Full Mommy makeover, BBL, TT & BA. Is this too much stress on the body with these surgery after a sleeve?

Question

I am currently obese (BMI 40, 5'10", 275) and will be undergoing a sleeve procedure. Is this too much stress on the body with these surgery after a sleeve? What is ideal BMI for me? Is my goal of 36-24-40 realistic? What should I do to ensure I'm healthy enough for plastics? Any advice is greatful. I just want to be prepared in terms of my consultation since I want to visit DR prior to surgery and meet with about 3 doctors (their team) thanks for reading!

Carlos Mata, MD, MBA, FACS · Answer

Hi xoxo,Thanks for your question. A mommy makeover is no small undertaking especially after massive weight loss. A safe BMI should be less than 30. Your ideal measurements can only be achieved if YOUR body structure allows for it. You can certainly find good plastic surgeons in the DR, but should you have a problem, you are likely on your own. Safety should be your number one priority. Standards in other countries are not regulated as tightly as the US. Be safe, have a stable weight for at least 6 months, and be realistic and make sure that your doctor checks your health status first before considering your surgery.

All the best,

Carlos Mata MD, MBA, FACS

#mommymakeover #massiveweightloss

Board Certified Plastic Surgeon

All the best,

Carlos Mata MD, MBA, FACS

#mommymakeover #massiveweightloss

Board Certified Plastic Surgeon

Jed H. Horowitz, MD, FACS · Answer

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, #breastreduction.Now, it is usually best to reach your ideal weight before the actual procedure. When patients have experienced extreme weight loss due to diet and exercise, #gastricbypass surgery, or #stomachstapling  or #lapband surgery, there will be excess body skin that needs removal. In order to correct this problem many patients will need a #TummyTuck surgery, #panniculectomy, or #abdominoplasty.  This is becoming a highly requested procedure among patients who wish to rid themselves of excess skin and tighten muscle in their abdominal area. This procedure can be beneficial for women with loose skin and stretch marks following pregnancy, and patients who have undergone significant weight loss. Note that there is also the option of liposuction in a mommy makeover to remove excess fat and tissue from different areas of the body.

Rodger Shortt, FRCSC · Answer

A breast lift, breast augmentation, and tummy tuck are often done together.  In healthy people this is a very safe combo.  It is possible that you will need more than just a tummy tuck after you lose all your weight.  When you lose a significant amount of weight then a body lift or what is known as a circumferential tummy tuck may be needed.  This is  a lot more involved.  The surgery takes a lot longer and the recovery puts more stress on your body.  In this case I usually would advise patients to stage the surgeries.  Your surgeon can better advise you as they will have a more complete picture of your overall health.

Prashant Soni, MD · Answer

I frequently perform this combination  of surgeries on my patients after gastric sleeve or bypass. Safety  requires a very thorough history and physical , that can only be performed in person with a board certified plastic surgeon.It is best if  your BMI  is  close to 30  and that your weight has been stable for at least  6 months.  . See your primary care doctor for a evaluation of  your nutritional status before  any  body  contouring.  .Discuss with your  plastic surgeon the use of deep vein thrombosis prophylaxis during and after surgery. Also have your surgery performed closer to home. Flying soon  after  abdominoplasty results in more blood clots. Furthermore, close followup with you surgeon often is impossible if you live  far away. This is very important if you are having concerns or healing issues. Best regards, Prashant Soni, M.D.

Camille Cash, MD · Answer

I wish you well on your weight loss journey!  Be sure to closely follow your surgeon's instructions for successful, healthy weight loss and obtaining your goal weight.  Once you have achieved this and can maintain your weight it will be time to schedule your consultations with board certified plastic surgeons.  It is recommended to keep surgical time to six hours or less, which means you will likely need to have two stages, especially with significant weight loss.  A BMI of 30 or under is recommended to be a candidate for surgery.

Ken Stewart, MD, FRCS Plast · Answer

Achieving a safe steady weight and maintaining a healthy dietvare essential for optimal outcomes.
The details of the procedures you need will be determined by the effects of the weight loss.

Jon A. Perlman, MD (retired) · Answer

Thank you for your question. I think planning ahead is a very good idea and should help you get through the initial healing phase after your sleeve procedure. Once your weight is stable you will be a good candidate for the procedures that you mention but will probably need to consider a full mastopexy in addition to the breast augmentation procedure. Since anesthesias over six hours have an increased risk of deep vein thrombosis and potential pulmonary embolism I would recommend that you consider separating the procedures sharing the breast lift//aug with fat harvest and injection into the gluteal area with a separate anesthesia for future tummy tuck. I know that this does increase the expense but is also safer in my opinion.

When the time comes discuss your options with your board-certified plastic surgeon. Best wishes.

Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California

When the time comes discuss your options with your board-certified plastic surgeon.  Best wishes.

Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California

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