Considering multiple procedures after weight loss - can they be combined and how long should I wait between surgeries? (photos)

Hello Silvershade and thank you for your questions regarding multiple procedures after weight loss, whether they can be combined, and how long you should wait between surgeries. These are very common questions. Congratulations on your weight loss. Every plastic surgeon has their own different method and steps regarding reconstructive plastic surgery after massive weight loss. Most plastic surgeons who specialize in the field, concentrate first on the lower body. Stage 1 includes the extended tummy tuck or 360 circumferential lower body lift combined with the thighs.
The thigh lift/reduction procedure is usually a longitudinal vertical medial thigh lift with an incision from the groin to the knee. Postoperatively, you would be required to be monitored for two days before discharge home.
Approximately 4 to 6 weeks later, you could undergo your Stage 2 surgery. This would include your upper body, specifically your back lift, breast lift (mastopexy) with or without mesh and implants, and arm lift/reduction surgery. During Stage 2, you may wish a BBL to be included. Again, you should 4 to 6 weeks and then consider Stage 3. During Stage 3, you can have a facelift or rhytidectomy.
This is the general pattern that most patients follow. Of course, every patient is different. Most plastic surgeon do NOT advise to have the arm surgery and the thigh surgery performed at the same time. If you have all your extremities operated upon, your recovery is very difficult.
All these procedures are performed under general anesthesia and are outpatient. Thank you for your question regarding what procedures can be done together and the timing of surgeries. Good luck. Please seek a board certified plastic surgeon who specializes in reconstructive plastic surgery after massive weight loss.

Thank you for your inquiry! We would love to sit down with you and discuss your options. Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your goals.

All procedures must be staged and each state should not last more than 6 hours.
4-6 months in between states to allow the body fully recover after suffering another physical trauma. You must understand after weight loss surgery represents always extensive and invasive procedures.
All labwork must be beyond perfect specially nutritionally (proteins level above normal) and hemoglobine above 13 gr at each stage.
You must come prepared physically doing exercise every day, nutritionally eating the most healthy food and mentally to endure the whole process.
You will be candidate at least to 3 stages.
My recommendation is not to invade different anatomical areas:
1rs. Lower body lift:369 skin resection, mons lift, front and outer lift, buttocks lift, butt augmentation using your own fat, liposuction and Fat grafting.
2nd: upper body lift: arm lift, breast lift and torsoplasty.
3rd stage: face
Be encouraged!
Dr. Cardenas

Hello and thank you for your question - Congratulations on your commitment to weight loss and transforming your body! It is wise to start planning body contouring surgeries in advance as you point out, most massive weight loss patients need multiple operations on different body regions to achieve their goals.

The question of how to stage out the surgeries is complex and highly individualized both on the patient's end (what areas need to be addressed, the priorities, normal and unique life events to plan around and of course, finances) as well as on the surgeon's end (experience/comfort level, operating room setting inpatient vs outpatient, support staff, etc). What is right for one patient may be vastly different for another.

In general, for someone with multiple body areas concerns with massive weight loss, I will counsel them on the need for at least 3 operations to accomplish everything well and safely. It is common to group adjacent body parts/regions (i.e. arms and breasts, back and gluteus, etc), as well as goals to accomplish on the front vs the back. If there is a turn (i.e. 360 trunk surgery), this adds significant time to surgery and thus limits the number of areas we can safely get done. The vectors/directions of pull is another consideration - i.e. we usually don't do the upper back at the same time as the lower back/gluteal lift as these can have opposite directions of pull. The other big consideration is how much can be accomplished within a safe time frame (i.e. what can be done under a 6-8 hour general anesthesia time). As far as how long to wait in between stages - I usually advise patients no sooner than 3 months (usually 3-6 months) between major surgeries in different body regions.

As you can see, the next best step for you would be an in-person consultation with a board certified plastic surgeon to find the right plan for you.

In general, any surgeries that can be combined should not exceed about six hours of total surgery. However, many of these procedures would be three hours long. For example, breast lift, arm lift, and facelifts each take about three hours. Therefore, the typical combination of procedures is two, possible three if some areas are of smaller concern. I recommend waiting at least 3, but ideally six months following each surgery before moving onto the next.

Congratulations on your weight loss journey. It is pretty common to combine procedures after weight loss. The sequence depends on your priorities, your surgeon's comfort, and of course safety. I personally do not like to spend more than 6- 7 hours in the operating room. I take in to consideration your mobility, meaning I will not combine an upper and lower extremity case together which would render you immobile. I also usually separate any facial surgery from any body surgery. Just keep in mind you have to be able to successfully recover. In regards to rounds, I typically wait at least 3 months to give your body adequate healing time.

Combining procedures is common and considered safe, but there is a limit. Typically elective plastic surgery is capped at about six hours. Certain procedures go well together such as breasts and tummy. If you have all of the procedures you mentioned completed you will likely be looking at three stages. The face lift would be done separately from the body procedures. I encourage you to visit with a board certified plastic surgeon once you are near your goal weight to design a personalized plan. I've included a video I hope you find helpful.

Congratulations on your weight loss journey. Your question is very common and my preference is to combine as many procedures together in these situations as massive weight loss patients often require more than one surgery to achieve their cosmetic goals. It is important to keep the surgeries no more than 6 hours in duration and I would advise at least 2-3 months between procedures. Once you have met with a board certified plastic surgeon you can formulate a surgical plan as to which procedures you would like to start with. Good luck!