Loose skin removal surgery - is it feasible to undergo these procedures in a single surgical session?

While it may be technically possible to combine multiple body contouring procedures in one surgery, it’s rarely advisable — especially when considering four major operations like:
Arm lift (brachioplasty)Thigh liftTummy tuck (abdominoplasty)Buttock lift (lower body lift)Each of these is a significant procedure on its own, and combining them all at once would result in:
Excessive surgical time (well beyond the 6-hour safety threshold)Higher risk of complications like wound healing issues, blood clots, infection, and fluid accumulationGreater physical stress on your body during recoveryWhat’s usually recommended?Most surgeons stage body contouring surgeries in 2–3 sessions, based on your priorities, anatomy, and healing capacity. A common sequence might be:
Stage 1: Lower Body Lift (includes tummy tuck + buttock lift + lateral thigh tightening)Stage 2: Arm Lift + Breast or Chest Contouring (if needed)Stage 3: Medial Thigh Lift + Additional Liposuction or Refinements3 months minimum, 6 months optimal time for intervals
This approach allows for:
Safer anesthesia timeBetter healing between regionsMore predictable resultsLess risk of wound tension and delayed healingImportant considerations:Your BMI, metabolic health, and nutritional status (especially protein and hemoglobin levels) play a key role in how much can safely be done at once.Many post–massive weight loss patients also have unique scarring patterns, which need strategic planning.Combining complementary areas (like abdomen + buttocks or arms + breasts) is often preferred.

Thank you for your question and congratulations on your weight loss. Typically these procedures need to be broken up based on time restrictions. The proximity of your incisions also play apart for optimal healing. For example- an abdominoplasty and thigh lift ideally should be spaced out as the incisions are close together and may impact healing. Different providers have different opinions, though, as well as different time restraints. You may also want to think bout recovering from all of these procedures at once vs. separating into 2 different surgeries- especially if you have other medical conditions that may put you at increased risk. Hope this helps.

Often a significant weight loss involving an abdominal "apron", significant hip/flank skin, and loose buttock areas will benefit from a "lower body lift", started in the prone (face-down) position, after which the patient is repositioned supine, and the recontouring continues around the hips to address the abdomen as well. A concomitant upper arm lift would be reasonable if the surgeon and anesthesiologist believes it to be safe (generally these procedures alone would take at least 8 hours), but I would recommend against all 4 extremities being addressed in the same session, safety/time-wise, and in consideration of the limitations in mobility and self-care post-op.

Hello, and thank you for your question regarding loose skin removal and whether it is feasible to undergo an arm lift, thigh lift, tummy tuck, and butt lift in a single surgical session. The short answer is no. This is too much surgery at one time; most experienced, board-certified plastic surgeons who specialize in reconstructive plastic surgery after massive weight loss suggest that these procedures be staged. The reason these procedures need to be staged is that the time under anesthesia is too long, the risk for infection is too high, your risk for a blood clot is increased, and it is too long an incision line for your body to heal all at one time. Therefore, most board-certified plastic surgeons who specialize in reconstructive procedures, such as these, would suggest staging these procedures into two or three surgeries. The first surgery usually includes a tummy tuck and butt lift. This procedure is typically called a 360 circumferential lower body lift, lower body lift, belt lipectomy, or belt abdominoplasty. You can include the thigh lift or thigh reduction at the same time, depending on the severity of the legs and the skill set of your chosen plastic surgeon. I would not suggest you have the arm lift and thigh lift combined. Getting out of bed after undergoing combined arm lift, and thigh lift is very difficult because you need your arms to get out of bed, your legs to ambulate to your bathroom, your arms to get out of the garment, your legs to sit on the toilet, your arms to get yourself clean, your arms to get the garment back on, and then, finally, your legs get back to bed. Even though your arm lift and thigh lift can technically be performed together, the recovery is very difficult. Therefore, most plastic surgeons recommend staged surgery. Do not have the arm lift, thigh lift, tummy tuck, and butt lift in one surgical setting. Good luck. I hope this helps to answer your question regarding whether it’s feasible to undergo these combined procedures in one surgical session. Most plastic surgeons offer free virtual or in-office physical consultations. Therefore, explore what other plastic surgeons have to say. If you have any further questions regarding arm lift, thigh lift, tummy tuck, or butt lift, please get in touch with an experienced plastic surgeon. Since the arm lift, thigh lift, tummy tuck, and butt lift surgeries are big procedures, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks. Do your research. If you cannot find an experienced arm lift, thigh lift, tummy tuck, and butt lift plastic surgeon in your neighborhood, consider traveling out of state. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Dear riri_rose,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

The most important consideration is whether it is safe for you to have all these surgeries at once. The rate of complications tends to increase after approximately six hours of surgery. If one surgeon was performing all of the surgeries alone, it would likely take much longer than 6 hours. If you could find a pair of surgeons who would be willing to work together, combining the surgeries may be possible and safe. Another consideration for performing a lower body lift at the same time as a thigh lift is the viability of tissue between the abdominal incision and the thigh incision. For this reason, the abdominal portion is usually performed first and at some later date the thigh procedure is performed. Discuss this in detail with your plastic surgeon about the safest way forward for you. Best wishes.

Congratulations on your impressive weight loss! It's appealing to want to have everything done at one time, but sometimes it's just too much. Your safety is always the number one priority and if all the procedures you mentioned are combined the surgical time would be too long and your safety could be compromised. In addition you face challenges in terms of recovery and also the quality of your results. It's best to have two stages of surgery.

A safe plastic surgery should never pass the 6 hours threshold because of safety. More hours of surgery the risks increase exponentially: more anesthesia, more blood loss, more exposure of the tissues, higher risk of infections, higher risk of open wounds, higher risk of hypothermia, higher risk of bleeding, etc.
For that reason who is expert in After weight loss surgery acknowledges that the surgeries must be staged: 1 rst stage: 360 lower body lift, next stage 6 months later upper body lift: arms, breast and back, and I will highly recommend to do thighs separately because they are reported to have the highest risk of complications.
Be encouraged!!
Dr. Cardenas

I don't recommend doing all these procedures together for the following reasons:

1. The surgery will last for too long which is not usually recommended
2. Healing process will be too hard since you will have scars on your arms, abdominal, lower back and inner thigh areas and it is hard to manage all these areas together, so the complication risk will be much higher.
3. Tummy tuck and inner thigh lift procedures create opposite forces on the skin which would cause wound healing problems, and it might compromise the quality of the inner thigh's result.

I'd recommend doing the tummy tuck, buttock lift in the first session and to do the arm lift and inner thigh lift in the second session,
Between the sessions, we need to allow between 4-6 months.

No, it is not possible to do so many extensive procedures in the same time; blood loss with multiple procedures may be significant, anesthesia times too long and patient would probably need multiple blood transfusions as well as prolonged, uncomfortable recovery time. Deviding these procedures in 2 or 3 surgeries is much safer and more predictable. In-person consultation with at least two board certified plastic surgeon familiar with body contouring surgery would help you to understand risks and possible results. Good luck.