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.

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.