Lost well over 100lbs many years ago & currently 5’1 &120lbs, skin, fat, or both?

At 5'1 and 120 lbs., your BMI is 23 which is at a normal range. At surgery, skin and fat will be resected from your thighs, which will remove additional pounds and you will drop even more weight. You do not need to lose more weight before surgery. Your skin tone looks good and you would be a good candidate for a thigh lift. You have not provided photographs of your arms but you would probably be a good candidate for a brachioplasty from your description.

Best Wishes,

Gary Horndeski, M.D.

Congradulations on your weight loss. I applaud your focus on health and optimizing your weight. The best sequencing is to do Lipedema Reduction Surgery first and then skin excision. Lipedema Reduction Surgery is often done to the whole leg often in staged surgeries. Skin excision on the calf can have a higher complication rate.

Personally, I see no evidence of lip edema.
Generally speaking, weight loss, patients need skin surgery, more than anything else.
At your current weight and based on your pictures, your subcutaneous fat layers are quite thin and you have substantial skin laxity or skin redundancy primarily due to your previews weight loss.
This means you are most likely a good candidate for skin reduction surgery.
Most massive weight loss patients usually begin with their midsection by having an extended or wraparound tummy tuck.
You can start with whatever procedure or area bothers you the most.
A brachioplasty and thigh lift does, with some negatives, and those procedures are not for everyone.
I suggest having a few in person consultations with plastic surgeons in your community to get a more accurate assessment and better understanding of various treatment options.
I do not believe you need Liposuction and I can assure you that there is no way anyone is going to remove 10 L of fat from your body at 120 pounds.
Weight loss patients typically do not get significant improvements from Liposuction and that is an especially true if they have a healthy BMI.
Skin laxity can be perceived as being access subcutaneous fat.
Rather than grabbing and recruiting skin when you’re assessing fat, try pulling the skin tight and then taking one finger and gently press against your skin till you feel the underlying muscle wall to understand the thickness of your fat layer.
If you measure your fat thickness correctly, I think you’ll find it that it’s actually quite thin.
Incorrectly, assuming skin redundancy has substantial amounts of subcutaneous fat it’s not uncommon.
In reality, individuals who have significant skin laxity will also have significant amounts of excess fat, even if the fat layer is quite thin.
I would not recommend liposuction, but do consider skin reduction surgery.
Best,
Mats Hagstrom MD