Congratulations on the weight loss! Whether or not it's safe to do both procedures together depends on a number of factors, and it varies based on factors related to both you and your surgeon. First, the extent of each surgery needs to be determined. Some patients require more extensive work than others, just based on body frame and amount of excess skin, and if there are additional things to be done such as hernia repair or working around a port, for example. Also, the thigh procedures to be recommended also vary based on the degree of excess volume and amount of excess skin. For example, some patients have a small triangle of loose wrinkly skin and excess volume along the upper inner thigh, and other patients may have extensive cellulite and volume circumferentially, plus excess loose skin. The procedures for these 2 patients will be different. In one patient it may be reasonable to do a single stage thighplasty, while in the other patient it may be better to do the thighs in 2 stages, first with liposuction and second with skin excision. Without seeing you in person or with photos, it is hard to answer how extensive or limited of a surgery you personally would require, or answer whether or not it would be safe for you. I do a lot of body contouring for patients who have lost a lot of weight, and every patient is different and has different problem areas, different degrees of laxity or volume issues, and different levels of surgical complexity. Therefore I make individual treatment plans for each patient, and discuss which procedures could be done together and which are safer to do alone. In some patients it would be safe to combine these two, and in others I would not recommend it. Keep in mind after a tummy tuck you will have soreness along your abdomen, and during recovery patients use their arms and legs to help take the load off of their core. For example, if trying to get out of bed, a patient may push up with their feet and pull themselves up with their arms. If you have thighplasty at the same time as a tummy tuck, your thighs are also sore and this makes it more difficult. If you're in good physical shape, and strong, and have high pain tolerance, combining procedures may be less of a burden to you than in someone who lives a more sedentary lifestyle, has less muscle tone, and is very sensitive to pain. The number one thing I worry about after a tummy tuck is actually the risk of DVT, which if unrecognized or untreated can be life threatening. Also, if comparing different surgeons, keep in mind each surgeon has a different level of experience, expertise, and stamina. Some surgeons prefer to do a tummy tuck and thigh lift on their own, and can do so in a reasonable time period with great results. Others prefer to have an assistant surgeon help close the incisions to minimize your operative time. Others feel they cannot deliver optimal results for both sites in one sitting, or simply prefer them to be done separately. There is a safety factor in terms of trying to limit operative time to ideally 6 hours or less too, so each surgeon has her/his own time estimates for each procedure to consider. The only way to give an accurate answer to your question would be to see you in person for a consultation, but I hope this information helps answer why different surgeons have recommended different things.
