In what order should I stage my procedures after massive weight loss?

Hello,Congratulations on your success! There is no set order, but instead it depends on multiple factors, including your personal priority, proper grouping of certain procedures, and time. I have found that the most expeditious way is to group brachioplasty, breast lift/aug, and either upper body lift or abdominoplasty together. This essentially leaves the rest of the lower body and inner thigh for the second stage. I prefer to break up the lower body lift into abdominoplasty and posterior body lift to reduce the risk of complications.  Additionally, I think it is realistic to prepare for a possible third stage for minor revisions, as the skin can frequently loosen just enough to affect contours in some areas.Best of luck!

Thanks for your question. There are different views on this but mine is to do the largest procedure first. In your case - as is most cases of massive weight loss - this would mean a lower body lift. This procedure excises tissue from around the entire body resulting in an abdominoplasty ("tummy tuck" is an understatement here) at the front, and a buttock lift at the back. It even tightens the lateral aspect of the thighs. I would not combine this procedure with anything else since it is rather extensive.Subsequent procedures I do in pairs, usually in order of patient preference. These include but are not limited to:Arm lift (brachioplasty)Breast lift +/- augmentationUpper body liftFaceliftThigh lift

Dear BeTheUnicorn,Again, congrats on the weight loss and keeping it off so long. The grouping of the procedures can very based on your goals.  There are a few ways to do this. This is one of the more common ways I approach it, but I will can tailor the order of these based on what bothers the patient most or their goals. 1. lower body lift, with or without gluteal autoaugmention (the usually flat buttocks gets even flatter with a body lift so most patient benefit from augmentation of the buttocks at the same time), some times a vertical component  to the tummy tuck (fleur-de-lis abdominoplasty) needs to be added to address the horizontal skin excess (or this can be addressed later with lateral thorax excisions)2. upper body lift with breast surgery, possibly adding the arms or thighs3. thigh lift, and possibly lateral thorax excisions (if necessary depending on your horizontal skin laxity)Some surgeons prefer to do everything on the front first followed by everything on the back feeling they get better results that way. The best way to figure out a good plan for you is to seek an in person consultation with a plastic surgeon so they can examine you and come up with a plan based on your needs and desires. Best wishes. 

It is usually more reasonable to divide the procedures with the tummy tuck/lower body lift performed first.Find a board certified plastic surgeon who performs hundreds of tummy
tucks and body contouring procedures each year. Then look at the
plastic surgeon's
website before and after photo galleries to get a sense of who can
deliver the results. Kenneth Hughes, MD Los Angeles, CA

Thank you for your question and photo. Congratulations on your weight loss. The way I prefer to stage these procedures, is to do the abdominoplasty and lower body lift first (this is where the money is!) You will feel better instantly with all that looseness gone from your body. My next stage would be extended arm lifts with a breast lift +/- an augmentation. I like to do the thigh lift last, but I often liposuction the thighs during the other stages to give you the best results with the lift. See a board certified plastic surgeon well trained in body contouring procedures for a consultation. Good luck.