Arm, thigh, breast, tummy after weight loss - will I have good results if combined?

Question

Hi I just had a consultation yesterday to get an arm lift, tummy tuck, breast lift and upper thigh lift. The Dr I seen is double board certified with over 35 years experience and seems confident that I can get this all done in a 7 and a half hour surgery. My question is.. are there patients that combine as many with good results is this doable if I have help a home as i would probably not be able to move much it seems. I lost almost 100 lbs and kept it off for 7 years. I am healthhy, I dont smoke, I occasionally drink, I am 43, I work out and strength train 4 to 5 days a week anf have a 21 year old. Would I be ok getting these all done in one big surgery? Thank you.

Paul M. Parker, MD, FACS · Answer

It would be helpful to know the specifics of what kinds of lifts you are having done in these areas. Some lifts take less time, some more. That said, it sounds like a lot of surgery to me to get done in 7 1/2 hours unless the surgeon has another surgeon working simultaneously with him--one surgeon working in one area while he works on another.

Kadir Berat Oyur, MD · Answer

Hi and thank you for your question.If there are too many combined surgeries and it will prolong the surgery time, sometimes either two doctors are involved or it is preferred to perform them in two separate sessions. It would be more appropriate to perform the surgeries you requested in two sessions.

J. Timothy Katzen, MD, FACS · Answer

Hi Versatile794412, Thank you for your question regarding whether you can undergo arm, thigh, breast, or tummy surgery after weight loss, and whether you will have good results if combined.  Thank you for your history.  Congratulations on your weight loss.  The short answer is that it is better to stage these procedures.  Even though your planned post-weight-loss surgeries can be performed physically, that doesn’t necessarily mean they are safe to perform as a single combined surgery.  In the late 1990s, reconstructive plastic surgery after a massive weight loss began to be a plastic surgery subspecialty.  This is primarily due to the obesity epidemic and the subsequent increased number of patients who were losing 100 pounds or more.  During that period, plastic surgeons specializing in reconstructive surgery after massive weight loss performed these procedures in a single surgical setting.  However, research from that time has found that recovery was longer, often required hospitalization, and many times required blood transfusions.  Research has shown that staging these procedures is safer and better.  Complicating issues include the length of your incision line.  Complication rates increase with surgical surface area or incision line length.  That means the longer the incisions, the higher the risk of infection, more wound-healing problems, and a greater chance of seromas, hematomas, or wound breakdowns.  If this were to include your arms, thighs, breasts, and abdomen, this is a significantly long incision line for your body to heal.  Additionally, your body needs many vitamins and protein to heal.  Unfortunately, most patients lose their appetite after surgery, fail to eat, and thus experience wound healing problems.  Also, many weight loss patients are anemic and do not have good oxygen-carrying capacity.  Anemia further complicates wound healing problems.  
Even though you are healthy and work out almost every day, most plastic surgeons who specialize in reconstructive plastic surgery would still stage your surgeries.  Additionally, the more surgeries, the more difficult the recovery.  Recovery after combined surgeries is multiplicative rather than additive.  The pain after combined plastic surgery procedures becomes harder to control, and the mobility becomes more limited.  After massive weight loss, most plastic surgeons specializing in reconstructive plastic surgery stage these procedures into 2 or more surgeries.  The first surgery would typically include the abdomen and the thighs.  One or two months later, you could undergo breast and arm procedures.  Please give yourself a 2-week recovery period for each procedure.  Research on plastic surgery has shown that staging these procedures is preferable to undergoing a single major surgery.
Good luck.  I hope I have answered your question about whether you can undergo arm, thigh, breast, or tummy surgery after weight loss, and whether the results will be good if combined.
If you have any more questions regarding combined surgeries after massive weight loss, contact an experienced plastic surgeon.  Please seek an experienced, board-certified plastic surgeon with significant experience in reconstructive surgery after massive weight loss. Ensure they have performed many of the procedures you are seeking and have before-and-after photographs to document them.  Carefully examine their before-and-after images and review their RealSelf reviews.   If you cannot find an experienced plastic surgeon in your neighborhood, consider traveling out of state.  Sincerely, Dr. Katzen.  ( 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.)

Daniel Barrett, MD · Answer

Dear Versatile794412,

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

Luis A. Mejia, MD · Answer

In my opinion, yes, this is doable in healthy, well-selected patients like you. Stable weight, non-smoker status, good fitness, and home support all work in your favor. Many post–weight loss patients safely combine a tummy tuck, breast lift, arm lift, and thigh lift with good results when surgery time and recovery are carefully managed.

Safety and planning are key.

Whenever you’re ready:
Let’s make it better.

Warmly,
Dr. Luis Mejía, MD
Board-Certified Plastic Surgeon
CECILIP, Dominican Republic.

Safety and planning are key.

Whenever you’re ready:
Let’s make it better.

Warmly,
Dr. Luis Mejía, MD
Board-Certified Plastic Surgeon
CECILIP, Dominican Republic.

Gary M. Horndeski, MD · Answer

Generally, the safe operation time for cosmetic surgery is 6 hours. I recommend you have 2 sessions to complete all these procedures. I would do the breasts and tummy first and then the arms and thighs second. Another alternative would be the breasts and arms first and then tummy and thighs second.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Harry T. Haramis, MD, FACS · Answer

While it may be possible to perform everything in one setting, the recovery would be extremely difficult. Getting up and moving around with abdomen, breasts, arms and legs would be difficult. Unfortunately, after massive weight loss, stages are commonly planned.

Rather for safety, recovery, we recommend staging these procedures.

Many combinations are possible. Generally, tummy tuck with or without breasts is one option. Also, breasts with arms as one stage, tummy tuck with or without thighs as another one or two stages. Time between depends upon recovery- usually several weeks to months.

Finny George, MD · Answer

Hi, thank you for sharing your question. There are significant risks to your health, recovery and cosmetic outcome when combining elective cosmetic procedures that last beyond 5 hours. Risks of blood clots, wound healing, infection/sepsis and uncontrolled pain should be considered.

Vasileios Vasilakis, MD, FACS · Answer

Hello,
Thank you for the question. If the surgeon specializes in these procedures, and body contouring is the field of his/her expertise, then these procedures can be combined. 
I wish you the best. 
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss! Combining procedures is common and considered safe but there is a limit.  The recommendation is that operating time for elective plastic surgery should not exceed six hours.  This is for your safety and to optimize your result.  It's difficult to determine if combining all of these at once can give you good results without examining you.  You may want to visit a few board certified plastic surgeons for opinions.

Arm, thigh, breast, tummy after weight loss - will I have good results if combined?

Answers (10)

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