Lower body lift, arm lift (non-extended), and breast reduction/lift - Is it safe to do all at once?

Hello, and congratulations on your incredible 90-pound weight loss! That is an amazing achievement, and it’s great that you’re now considering body contouring surgery to complete your transformation.

A lower body lift typically takes around 6 to 7 hours, as it involves removing excess skin and fat from the abdomen, hips, outer thighs, and buttocks. A breast lift and reduction will depend on your breast size, but generally, this procedure takes around 3 to 4 hours. However, if your breasts are larger and require a significant lift and reduction, this could take longer.

For the arm reduction, it's important to clarify what you mean by "non-extended." Are you referring to a crescent incision hidden under the armpit, or are you considering an incision halfway down the bicep? Without knowing this, it's difficult to estimate the surgical time, but you're already looking at too much surgery for one round.

Most experienced, board-certified plastic surgeons would not recommend doing all of these procedures in one session because of the extensive surgical time, blood loss, and prolonged recovery. Instead, I would suggest staging your procedures:

Do the body lift and arm lift together in one surgery.
Wait at least 2 months, then proceed with your breast lift and reduction in a second procedure.
Alternatively, if you’re more concerned about recovery and minimizing risk, you could do the body lift first, then schedule the arm and breast procedures together about 2 months later.

This approach will give your body time to heal properly and will reduce your risk of complications such as poor wound healing, increased swelling, and prolonged anesthesia time.

Again, congratulations on your weight loss! I hope this helps guide your decision. Wishing you the best of luck with your surgical journey.

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FACS, FICS

Hi there,First of all — congratulations on your impressive weight loss! You’ve done the hard work, and now it’s absolutely reasonable to want to complete your transformation with body contouring surgery.
Can these procedures be combined?Yes — in the right candidate, combining a lower body lift, breast reduction/lift, and non-extended arm lift is medically feasible and commonly performed. The key lies in individual surgical planning, operating time, and patient-specific risk factors.
You mentioned that:
You’re 46 years oldWeigh 155 lbs at 5’4” (BMI ≈ 26.6)Have no need for abdominal muscle repair, which shortens operative timeWere quoted ~6.5 hours for combined surgeryAll of these are positive indicators in terms of surgical safety.
What we look at when considering combination surgery:1. Total Operative Time
Most plastic surgeons aim to keep surgery under 6–7 hours for combined procedures. Beyond that, risk of complications like blood clots, wound healing issues, and anesthesia-related events increases. At 6.5 hours, you’re within the safe range — assuming your surgeon has a well-coordinated team and operating facility.
2. Your Health Status
Age alone (46) is not a concern if:
You’re in good general healthYou’re a non-smokerYou have no uncontrolled medical conditions (diabetes, anemia, etc.)Your BMI (~26.6) is well within a safe and healthy range for body contouring.
3. Procedure Scope
Lower body lift: Moderate in surgical complexity, especially without muscle plicationBreast lift/reduction: Adds operative time, but is often done simultaneouslyNon-extended arm lift: Lower surgical burden than full-length brachioplastyThe combination is ambitious, but not excessive for a fit, healthy patient with good skin elasticity.
Our personal approach is usually to do these operations in 2 stages; 1st the lower body lift, 3 months after breast lift and arm lift. This will be the best and safest combination

Combining all the procedures that you want into one operation is possible, especially if your plastic surgeon is working with another plastic surgeon that can decrease the amount of time that you’re on the operating table. Most surgeons understand that after six hours, the rate of complications increases and therefore tried to avoid longer operations. In addition, you want your surgeon to be meticulous, and it is very common for patients to do the lower body lift first, recover for a few months and then have the upper body work done. Before either the separate operations or the combined operation, you should have a full history and physical by your primary care doctor with appropriate laboratories to be assure that it is safe to proceed with the procedure. Best wishes.

Thanks for your very important question. First of all, congratulations on your significant weight loss. That is not an easy feat! As for procedures, I typically recommend staging them when dealing with multiple areas in weight loss patients. An upper body lift is usually some combination of addressing the breasts, arms, and upper back. A lower body lift will address the midsection (abdomen, buttocks, hips, mons pubis). I would not recommend doing both of those together as the time under anesthesia is likely to be longer than what is considered safe for elective surgery.

Congratulations on your weight loss, well done!! The fact that you have no diastasis simplifies matters significantly. Your BMI is good at 26.6. Regarding your mid-section, I would recommend STAGE I liposuction of the abdomen, hips and waist combined with the circumferential body lift with umbilical transposition. This can be done with an oral cocktail for sedation and local tumescent anesthesia, no need to go under deeper anesthesia. No drains are needed. I have gravitated toward doing as much with local anesthesia given the safety profile and lack of complications. For STAGE II, I would proceed with the mastopexy and liposuction of the front bra rolls and arms with the brachioplasty. The outer aspect of the mastopexy scar will continue to the brachioplasty scar with the additional benefit of tightening and lifting the bra roll skin (see attached link for an example case). Thank you for the inquiry!

Thank you for your query. These are extensive procedures and combining them increases the risks and prolongs the recovery. I often combine minor upper body procedures with Lower Body lift , but would not advise combining all of them. Please discuss the risks and benefits of combined procedures with the different Plastic surgeons you have met and also the Anaesthesiologists, before making a decision. All the best!

Dear Thriving103304,

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

Congratulations on your impressive weight loss! For elective plastic surgery it is recommended to keep surgical time to six hours or less for safety and to maximize your results. From the procedures that interest you it would be wise to break them into two stages. I would also get a second opinion on the muscle repair. It would be unusual for someone to have lost that much weight and not benefit from muscle repair. It would be even more unusual if you have previous pregnancies.