Would it be safe to do a tummy tuck, thigh lift, and arm lift in the same surgery? (Photo)

Question

I have lost 120 lbs (need to lose 25 more). Thankfully, I don't think my stomach is in terrible shape. My inner thighs have a lot of loose skin. My arms seem to be in the worst shape. I react badly to anesthesia. I would prefer one surgery with a tummy tuck, thigh lift, and arm lift. Is this recommended? I'd think while legs are recovering, I would need to rely more on my arms to complete daily tasks, then rely on lower body while my arms heal. Can both be done at the same time?

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Congrats on your transformation! I would say that I would not recommend having all three procedures done at the same time. First, the operating room time would be too great and would increase your risk of complications such as infection, wound healing problems, blood clots, etc. Second, I do not think it wise to have a recovery period that includes the torso as well as all 4 extremities. Best to discuss with your chosen board certified plastic surgeon how best to stage your procedures. Always best to put safety first.Hope this helps!

Suzette Miranda, MD · Answer

Thank you for your questions and pictures. Congratulations on your weight loss and I wish you luck on achieving 25 more lbs of weight loss! This is an accomplishment. Massive weight loss patients often require multiple surgical procedures to address excess skin and fat throughout their entire body. Your surgeon should want what is best for you from a safety perspective and should stage your surgeries to optimize your healing and healthy recovery. I would not advise having all these procedures done at one time because your safety and healing would be compromised. You should be seen by a plastic surgeon in person so that you and her/him can form a plan based on your goals. The in-person evaluation would be beneficial in decising wether a lower body lift would be best for you versus just a tummy tuck with liposuction of certain areas. As you have now experienced, when patients lose weight, their loose arm skin creates what many call a "bat wing" appearance. I think that you are a candidate for a brachioplasty or arm lift based pn your pictures. The procedure can be performed in conjunction with liposuction depending on your physical evaluation. Im happy that you have lost weight and are now thinking of ways to make you look the way you feel (after so much effort). Good luck!
Best wishes, 
Dr. Suzette Miranda

Trent D. Douglas, MD, FACS · Answer

Congratulations on your weight loss and wanting to improve your figure with body contouring surgery.  Certain combinations of surgery work better than others, especially when it comes to recovery after massive weight loss body contouring surgery.  Make sure you choose a board-certified plastic surgeon with expertise in body contouring surgery and partner with that surgeon to develop a plan that individualizes your treatment and helps you safely reach your goals.  Spacing the surgeries by 4-6 months and allowing ample time for recovery is a safe approach.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  Congratulations on your weight loss.  I would not recommend having all three performed at the same time.  I think a tummy tuck and arm lift could safely be performed together.  Based on your
photograph, you are a great candidate for a tummy tuck with liposuction.  This can be done through a low and short
incision, all completely below the bikini line. 
The belly button can be designed to look natural and have no scars on
the exterior.   Your muscles can also be
plicated resulting in a flat abdomen.  An arm lift could be performed at the same time for a nice result.   
Make sure you specifically look at before and after pictures of
real patients who have had this surgery performed by your surgeon and evaluate
their results.  The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

George Marosan, MD · Answer

Thank you for your question and photos. Although all these procedures could be done together, I personally would not advise it. We have to think about your recovery process and also to minimize your risks for complications and poor surgical outcome. I would suggest doing your tummy tuck and circumferential liposuction of your body with possible fat transfer to the buttocks to enhance  your feminine shape. The arms are still poorly "deflated" and an arm lift will be suboptimal. I would do arm liposuction first to define your muscles, at the time of the TT and an arm lift later (you want your arms to match your new body). It is difficult to evaluate your thighs from this photo and decide what type of thigh lift you need. I reserve this operation as the last procedure after body contouring, since it is a more difficult recovery.I'm not sure what "I react badly to anesthesia means". I do these procedures in my accredited office surgical suite under intravenous sedation only, including the tummy tuck. No general anesthesia or epidural required! I've been using this technique for the past 5 years and my patients are very pleased with the fast recovery.See a board certified [plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Adolfo Sesto, MD · Answer

Hi and thanks for posting your photos. Congratulations on your weight loss. "No it will not be safe". After Massive Weight Loss recontruction of the body countour is perform in different stages being the first one Abdominoplasty (Tummy Tuck ) with Liposculpture and BBl if needed or wished. In this procedure thighs will also improve since we pull the abdominal skin downwards and upwards. In a  second procudure we address Breasts and Arms Lift. Its done like this to avoid raising your surgical and life  risks by not making too much procedure at a time. So the most important  is the patients safety.Member of the American Society of Plastic Surgeons (ASPS)
Member of the International Society of Aesthetic Plastic Surgery (ISPAS)
Certified Plastic Surgeon

Curtis Wong, MD · Answer

would not be advised as you will have considerable trouble moving around post-op.  This is said even if your surgeon is very quick and could get it all done in 6 hours.  Best to do arms and tummy then thighs later and use that as an  opportunity to revise anything you didn't like about your results.  Its safer and you will be more mobile post-op.

Nicholas A. Flugstad, MD · Answer

Abdominoplasty, thigh lift, and arm lift require incisions of significant length on your body. 2 of the 3 could probably be combined safely, but not all 3. You will be at risk for more healing complications and as slower recovery if you are wanting to do all 3 at once. So great that you are losing weight. These procedures have the most powerful results when you are done losing weight. Make sure your surgeon is certified by the American Board of Plastic Surgery.

Robert Singer, MD · Answer

Combining cosmetic plastic surgery procedures is not uncommon. Whether you are a reasonable candidate for those procedures depends on your anatomy, your medical history, the extent of the procedures, realistic expectations of the outcome and an understanding of the pros and cons of the various procedures. 
 
 Safety should always be the main concern. It is generally recommended that the length of elective surgery be less than six hours. The procedures should be performed in an ambulatory facility that is accredited by one of the national organizations like the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF) or in a licensed hospital. Many surgeons would recommend an overnight stay at an appropriate facility where you can be appropriately monitored. Most patients prefer undergoing one anesthesia and one recovery period which is usually more cost effective.

Having said all of that, many ethical well trained plastic surgeons would feel that the combination you are asking about is excessive and has significant risks factors if performed in one stage.
 
 Keep in mind that following the advice of any surgeon on this or any other web site who proposes to tell you what to do without: examining you, physically feeling the tissue, assessing your desired outcome, and taking a full medical history, as well as discussing the pros and cons of each operative option would not be in your best interest. I would suggest you find a Board Certified Plastic Surgeon certified by The American Board of
 Plastic Surgery who is ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with, and discuss your concerns with that surgeon in person. That way, you can have a better idea what is safe and makes the most sense for you. 
 
 Before proceeding with a combination of these procedures, you should have medical clearance from your primary care physician and a discussion between him or her and your plastic surgeon.Robert Singer, MD FACS 
 
 La Jolla, California

Jean Paul Giudicelli Saba, MD · Answer

Hi, thanks for sharing your concern and photos with us!
First I want to congratulate you for making this important decision. Deciding to get an aesthetic procedure to change your body and get a new life style is a big step!
  
Looking at your photos I might say that you´ll be a great candidate to get an arm lift with  tummy tuck, this is because all the extra skin located in this areas plus your abdominal muscle needs to be repaired. Before all this, of course, you need to get a complete medical evaluation and laboratory exams to check everything is fine. For us your safety, always, is going to be first.
  
Have a great day! 
  
Dr. JPG

Would it be safe to do a tummy tuck, thigh lift, and arm lift in the same surgery? (Photo)

Answers (14)