What would be suggested first? (photos)

I have lost 130# and have maintained the same weight for over a year and a half. Wanting to revamp my whole body. My chin/neck is what I dislike in every picture. I'm wanting start with it.. and my upper body lift.. whatever you can do in one surgery. I'm wanting to shed my batwings and have a breast lift, lipo and reshaping of my mid section (an appendectomy scar has made me lopsided), a tummy tuck, back lift and lipo to get rid of my back rolls. Then lower body lift could be in a 2nd surgery?

Doctor Answers 9

Which procedure first after massive weight loss?

Your priority should take precedence when selecting which procedure to start your post weight loss contouring. The ideal starting point is when your BMI is below 30. You'll expect to have several stages of different operations given the variety of goals which you have stated. The most common combination is probably tummy tuck and breast lift. If your face/neck appearance bothers you, then this can be approached first without burning any bridges for the subsequent procedures. Be certain that the Board Certified plastic surgeon has plenty of experience with body contouring and facial cosmetic surgery.


Norfolk Plastic Surgeon
5.0 out of 5 stars 11 reviews

Weight Loss and the Mommy Makeover

Congratulations on your weight loss success! It is best to undergo #MommyMakeover procedures when your weight has been stable for at least one year. 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, or #breastreduction. In addition to a one-on-one consultations with a board certified Plastic Surgeon, patients always need to be seen by their primary care doctor prior to such procedures.  We screen every patient and their medical records for risks of blood clots (DVT) and then take appropriate measures.  MWL (massive weight loss patients of  75 lbs or more) tend to have poor skin elasticity and will frequently need additional tightening even afte 6 -12 months regardless of who or how their surgery is performed. This is simply the nature of such body tissues and the ability to heal with the lack or limited elasticity. The costs of a #Mommy Makeover will depend on several factors. Such include the geographic location, the skill and experience of the surgeon, and operating room and anesthesia fees.  Also, such #combined operations are often performed with our Gynecology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries included with Mommy Makeovers. Therefore, if you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your doctor. Combining these procedures decreases anesthetics, costs, and recovery time. 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Body lifting after major weight loss

Thank you for asking about your body lift after major weight loss.
  • You are right to start with the area that bothers you most - your face and neck.
  • (You will probably get a much better result than a neck lift alone - because the face and neck skin are one unit.
  • The arm lift and breast surgery should probably be done separately. but this needs to be discussed with your surgeon after a full examination.
  • Surgery shouldn't take longer than six hours for safety - so it is best not to do too much at once.
  • The lower body usually will be a final procedure.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

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What would be suggested first?

Congratulations on your weight loss and your rejuvenated lifestyle! Keep it going! I would suggest you consider-  doing breast and abdomen at the same time. This will give you your greatest immediate benefit. Any more than this at one stage- may increase your risks. Your back, neck , thighs can be addressed in a second and third stages.

What would be suggested first?

Congratulations on your weight loss! Keep in mind that you may need more than just two surgeries to help you safely achieve the look you want. Best to communicate your preferences with a board certified plastic surgeon who takes the time to examine and evaluate you in person. He or she will then be able to figure out the best surgical plan for you! Good luck!!

What would be suggested first?

We have no information on your Ht/Wt and so cannot calculate your BMI, but it looks like it is still pretty high from the photos. The order of surgery is usually done based on your preference, but much better results can be obtained if your BMI is below 30.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

What is Suggested First?

Thank you for your question, and congratulations on your weight loss!
It sounds like you have already done the first step, which is prioritizing your "trouble spots".  By communicating that priority list to your surgeon, they will be able to come up with a good plan to combine surgeries safely to get you to your ultimate goals faster.
My patients typically desire contouring of their trunk first after they have hit their "weight loss plateau", and very often patients that have abdominoplasty/body lift procedures lose more weight after the procedure.  Removing the excess skin in the abdomen (especiall)y causes the body to have to "burn fat" from other areas, and having a tighter midsection improves the ability to exercise more effectively.  As the weight comes off, the other areas can be contoured.  Having said that, while that is "typically" the approach because most of my patients prioritize their abdomen highest, there is nothing wrong with doing the surgeries based on your priorities.
Again, congratulations on the weight loss, and best of luck on your journey!

-Dr. Dan Krochmal
MAE Plastic Surgery
Northbrook, IL

Daniel Krochmal, MD
Chicago General Surgeon
5.0 out of 5 stars 19 reviews

Which surgery first?

Congratulations on your successful weight loss!!!  Typically, I advise patients who will require multiple procedures to start with what bothers them the most.  So, I think that plan you have proposed is great since you say that your chin and neck bother you the most!  I would suggest that you discuss the staging of your procedures with your plastic surgeon, and good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 17 reviews

Sequence of events

I think that you have proposed a very good suggestion for the sequence of surgical event. In our practice we do a lot of weight loss surgery. One of the things that we do first is to prioritize your desires and sequence them  accordingly. I think that starting with your arms in chest is a great idea. And then the lower body lift, thigh lift and facelift can be done at anytime. In our practice we have three board-certified plastic surgeons and quite often we work together to make the procedures go faster for you. I would suggest seeing a practice that is able to offer you those kind of services.
Congratulations you're on the right  track! 

Mark T. Boschert, MD
Saint Louis Plastic Surgeon
4.9 out of 5 stars 19 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.