Hello, and thank you for your question regarding whether it’s safe to have skin removal surgery on your stomach and arms at the same time. First, congratulations on your incredible 118-pound weight loss after bariatric sleeve surgery — that’s a major achievement, and you’ve clearly worked hard to get here. You’re now in the final stages of your transformation, and that’s something to be very proud of. Yes, it is generally safe and common to combine a tummy tuck (abdominoplasty) with an arm lift (brachioplasty) in the same surgery — as long as you're healthy and your plastic surgeon is experienced in performing combination procedures after massive weight loss. In fact, many post-bariatric patients choose to combine surgeries like this to reduce the number of anesthetics, hospital visits, and recovery periods. The advantages of combining these procedures are: One surgery and one anesthesia event One recovery period instead of two Potentially lower total cost than staging the surgeries separately However, there are also some drawbacks to consider. Recovery can be more challenging because your core and arms will both be healing at the same time. This means you’ll need extra support at home to help you get in and out of bed, prepare meals, and move around safely — especially in the first 10–14 days. You’ll also have two areas of post-op discomfort, and the overall surgical time will be longer, which slightly increases the risk of complications like wound healing issues or infection. That said, if you're in good health, your BMI is stable, and your labs are normal, most board-certified plastic surgeons with experience in post-weight loss body contouring are comfortable performing this combination. Just make sure to discuss all aspects of recovery with your surgical team so you can plan ahead and set yourself up for a smooth healing process. If you haven’t already, I highly encourage you to review your plastic surgeon’s before-and-after photos of patients who had both procedures and ask how many similar cases they’ve performed. Experience in massive weight loss patients is key — skin behaves differently, and the surgical planning needs to reflect that. Wishing you all the best as you continue this final step of your journey. Sincerely, Dr. J. Timothy Katzen, MD, MBA, FASMBS, FICS (Certified by the American Board of Plastic Surgery and President of the American Society of Bariatric Plastic Surgeons; Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and the American Board of Metabolic and Bariatric Surgery; Member of the American Society of Plastic Surgeons, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame) Before moving forward, be sure to check your surgeon’s qualifications, review detailed before-and-after photos, and read reviews from massive weight loss patients. These surgeries are transformative when done by the right hands.