How much weight do I have to lose to get the procedures I want and can I get them all at once?

Thank you for sharing your question.  In most cases it is best to be at a BMI of 30 and below in order to maximize surgical results and minimize surgical risks.  That said in order to approach a BMI of 30 you will develop increased skin laxity that may require an excision procedure such as a thigh/arm lift.  Best to see a series of surgeons in consultation to discuss your concerns. 

Dear  Epic2020,
generally speaking, you want to reach your goal weight before you consider a surgery, otherwise your results will be suboptimal if you continue to lose weight after the surgery. 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

A BMI of 35 is probably the upper limit that a plastic surgeon would consider for this procedure.  Losing to 180 pounds would put you in the normal BMI range for your height and weight.  Recommend that you discuss a diet and exercise plan with your PCP provider to "jump start" your progression to fulfill your goal of having a MM along with arms and thighs lipo.  

Hello and thank you for your question . The desirable BMI should be 30 or below before you have any surgery. A BMI of 42-45 is too high and your safety comes first. When you are close to your goal, meet with a Board Certified Plastic Surgeon in your area.

Based on the information provided your current BMI is 45.3.  It is recommended to have a BMI of 30 or under when considering elective plastic surgery.  At your height that would equate to a weight of 200lbs.  Those above the BMI threshold of 30 are at higher risk of complications from surgery such as poor wound healing, seroma and infection.