; lipo on my back/flank area. Too many procedures to have at once? (Photo)

33 years old, 5'7", 265 lbs. I had twins a year & half ago (both over 5 lbs by c-section), that ruined my abdominal muscles and my stomach hangs so far over I can't see my pubic area w/out holding it up. I have lost 50 lbs since New Years and I have a consultation with Dr. Sacha Obaid on June 1st. I really just want to do everything at once because being a full-time mother of four and working full-time will not allow me to go through several recovery periods.

Doctor Answers 6

Combining a Mommy Makeover with Additional Surgery Sites

It's difficult to suggest without a in-person one-on-one consultation. 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.  

#Combined operations are often performed with our #Gynecology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries included with a #MommyMakeover. If you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your physician and board-certified plastic surgeon. Also, combining these #procedures may decrease anesthetics, costs, and recovery time.
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. 

Your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Multiple operations at BMI of 41

Thank you for your question about your mommy make-over.

  • You have been through a lot and have done well to lose weight.
  • Your BMI is 41 - you are unfortunately morbidly obese.
  • This puts you at a high risk for anesthetic complications with any surgery
  • Even if you were a normal weight, your surgical plan is too much for one time.
  • Given your BMI I would require you to do one procedure at a time and require it to be done in a hospital, not a surgery center and the anesthesiologists I know would feel the same.
  • You are at high risk of serious anesthetic complications.
  • You will do your children a big favor if your, their Mom, gets healthy by getting down to a normal weight.
Always consult a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Staging multiple procedures as part of a mommy makeover.

This is in large part a matter of opinion but in my practice I would insist that you stage these procedures. Although convenient, the physiologic insult with all of these operations done concurrently in my opinion would be too much for elective cosmetic surgery.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Staged cosmetic surgery will be safer for you!

Hello CBezi,
Thanks for your question.
Unfortunately, I believe that staging your procedures will be necessary and the safer option for you.  Because of your current weight, your anesthetic risk during elective surgery is too great.  You really need to drop closer to around 180 lbs. to have the same anesthesia risk as patients of normal body weight.  The risk of blood loss, pulmonary dysfunction, and poor cosmetic results are too great at this point.
If you have surgery and then continue to lose weight, you will ruin your results.
I would recommend that you continue to be patient and keep losing that weight.  Spend a little money on a good personal trainer who can tune your diet and exercise patterns to get you to your goal.  50 lbs. of weight loss in 5 months is awesome and you should be proud of yourself.  I have no fear that you can safely lose the rest.  If you are done having children, you owe it to yourself to have a safe surgery that restores your pre-baby body to it's best form.  
I'm assuming this is what Dr. Obaid will also tell you!
Good luck,
Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 55 reviews

You will need to stage procedures...

Congratulations on your significant weight loss; keep up the good work!  Generally speaking, these types of combination surgical procedures are done routinely. However, you are wise in being concerned about the safety of combination surgery; risks/possible complications do increase with increased length of surgery…  Given the number of procedures you are considering, you will be best off staging the procedures.

It is best to evaluate each patient's suitability for combination surgery on an individualized basis. During this consultation process, after a complete history and physical, the SAFETY of combining these surgical procedures becomes of paramount importance. Plastic surgeon, anesthesia provider, duration of surgery, surgery facility all important considerations. Your best bet: choose your plastic surgeon very carefully; everything else including good judgment/advice/planning, anesthesia provider and safe surgery facility will follow. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Multiple surgeries

One needs to be realistic. The role of the surgeon is to minimize the risks of complications for the patient. This is done by full assessment, realistic plan for surgery, clearance from all needed specialties and the patient's own inherent risks and the inherent risks of the even the smallest surgery.
Surgery is a trauma to the body. Plus the risks of bleeding, infection, anesthesia and blood clots, any one of these can lead to death.
The more the trauma the more the risks, All the Risks. 

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

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.