Dangerous to Have Breast Lift, Tummy Tuck, and Arm Lift at Once?

Question

I've lost approx.100 lbs and now have very saggy skin. I am considering having a Breast Lift, Tummy Tuck, and Arm Lift.  Would it be dangerous to have all three procedures done and once?

John Diaz, MD · Answer

Since you have lost 100 lbs, I assume you have a lot of extra loose skin. This makes these procedures much more difficult and time consuming to perform nicely.
Each one of the operations you listed takes several hours to perform. This is true even if there are two surgeons working at the same time.
It is not a good idea to do all 3 in your case. The anesthesia time will be too long. This increases your risk for all kinds of problems, especially the formation of blood clots in your legs.
Also, this involves a lot of skin and fat removal, which equals blood loss. Doing all 3 can put you at risk for losing too much blood and possibly needing a transfusion.
Lastly, if you do all 3, the surgeons will not be able to give their full attention to any one of the procedures. They will become exhausted (after all, each procedure is very labor intensive). Although we always try to do our very best for any procedure we do, this is just too much to do in one setting. It may compromise the result that surgeon can achieve.

Young R. Cho, MD, PhD · Answer

Thank you for your question. A tummy tuck and breast lift are great procedures to combine as they address some of big changes that happen after pregnancy or weight changes. It is often referred to as a mommy makeover. It is a bigger procedure and may often require a night in the hospital. Adding an arm lift at the same time may be too much depending on how long the combined procedures will take, your medical history, and what you want to tolerate during the recovery process.  I would generally recommend staging this into two procedures.I would consult with a board certified plastic surgeon in your area to discuss your options in more detail, review if there are any medical reasons to stage the procedure.  If they deem you are healthy to have have the combined procedure, then you will only have one recovery.

Michael Kulick, MD, DDS · Answer

Hi there,
Not enough information to give you a credible answer.  Maybe yes if the surgery time is relatively short and you are in good health as determined by your primary care doctor.  Maybe no if you are not in good health.  
Good job about your weight loss.  That will go a long way in helping you actually "be" in good health.

Tom J. Pousti, MD · Answer

Congratulations on your significant weight loss.  After this type of successful weight loss,  is not unusual for patients to want to make improvements to as many body parts as quickly as possible.

	Although some combination surgery can be done safely, I  would not recommend having the three  procedures you are considering  done at the same time. Both from the safety and length of surgery aspects  and the difficulty with recovery aspect,  you will be better off staging the procedures.

	One possible combination would be to have the breast lifting and arm lifting done at the same time;  the tummy tuck ( standard or extended)  can be done separately.  Of course other  combinations are also possible.

	I hope this helps.

Steven Wallach, MD · Answer

Combining all the procedures that you mentioned may be a bit too much for you.  This is something that is based upon your health and also the amount of time the procedures would take.

Pat Pazmino, MD, FACS · Answer

Please keep in mind that this is a lot of surgery that you're considering performing at the same time. For aesthetic surgery, it is essential to limit risks and to stay extremely safe. It is common to perform a breast lift with tummy tuck in one setting but caution should be taken when adding anything else to this combination. Discuss with your surgeon what other options are possible and if these procedures may be staged. Also discuss the level of anesthesia and the time that the surgery will take and the recovery process from the anesthesia alone. Also consider how you will emulate and perform your activities of daily living with wounds on both arms, both breasts and throughout your abdomen.

Samir Shureih, MD · Answer

One can combine multiple surgical procedures safely. In your case, each of the procedures you want require at least  3 hours each.
Unless you have a team of plastic surgeons working simultanuosly and some technique, then you can't do all that.
Divide your surgeries into smaller surgeries.

John P. Di Saia, MD · Answer

Hello,
Combining multiple large scale operations in one sitting is counter productive frequently. The reasons are in brief:
(1) Cosmetic surgery for extreme weight loss patients frequently requires extension, so each procedure will take longer than it would in a non-weight loss patient.
(2) When multiple procedures are planned, each is either abbreviated or the patient is exposed to longer anesthesia times and more risk. Either of these options short-changes the patient.

Reza Nabavian, MD · Answer

And don't let anyone tell you otherwise.  There is no reason to combine so many extensive surgeries at once.  If your surgeon is recommending this, make sure to get a second opinion.  
The issues are length of surgery, the extent of healing required, as well as surgeon attention to detail and meticulousness. You do not want the surgeon to rush through your surgery.
If needed, any two of the above three procedures could be combined, assuming that you are in good health and have a pre-operative medical evaluation.

Bahram Ghaderi, MD · Answer

The procedures by themselves are important but the amount of time spent in surgery is the crucial factor in deciding whether or not to combine procedures. The three you mentioned are long procedures and together do not sound like a good idea. Remember your recovery is also important. Imagine if you are trying to get out of bed and can't use arms and can't strain your abdomen. It become difficult to move around. If you don't move around, you are at risk for blood clots in your leg which are dangerous. Also about 6-7hours in surgery is the upper limit of what is reasonable. Discuss with your surgeon your goals and there is nothing wrong with staging the procedures. Two shorter surgeries are safer than one extremely long one.

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