Where to start to remove excess skin after 150+lbs weight loss?

Hello ShelMert in Deerfield Beach. Thank you for your question regarding where to start with excess skin removal after significant weight loss.

First off, congratulations on your incredible weight loss! I recommend starting with the areas that bother you most. Given your situation, I understand that the arms and thighs are your biggest concerns. However, please note that recovery from surgery on both the arms and thighs can be very painful and challenging to manage simultaneously.

If you have adequate support at home—someone to help with feeding, getting to the restroom, drinking water, taking medications, etc.—then it might be feasible to get both procedures done together, along with neck liposuction since that is a relatively small procedure to add on.

For the next step, you could consider a body lift combined with a breast lift and augmentation, if that aligns with your goals.

Good luck, and I hope I’ve answered your question regarding where to start with your skin removal journey.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Thank you for your question and congratulations on your weightloss journey!
Body contouring combinations can vary depending on your goals and priorities. We typically start with the abdomen (tummy tuck or 360 torsoplasty/lower body lift) and a breast procedure (lift, reduction, implants/lift). This tends to provide a very dramatic transformation for the first stage. The arms and thighs are often done next.
However, if the arms and thighs bother you the most - there is nothing prohibiting you from doing those surgeries first.
I would seek out a couple consults with board certified plastic surgeons who specialize in body contouring to get more information.

The best way to start is precisely with what you feel bothers you the most in this case if it is arms thighs they can be done at the same time and in a separate session you can finish up tummy, tuck breast and arms! Would have to wait around 4 to 6 months in between the procedures once everything is healed to be able to submit to the second session. By the way, congratulations on the weight loss that is an amazing accomplishment!

Congratulations on your successful weight loss! I would recommend prioritizing your wants. Schedule a consultation with a board certified plastic surgeon to discuss your options. Your surgeries will be staged for safety. Wish you the best of luck!

Great question and certainly a personal one. I tell all my patients to start with what bothers them the most. There are combinations however that make sense in recovery.
For upper body:Breast lift with arm lift. Can do lipo under chin as well
For lower body:Abdominoplasty with thigh lift.
Separate the procedures by 6 months.Hope this helps.

Thank you for the question! If the excess skin on your arms and legs bother you the most then that is what I would recommend that you start with. A brachioplasty and thigh lift can safely be done in one procedure. There are multiple different procedures that can safely be done in one procedure. I would recommend consulting with a board certified plastic surgeon like myself so you can make a surgical plan that meets your goals.

hello,

First, congrats on losing the 150 pounds! That is really fantastic and it sounds like you have kept the weight off. Great!

All of these procedures can be done separately and many of them can be combined in one operative session. You mentioned that you dislike your arms and thighs the most. My only suggestion with regards to timing of these two procedures is to do the lower body lift *prior* to doing the inner thigh lift.
However, the lower body lift does include the OUTER thigh lift.

The lower body lift includes a tummy tuck, outer thigh lift, and posterior buttocks lift. With the lower body lift, you will see a dramatic improvement in your outer thigh profile-- giving you leaner looking legs, In some instances, the lower body lift will slightly improve the inner thighs. But you may decide to have the inner thigh lift done later anyways.

Another option for you is to do an Extended Tummy tuck, which is a Tummy Tuck with the Outer Thigh Lift. This is for patients that do not have a lot of skin hanging over the buttocks, and do not need the full lower body lift. That procedure can be combined with a breast lift in the same session.

Lipo under the chin is the easiest of all the procedures, and it can even be done under local anesthesia. You can also do the chin lipo with *any of the other procedures*. All the other procedures must go under IV sedation or General Anesthesia. I perform all of my procedures under IV sedation to reduce the pulmonary risks associated with General Anesthesia.

You can do the arm lift at any time, and in combination with a breast lift. IMO the lower body lift will give you the biggest transformation of your body, and expand the type of wardrobe that you can wear. I think patients who get this done first are very happy.
However, you have to go with the areas that bother you the most!

I have provided a link to information about the Body Lift Cost . Hope this information helps you!

Ricardo L Rodriguez MD
Board Certified Plastic Surgeon
Baltimore, Maryland

It will be extremely important number one to achieve a healthy BMI below 30. I. The mean time you get your procedures done, it will be advisable to Prepare yourself in 3 areas: exercise every day 30-60 minutes daily to increase blood flow to all tissues and organs because all will participate in the healing process. Improve your nutritional status because all the “fuel” your body will need to heal will come from your nutrition. Prepare mentally because the surgery and the recovery periods will be very difficult physically and emotionally, so coming prepared will be a great help.
As expert in After Weight Loss Surgery (AWLS) my recommendations based on SAFETY: always to stage the procedures, no more than 6 hours surgery, start with the Lower Body lift (femur de Lis if needed) which means 7 procedures: 360 skin resection, muscle repair, mons lift/reduction, tightening of outer thighs, real lifting of buttocks, some liposuction to achieve a feminine shape and if needed some fat grafting.
6 months later upper body lift: arm lift, breast lift, lateral torsoplasty and if needed back lift.
6 months later Inner Vertical Thigh tightening always associated with liposuction to thighs. This is one of the most difficult recovering for that reason I don’t combine with any other surgery.
6 months later Facial procedures.
This is my approach and it has been proven it is the safest.
Hugs.
Be encouraged.
Dr. Cardenas

Dear ShelMert,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thank you for your questions and congrats on your weight loss! The process of body contouring after massive weight loss can be a big undertaking and usually requires multiple stages. For example, a lower body lift is usually enough surgery that it needs to be done in one stage. Then for most patients, the breast and arms tend to pair well together. And then possibly a third stage to address the thighs, neck, or any other areas still of concern. It would be best to see a board certified (ABPS) plastic surgeon in your area for an in-detail consultation going over all of your areas of concern and making a plan and timeline for treatment that makes sense for you. Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL