Maintaining a weight of about 160 and I'm 5'4. How many procedures could I have done at once? (photos)

Question

I had VSG surgery June of 2020 and have lost a little over 100 pounds. I've been maintaining a weight of about 160 and I'm 5'4". I'm looking to start my plastic surgery journey but I'm curious as to how many procedures I could have done at once as well as what procedures should I start with. My main areas of concern are pretty much my entire top half; arms, upper back, breast, tummy and I desperately want a bbl.

Gary M. Horndeski, MD · Answer

I would begin with your breasts and abdomen. The technique I recommend for the breasts is a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. At the same time, a tummy tuck can be done. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight. After these have been completed, you can consider a circumferential lift or back lift or liposuction. The last procedure would be fat transfers to the buttocks.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear J215_267,
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

Miguel Mota, MD · Answer

Congratulations on your weight loss! If you want everything done, for safety reasons, you will need several rounds of combined procedures, assuming your pre-op evaluation is good and you qualify for combined procedures.

If the BBL is your main concern, start with a TT lipo BBL. You will definitely need a back lift after that. So I recommend a Back Lift plus Breast Lift with Implants as your second round. If you want to keep going, a thigh lift is a possibility. Thigh Lift plus Arm Lift as your third round should work.

Best of luck,
Dr. Miguel Mota

Michele A. Shermak, MD · Answer

Hello! Congrats on your weight loss success!
There is no set answer for this question. Much depends on your goals, your medical health, and any financial limitations. In a healthy patient it is not unreasonable to address arms, breasts and abdomen at same time. Liposuction of the back and fat transfer need to be discussed and considered after closer assessment of time need and any health concerns.
Best of luck to you. Be sure to find a board certified plastic surgeon. You can find one at plasticsurgery.org.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  Combining procedures is common and considered safe but there is a limit.  Generally elective plastic surgery is limited to 6 hours of surgical time for safety and to optimize outcomes.  I encourage you to visit with a board certified plastic surgeon near you to discuss your goals and prioritize the procedures.  It makes sense to address the breasts and tummy first since they are adjacent.  I've included a video I hope you find helpful.

Mehmet Fatih Okyay, MD, FEBOPRAS · Answer

Hello,
Post-Bariatric surgery journey starts with being at the same weight for minimally three, ideally six months.It's first principle is start from the centre. In my opinion first plan might be Lipoabdominoplasty including 360 degree waist liposuction with also 360 degree thigh liposuction and for breasts augmentation mastopexy. If necessary arms could be added as liposuctionSecond shot would be bra-line back lift and thight lift.It is possible to get early result at the end of 2-3 months and final result could take 6-12 months with 3-6 weeks corset usage. We minimize this period thanks to lymph drainage massages.
Best.
Mehmet Fatih Okyay, MD, FEBOPRASAesthetic & Plastic Surgery Specialist

Eric Maiorino, MD · Answer

Congratulations on your weight loss journey! That's pretty amazing. The number of procedures performed and in which order to have them done is partly a decision to be made by you (what areas bother you the absolute most) and your surgeon (timing, safety, recovery after surgery). For my massive weight loss patients, I usually recommend starting with the trunk procedures first (breast, abdomen, back) because that usually offers the biggest change in your appearance and also is the biggest recovery. I usually don't combine the arms with a tummy tuck since you'll need to use them to help with mobility. Hope this helps and good luck on your journey!

Darryl J. Blinski, MD · Answer

Congrats on the weight loss! As you state 'desperately want a BBL'. Then start there! You will need at least 3-4 separate surgical procedures over the course of a few years in my opinion.

Mats Hagstrom, MD (license on probation) · Answer

There are advantages and disadvantages to having combined procedures.

Adding too much surgery increases risk for medical complications and makes recovery more challenging.

Most patients start with the procedures that will have the greatest impact and surgeons will typically set a limit on how many procedures or hours of surgery they feel comfortable doing in one session.

When too many procedures are scheduled for one day surgeons may be tempted to cut corners to get through the procedure in a reasonable amount of time.

Doing things well simply takes time.

I would say the first procedure most weight-loss patients and bark upon is an extended or wrap around tummy tuck a.k.a. body lift.  this could be done in conjunction with a breast lift with or without implants.  that is probably a reasonable and appropriate combination to start with.

A second stage procedure could include arm lift, armpit skin excision and BBL and add any revision work that may be needed from the first procedure.

Different plastic surgeons will have different opinions and different approaches on how to do this. I suggest starting the process by having multiple in person consultations with local board-certified plastic surgeons to get an accurate assessment and better understanding of each procedure.

Best,

Mats Hagstrom MD

Gokhan Temiz, MD - Account Suspended · Answer

Hello and greetings from Turkey. First of all, congratulations on your weight loss. It is a very good progress. After the massive weight loss, patients require multiple sessions of plastic surgery to get the desired body shape. In your case the required procedures will be 360 body lift to get rid of the excess skin around tummy, sides and lower back, breast implant&Uplift to lift the saggy breast tissue and achieve the good volume, Arm Lift, Back Lift and Thigh Lift procedures. All treatments should be divided into different sessions. I personally decide the combinations of the surgeries that can be performed after the medical background check because all of them are the major procedures. I strongly advise you to contact with the board certified surgeons to decide the combinations of the treatments.

Maintaining a weight of about 160 and I'm 5'4. How many procedures could I have done at once? (photos)

Answers (10)

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