How safe is it to combine TT, BBL, breast lift and arm lipo for loose skin following weight loss?

Question

I had major weight loss, going to have surgery in August. Lost 70lbs & have loose skin. Surgeon is experienced in combo procedures & is confident in combining. Aware that with TT & BBL I won’t be able to sit on my butt or lay on my stomach, but I’m prepared for that. I'm combining everything b/c it’s going to be hard for me to take off more work & I’d rather get everything over with. Concerned about the dangers of being under anesthesia for so long + possibility of shock due to so many procedures. BMI is 24, exercise everyday, healthy 25 year old.

Kenneth Hughes, MD · Answer

Because of your age, health, BMI, and exercise routine, these procedures can be combined in one surgery if your board certified plastic surgeon is an expert at all of the procedures and has great reviews and great before and after pictures on his/her web page. For safety reasons, your PS would want to limit the surgery time to six hours or less.  You also need to consider the recovery involved with each of these procedures. You might want to stage the procedures:  lipo and BBL first; three to six months later have the TT, and breast lift.

Luis A. Mejia, MD · Answer

Hello, thank you for the question.Congrats for you hard work girl! Personally, I think is safe but with a limit. If youre healthy enough, yourr hemoglobine levels are high enough and all the exams says you're ready, we could do it. Safety first!!Make sure you're getting a surgery with a responsible board-certified plastic surgeon and everything's gonna be alright!
Best of lucks :)
Dr. Luis Mejia

Gregory Lakin, MD · Answer

Thanks for your question. Combining these procedures is difficult to obtain optimal fat graft results because during recovery you need to avoid lying on your sides/butt after a BBL which is difficult to do if you simultaneously had a tummy tuck and breast lift. Good luck

Daniel Barrett, MD · Answer

Dear  Tasteful684820,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question.  In most surgeons hands this combination of procedures would exceed what would be reasonable for an aesthetic procedure but it ultimately depends on the exact extent of work each procedure would entail for you.  I would recommend posting photographs for better answers, or seeking out second opinions in your area.

Robert M. Tornambe, MD · Answer

Congratulations on your weight loss! Most board-certified plastic surgeons prefer to stage that many procedures. It is safer and better for your recovery. BBL and Tummytuck operations each carry a higher incidence of blood clot formation and possible harm or blockage of the lungs. Performing them simultaneously statistically increases the chances of this occurring. Also, recovery from BBL requires no pressure on your buttocks for two weeks after surgery to preserve fat take. You also cannot lie on your stomach after tummy tuck, so this limits the positions that you can recover.  Also, the maximum OR time for an ambulatory operation should be no more than 6 hours, BBL and MM certainly takes longer.  It is best to perform the BBL and arm liposuction first, to allow your surgeon to harvest as much fat as possible for transfer. 4 to 6 months later, mommy makeover surgery can then be performed. Be certain to consult with a board-certified plastic surgeon  to increase chances for the best possible results. Best of luck.

Heather Vande Ven, DO · Answer

It's important to consult with a experienced cosmetic surgeon who can provide personalized advice based on your specific medical history and needs.Combining multiple surgical procedures, such as tummy tuck (TT), Brazilian butt lift (BBL), breast lift, and arm liposuction, can be done in certain cases, but there are several factors to consider:
1.) Overall Health: Your general health and medical history will play a significant role in determining whether it's safe to combine multiple procedures. Your surgeon will assess your fitness for surgery, anesthesia considerations, and potential risks.
2.) Surgical Time: Combining multiple procedures can increase the duration of surgery, which may increase the risk of complications, such as blood clots, infection, and anesthesia-related issues.
3.) Recovery: Combining multiple procedures can also extend your overall recovery time. Recovery can be more challenging when multiple areas of the body are healing simultaneously, and you'll need to follow post-operative instructions carefully to minimize complications.
4.) Blood Loss and Anesthesia: Longer surgeries can lead to increased blood loss, which may require blood transfusions. Additionally, undergoing anesthesia for an extended period can increase the risk of complications.
5.) Results: While combining procedures can offer comprehensive results in a single session, it's important to manage expectations. Your surgeon can help you understand what results are realistic and achievable.
6.) Surgeon's Expertise: It's crucial to choose an experience plastic surgeon with ample experience in the procedures you're considering. A skilled surgeon can minimize risks and help achieve the desired outcomes.
7.) Individual Assessment: Every individual's body and medical history are unique. A thorough consultation with your surgeon will help determine which procedures are most appropriate for you and whether they can be safely combined.
8.) Alternatives: Depending on your specific goals and concerns, it might be possible to stage the procedures over multiple sessions, allowing for safer recovery and reduced risk of complications.
Always prioritize safety and thorough communication with your surgeon. They will assess your specific case, discuss the potential risks and benefits, and guide you in making an informed decision about combining multiple procedures.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss! Combining procedures is common and considered safe, but there is a limit.  Typically elective plastic surgery is limited to 6 hours or less.  Depending on the extent of the procedures you are considering you may be going over this timeframe.  This increases the risk of complications as well as the outcome of your surgery. I would also caution you that liposuction to your arms if you already have loose skin will likely lead to more loose skin.

Robert Singer, MD · Answer

Congratulations on your weight loss. Combining cosmetic plastic surgery procedures is not uncommon. Whether you are a reasonable candidate for those procedures depends on your anatomy, your medical history, the extent of the procedures, realistic expectations of the outcome and an understanding of the pros and cons of the various procedures. 
 
 Safety should always be the main concern. It is generally recommended that the length of elective surgery be less than six hours. The procedures should be performed in an ambulatory facility that is accredited by one of the national organizations like the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF) or in a licensed hospital. Many surgeons would recommend an overnight stay at an appropriate facility where you can be appropriately monitored. Most patients prefer undergoing one anesthesia and one recovery period which is usually more cost effective.

Having said all of that, most ethical well trained plastic surgeons would feel that the combination you are asking about is excessive and has significant risks factors if performed in one stage. 
 
 Keep in mind that following the advice of any surgeon on this or any other web site who proposes to tell you what to do without: examining you, physically feeling the tissue, assessing your desired outcome, and taking a full medical history, as well as discussing the pros and cons of each operative option would not be in your best interest. I would suggest you find a Board Certified Plastic Surgeon certified by The American Board of
 Plastic Surgery who is ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with, and discuss your concerns with that surgeon in person. That way, you can have a better idea what is safe and makes the most sense for you.
 
 Before proceeding with a combination of these procedures, you should have medical clearance from your primary care physician and a discussion between him or her and your plastic surgeon.
 
 Robert Singer, MD FACS
 
 La Jolla, California

Robert L. Kraft, MD, FACS · Answer

This is much too much surgery. The risks aren’t solely with respect to an embolic event, which is real, but also results oriented.   Real life is not like what you see on television. If you have loose arm skin, then liposuction would aggravate the sagging.   Surgery should be divided into two sittings with three months between them, given the extent involved.

How safe is it to combine TT, BBL, breast lift and arm lipo for loose skin following weight loss?

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