Thigh Lift, Arm Lift, Abdominoplasty Done Together Concerns and Recovery?

        That is a lot of surgery at one time.  The body will have a lot of healing to do, and the best thing to do after surgery is to focus on allowing your body to heal.  Training in 5 to 6 weeks is probably not realistic.

 

Kenneth Hughes, MD Los Angeles, CA

Hello, and thank you for your question regarding having a thigh lift, arm lift, and abdominoplasty with hernia repair performed together. First, congratulations on your incredible 150-pound weight loss and your recent half-triathlon — that’s an amazing accomplishment, and it’s clear you're in excellent physical condition.

That said, while it’s technically possible to perform all three surgeries — arm lift, thigh lift, and tummy tuck — at the same time, most experienced plastic surgeons would not recommend combining all three in a single operation, especially with liposuction in all three areas. The reason has less to do with time under anesthesia and more to do with your ability to recover safely and comfortably.

When both the upper and lower extremities are operated on, it becomes extremely difficult to get out of bed, use the bathroom, clean yourself, change garments, or simply move around — especially in the first 10 to 14 days. You’d have limited use of your arms and legs at the same time, which puts a major strain on your body and can increase your risk of wound complications or dehiscence (incision separation). For this reason, most surgeons prefer to stage the procedures: combining either an arm lift or thigh lift with your abdominoplasty, but not both.

Regarding surgical preparation, most plastic surgeons recommend increasing your protein intake to at least 100 grams per day for at least two weeks prior to surgery. Protein is essential for wound healing and helps preserve muscle mass, especially since the body tends to break down muscle before fat after major surgery. It’s also a good idea to avoid any strenuous exercise in the two weeks leading up to surgery to reduce inflammation and conserve your energy for recovery.

As for your training and race schedule, I want to be honest with you. While many patients can return to light cardio or low-impact movement by 4 to 6 weeks post-op, more intense triathlon-level training will likely be too much at that point, especially with three major surgical sites healing simultaneously. You may be able to return to about 50% of your activity by two months and 75% around the three-month mark, but that still depends on how your body heals. Overdoing it too early can lead to wound opening, infection, and setbacks that can delay your recovery even further.

If your biggest race is in three months, you should consider competing first and then having the surgery. If the race isn’t critical, you can move forward with surgery, but be prepared to adjust or delay your participation based on how your body responds. You’ve come so far, and pushing too hard too soon could compromise not only your healing but your long-term results.

Thank you again for your question. You’re clearly a disciplined and motivated patient, and I applaud your dedication to both your health and your sport. Please be sure to consult with a board-certified plastic surgeon who has performed at least 100 body contouring procedures and is very familiar with the unique needs of post-bariatric, athletic patients. Look carefully at their before-and-after photos, read reviews on RealSelf, and make sure your chosen surgeon truly understands your goals.

Wishing you strength, clarity, and a smooth recovery.

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FASMBS, FICS
(Certified by the American Board of Plastic Surgery and President of the American Society of Bariatric Plastic Surgeons; Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery; Member of the American Society of Plastic Surgeons, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame)

Before moving forward, make sure your surgeon has extensive experience with combination body contouring procedures after massive weight loss. Always ask to see photos, confirm credentials, and make sure their plan aligns with your healing and performance goals.

Thanks for your post and concerns. These three areas - arms, thighs, and tummy all at once will likely lead to a longer recovery than typical. I have done this combination, but only on ideal patients and with 72 hour stay at the hospital. Ask your surgeon about how best to prepare and whether an overnight stay facility is available. Best wishes, Dr. Aldo.

That sounds like alot of surgery for one sitting. I would be concerned about doing your legs and arms at the same time because all 4 of your limbs would be recovering, swollen and painful. That's a tough recovery! As a rough guide, I would limit your anesthesia/surgery between 6-8 hours in one sitting and separate your arms and legs into 2 different stages.

Also, ask your surgeon this question. How many hours can you perform surgery and not get tired? Think about it, these are long, mentally and physically exhausting procedures. Do you want a tired surgeon at the end of it?

I do think 6 weeks is a reasonable time to recover to full activity (void of complications, etc). 

Many massive weight loss patients do have nutritional and mineral deficiencies. You should have had a comprehensive panel of labs done prior to surgery. If there are deficiencies, these can be addressed before the surgery to maximize your success.

Hope this helps

Although multiple procedures can be safely performed in one setting with proper patient selection, your treatment plan involves a lot of surgery in just one setting.   If you opt to proceed with the stated plan, I think you need to prepare to have a longer recovery than what you expect.  It is very unlikely you will be ready to "train" just 5 weeks after all those procedures.  Perhaps you should explore breaking the procedure down to small procedures and having them done in stages.  It may be safer and more comfortable for your recovery to, as they say, come back and "fight another day."   Should you opt for such  a lengthy procedure, I would suggest you have the procedure done by a board certified plastic surgeon only in a hospital setting where you can stay overnight (at least one night) to facilitate your recovery and have that extra level of postoperative care/monitoring.   Best wishes.

Dr. Basu

Houston, TX