Can a facelift be performed at the same as body contouring for patients after massive weight loss?

Question

Is it usual/advisable to attempt to take care of loose skin around neck and lower face at the same time as a different body contouring procedure? Are surgeons specializing in body contouring usually not specialized in procedures to the face?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your request regarding "can a facelift be performed at the same as body contouring for patients after massive weight loss?"  Most massive weight loss patients undergo multiple staged surgeries for total body reconstruction. Typical staging includes a 360 circumferential lower body lift during Stage One. The lower body lift includes an abdominoplasty (tummy tuck), hip lift/reduction, and butt lift/reduction.  During Stage Two, a thigh lift/reduction or thighplasty is performed. During a thigh lift/reduction, thigh liposuction is performed with an incision from the groin to the knee. For some patients with smaller thighs, the thigh lift/reduction is performed at the same time as the lower body lift or during Stage One. During Stage Three, patient can undergo arm lift/reduction, brachioplasty, breast lift/reduction, mastopexy, breast augmentation or breast reduction and possibly, a back lift. During Stage Four, patient undergo a facelift and neck lift  procedure. Procedures can be combined. However, most patients undergo the staging mentioned above.  All these procedures are performed under general anesthesia and require two to four weeks of recovery.  Most procedures require a drain.  Plan one one or two months between each surgery.   
In regards to your question, “are surgeons specializing in body contouring ,usually not specialized in procedures to the face? “ All Board Certified plastic surgeons are trained in body and facial plastic surgery. However, most facial plastic surgeons are only trained in facial surgery and not in body surgery. Therefore, ENT facial plastic surgeons may not have the proper training to perform body surgery. Most plastic surgeons would suggest you seek and experienced, Board Certified plastic surgeon who specializes in massive weight loss patients.  Good luck. I answered your question regarding "can a facelift be performed at the same as body contouring for patients after massive weight loss?"

Daniel Barrett, MD · Answer

Dear Persistent123642,
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

Camille Cash, MD · Answer

Combining procedures is common and considered safe, but there is a limit.  The recommendation for you will depend on the procedures you are considering and the time that it takes to perform each one.  I encourage you to begin by visiting with a board certified plastic surgeon near you.  I've included a video I hope you find helpful.

Mats Hagstrom, MD (license on probation) · Answer

There are certainly plastic surgeons who can competently perform body, contouring procedures, and facelift surgery.
Quality work is detail oriented and takes time.
There is an appropriate amount of surgery that should be done in a single session.
I’ve seen plastic surgeons do facelift in less than two hours, and I’ve seen surgeons spent 12 hours doing facelift surgery.
The same is true to some degree when it comes to body contouring procedures.
An operation like a wraparound tummy tuck is probably about the extent of surgery though it’s not uncommon to add an additional procedure in conjunction.
Each provider will have their own view on what’s appropriate and what’s not.
The overall size of the patient also makes a difference. A tummy tuck even an extended procedure on a petite person may include, 3 feet of skin closure while this excessively large person may be three times the size. 
To get a quality assessment and better understanding of treatment options I suggest having multiple in person consultations with plastic surgeons in your community.
There is a significant difference in outcome, depending on what surgeon you choose.
I cannot emphasize enough the importance of properly, vetting providers, and having multiple consultations before selecting a provider regardless of what procedure you’re interested in.
 During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who have similar body or facial characteristics to your own.
And experience provider should have no difficulty showing you the before and after pictures of at least 50 previous patients.
 During each consultation, you can ask providers what their recommendations are in regards to doing combined procedures.
Sometimes there are advantages to combining procedures, and sometimes it’s much better to do them as separate procedures.
This is a complex topic, and there are a lot of variables to take in the consideration.
There is no yes or no answer to your question. 
Best,
Mats Hagstrom, MD

James Hoyt, MD (retired) · Answer

Yes, it is possible for a facelift to be performed concurrently with body contouring procedures for patients who have undergone massive weight loss. This combined approach can address both facial aging concerns and excess skin and tissue in other areas of the body resulting from significant weight loss. Here are some important points to consider:1. Comprehensive Evaluation:• Before undergoing combined procedures, patients will typically undergo a comprehensive evaluation by a board-certified plastic surgeon.• The plastic surgeon will assess the patient's overall health, medical history, aesthetic goals, and specific concerns related to facial aging and body contouring.2. Customized Treatment Plan:• Based on the patient's individual needs and goals, the plastic surgeon will develop a customized treatment plan that may include a combination of procedures.• This may involve addressing facial aging concerns with a facelift, neck lift, or other facial rejuvenation procedures, as well as body contouring procedures such as abdominoplasty (tummy tuck), breast lift, arm lift, or thigh lift.3. Timing of Procedures:• The timing of combined procedures will depend on various factors, including the extent of the surgical procedures planned, the patient's overall health and recovery capacity, and the plastic surgeon's recommendations.• In some cases, it may be appropriate to stage the procedures, performing facial rejuvenation and body contouring surgeries separately to optimize safety and recovery.4. Surgical Approach:• Performing combined facial rejuvenation and body contouring procedures requires careful planning to ensure optimal outcomes and minimize the risk of complications.• The plastic surgeon will discuss the surgical approach, incision placement, and techniques used for each procedure to achieve natural-looking results and minimize visible scarring.5. Recovery and Aftercare:• Recovery from combined facial and body contouring procedures may require more time and careful monitoring compared to individual surgeries.• Patients will receive detailed post-operative instructions from their plastic surgeon and will be advised on activity restrictions, wound care, and follow-up appointments to monitor healing progress.6. Benefits of Combined Procedures:• Combining facial rejuvenation and body contouring procedures allows patients to address multiple concerns in a single surgical setting, minimizing overall downtime and recovery.• Patients can achieve comprehensive rejuvenation and transformation, restoring a more youthful facial appearance while also improving body contour and proportion.In summary, a facelift can be performed concurrently with body contouring procedures for patients who have undergone massive weight loss. By working closely with a skilled plastic surgeon, patients can develop a treatment plan to address their specific concerns and achieve their aesthetic goals safely and effectively.

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