Several procedures! Lipodema removal required. Breast lift (no augmentation), tummy tuck & lower body lift? (Photos)

I am 43yrs old. I have lost in excess of 110lbs naturally & gradually over several years & the lipodema I have is now much more prominent. In the photos you can see it is most noticeable in my lower legs/knees/upper arms. I also want to have a breast lift/tummy tuck/lower body lift. The lipodema bothers me most as it affects the most basic stuff like the clothes I feel I need to wear to camouflage it. I'm not sure about the best order of surgery, treatment approach, total cost etc

Doctor Answers 4

Combining a Mommy Makeover with Additional Surgery Sites

It's difficult to suggest without a in-person one-on-one consultation. The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.  

#Combined operations are often performed with our #Gynecology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries included with a #MommyMakeover. If you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your physician and board-certified plastic surgeon. Also, combining these #procedures may decrease anesthetics, costs, and recovery time.
In addition to a one-on-one consultations with a board certified Plastic Surgeon, patients always need to be seen by their primary care doctor prior to such procedures.  We screen every patient and their medical records for risks of blood clots (DVT) and then take appropriate measures.  MWL (massive weight loss patients of  75 lbs or more) tend to have poor skin elasticity and will frequently need additional tightening even afte 6 -12 months regardless of who or how their surgery is performed. This is simply the nature of such body tissues and the ability to heal with the lack or limited elasticity. 

Your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.


Orange County Plastic Surgeon
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Finding the right surgeon

 All too often, women find it emotionally and physically difficult to adjust to these new changes in their bodies affecting their self-esteem and personal self-image. These changes vary greatly and range from stretch marks and varicose veins to the more significant changes such as, smaller and sagging breasts, enlarged waist with redundant skin and larger hips.
Fortunately, there are many treatments available to correct or improve these common post-pregnancy changes. Many of these procedures are non-surgical or relatively simple outpatient surgeries. Some treatments are possible because of new technology such as lasers and liposuction developed in just the last few years. These surgeries are commonly known as the “mommy makeover”.

Far more important than deciding if a tummy tuck or a mommy makeover is for you is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let him explain why one technique may be better than another and if you need a tummy tuck. Many board certified plastic surgeons provide a free first time consult and you should take advantage of that!
See the below link on some suggestions on finding the most qualified Plastic Surgeon for you!
I have also attached a video for a possible Mommy Makeover Candidate.

Massive weight loss - what is best sequence of operations?

Thank you for asking about your body make-over.

  • First of all, congratulations on your weight loss - what a great achievement.
  • Generally the upper body surgery is done first because it affects the support of the lower body.
  • I unjderstand your concern about your lower legs - and exam is needed to determine what can be done.
  • But your photos strong suggest that a considerable part of your problem is varicose veins.
  • They can be responsible for much (possibly even all) of your lower leg irregularity and swelling.
  • If you have not seen a vascular specialist to have these veins evaluated and treated, it should be done before your body lifting. 
  • Lipidema it is a diagnosis of exclusion - that means other causes are detected and treated first so I suggest you start with your veins.
  • Planning a body make-over after major weight loss is complex and requires a consultation.
  • For the surgery, I suggest you find several experienced plastic surgeons in your area to come up with a plan - and with a plan, you will be given the cost for that plan.
  • Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

Several procedures! Lipodema removal required. Breast lift (no augmentation), tummy tuck & lower body lift?

Congratulations on your significant weight loss; you should be very  proud of this accomplishment.

Generally speaking, combination surgical procedures are done routinely. However, you are wise in being concerned about the safety of combination surgery; risks/possible complications do increase with increased length of surgery…
  It is best to evaluate each patient's suitability for combination surgery on an individualized basis. During this consultation process, after a complete history and physical, the SAFETY of combining these surgical procedures becomes of paramount importance. Plastic surgeon, anesthesia provider, duration of surgery, surgery facility all important considerations. Your best bet: choose your plastic surgeon very carefully; everything else including good judgment/advice/planning, anesthesia provider and safe surgery facility will follow. Best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.