I have a pacemaker - can I have arm lift & tummy tuck at the same time? (Photos)

Question

Gastric bypass in 2018, Highest weight 403lbs and currently 176lbs. I've maintained this weight for over a year and feel time for skin removal. Id like an arm lift and tummy tuck. Problem is, I have a pacemaker. I cant seem to find a surgeon that will do both surgeries at once so that I can cut cost. I cant afford to dish out $40,000 per surgery or even for just 1. My cardiologist has given me the go ahead and said the skin removal would be beneficial. Please HELP

Carmina Cardenas, MD · Answer

It is wonderful what you have achieved after the bariatric procedure!!!
But you must acknowledge that what you need is way bigger than just a Tumky Tuck. TT is for patients who have had 2-3 babies and have developed saggy skin only on the front abdomen.  You are a massive weight loss patient and you have developed a severe degree of saggy skin on multiple vectors: length and width, so,the correct approach is completely different. You are candidate for a Lower Body lift Fleur de Lis ((360 incisión and a vertical un the mid line) in order to romove and tighten the double vectors of saggy skin. Otherwise your results will be very Poor. 
Regarding doing combination of procedures of different anatomical regions it is best to treat one at a time. You are absolutely an Arm Lift candidate. 
Because of safety your procedures must be staged. Safety must be priority and not the money. 
Long and invasive procedures together are proven to have higher risk of complications and you don’t want that. 
Look for a PS expert in After Weight loss surgery and first priority Safety. 
Be encouraged. 
Dr. Cárdenas

Gary M. Horndeski, MD · Answer

If you are cleared medically for 4-6 hour surgery then you can have both surgeries done simultaneously. The tummy tuck takes about 3 hours and the arm lift takes about 2 hours. Your physician will also need to know if the pacemaker can be turned off so it is not activated by electrocoagulation used during surgery.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Harry T. Haramis, MD, FACS · Answer

Wow that’s a tremendous weight loss!

You may want to consult with more plastic surgeons for estimates combined as well as staged arms plus tummy tuck.

Any massive weight loss may require more than one stage in various body parts for optimal results.

Cardiac clearance is good to have.

In my experience, combining is a long surgery but may be possible.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Congrats on all your weight loss! First let me say that it is possible to have an arm lift and a tummy tuck at the same time, there is no absolute contraindication for that. However, if some doctors are advising against it, there is likely a reason for that and it is probably for a safety reason. A combo procedure like that is going to be a long surgery and there may be other issues in your medical history (pacemaker or other) that are leaning your consults from combining the surgeries. And it is not to try to charge you more money but it is in the interest of your safety. However, only a consultation and discussion with a plastic surgeon who is board certified by the American Board of Plastic Surgery will tell you for sure. Also just a side note, based on your photos and your history, you are likely going to benefit from more skin removal from the trunk than a standard tummy tuck and are likely going to be a better candidate for a fleur-de-lis tummy tuck or circumferential body lift. Hope this helps

Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Ronald J. Edelson, MD · Answer

I don't think I would do both procedures at the same time either. It's a lot of surgery to do at once in someone with any cardiac issue.  It's simply not a good idea to do both together. Don't take the risks. It's not worth it

Daniel Barrett, MD · Answer

Dear ChristalB43,
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

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  Safety is always the number one priority with surgery.  Typically surgeons limit elective plastic surgery to 6 hours.  With the amount of excess skin that you have you will likely need to stage your procedures.  This is for your safety and to optimize your results.  I've included a video about plastic surgery after major weight loss that I hope you find helpful.

Darryl J. Blinski, MD · Answer

Congratulations on the terrific weight loss. The issue is you need in hospital surgeries. In addition a team of boarded Plastic Surgeons most be available to decrease the surgical time. Along with written clearance from your cardiologist and internist. The operations would be in 2-3 separate stages and YES the fees are in the $40,000+++ ranges in toto. BTW are you anemic?

Mark Eberbach, MD · Answer

Congratulations on your weight loss.

You are a candidate for brachioplasty and probably a trunk lift. A TT will not be sufficient. So there are at least two problems to understand. Duration of surgery and complications from the pacemaker.

Arms would take about 2,5 hours. The trunk lift will take 4-6 hours. both is too long for a single operation.

Pacemakers sometimes act up with cautery making you need a hospital setting rather than an outpatient office center.

It can be complex.

I attached a link that discusses this.

Good luck.

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