Thank you for your question and for sharing your details. The combination of a breast lift with mesh and implants, lower body revision with skin removal and liposuction, arm lift, and back lift is a significant amount of surgery to undertake in a single session. While it may seem appealing to get everything done at once, this is too much for one procedure in terms of safety, recovery, and achieving optimal results. Even though your surgeon estimated it would take about five hours, these types of surgeries often require more time when done together. Prolonged surgical time increases risks, including complications with anesthesia, wound healing, and blood clots. Additionally, combining too many procedures can lead to a prolonged and more challenging recovery, making it harder to focus on healing specific areas effectively. I recommend breaking these surgeries into two stages: First Stage: Start with your breast lift with mesh and implants combined with either the back lift or arm lift. These procedures focus on the upper body and allow you to heal thoroughly in this area before addressing the lower body. Second Stage: Once fully healed, address your lower body revision with skin removal and liposuction. This area requires precise surgical work, and separating it ensures the best aesthetic and functional outcome. This staged approach prioritizes your safety while ensuring excellent, long-lasting results. Each area of your body deserves focused attention, and recovery will be smoother and more manageable. I encourage you to discuss a staged plan with your surgeon and ensure they are board-certified and experienced with complex body contouring procedures. Sincerely, Dr. Katzen