I've lost 110 over the last 18mths, Can I have a tummy tuck, breast lift, upper arm and thigh lift?

I'd like to have all four done at the same time and I've seen various information sources online that offer this all together, what is the opinion of doctor's on whether I should do them all together and what recovery time should I expect for all or split them up and if so what to have together?

Doctor Answers 14

What is the Right amount of Surgery

All mommy makeover procedures begin with one important goal - "DO NO HARM!".
The moms that walk into my office all have unique concerns, complaints and issues. The final decision for type and extent of surgery will focus on safety first and quality of outcome second. If there is any question that safety is jeopardized then the plan is altered.
My first consideration is surgical time. For surgery that extends past four hours, the risks of blood clots in the legs and infection rise. In addition, most surgeons will agree that their own skills are not as sharp when surgery drags on.
The second consideration is being sure that the procedures combined will be safe at the time of surgery and will do well together in the post-op period. For instance, performing a buttock lift (lie on your stomach) and a breast lift (lie on your back) at the same time is impossible unless you plan to stand for three weeks.
Weight considerations are important for the surgery as well as the long term success of the procedures. I always want my patients to be at a stable weight. It is less important to be skinny and more important to be stable. It is also important to have lost all the weight from prior pregnancies so the assessment can be accurate.
The cost of the procedure is like an a la cart menu. Different procedures are added to the price. More procedures performed at one sitting does have some cost advantages including decreased anesthesia, nursing and facility fee costs. Performing all procedures at one time also allows for one recovery.
For a full tummy tuck I prefer the High Lateral tension abdomenoplasty. This technique allows the best hourglass shape abdomen and also allows liposuction to be performed on the upper abdomen and the flanks.
The typical time for this procedure is 2 to2 and 1/2 hours.
Typical time for the thigh lift is 2 1/2 hours, breast lift is 1 1/2 to 2 hours and the upper arm lift is 1 1/2 hours.
I would consider performing the breasts and tummy together. At a second stage performing the thigh and arm lifts.
I hope this is helpful.

New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

Multiple procedures at one time

Congratulations on your weight loss over the past 18 months! The next step in your journey is addressing the skin excess and laxity of the tummy, breasts, arms and thighs that results from such a significant weight loss. There are several advantages to combining multiple procedure.  You recover from your procedures simultaneously and there can be cost savings involved in theatre and anaesthetic costs.  As you have undergone massive weight loss, you will need more than a tummy tuck to address your lower body issues and an operation called a bodylift will be required.  This removes and tightens skin of the tummy as with a tummy tuck but also loose skin of the outer hip and buttock regions.   As long as you are healthy, I would usually recommend performing your bodylift first as it will give you the most dramatic improvement.  Sometime months later, a combination of other procedures can be planned and breast lift, upper arm lift and inner thigh lift can be combined into one surgery.  This approach allows you to achieve optimum results and a safe recovery period that has you back on your feet quickly after each surgery.

Robert Drielsma, MBBS, BSc, FRACS
Sydney Plastic Surgeon
4.7 out of 5 stars 48 reviews

Weight loss and multiple surgeries

Congratulations on your weight loss!  Contemplating your next steps in removing your excess tissue can be exciting and rewarding.

I would not recommend having all four surgeries done at the same time.  I limit operating room time for a single patient to around 6 hours at a time.  After this time frame the risk of wound complications can rise.  It is nice to combine procedures to limit the recovery and cost of multiple procedures.  Some of these procedures can be combined and it is common to combine a breast lift with upper arm surgery and possibly a thigh lift depending on each patient's particular need.  Often people need a total body lift rather than an abdominoplasty after having significant weight loss which takes longer and I often do not combine that with another procedure.  But an abdominoplasty can be combined with one or two of the different procedures you asked about, again depending on each patient's particular need and body.  I recommend waiting three months between surgeries. 

I wish you the best in your treatment.

Vanessa Voge, MD
Wichita Plastic Surgeon
4.6 out of 5 stars 10 reviews

I've lost 110 over the last 18mths, Can I have a tummy tuck, breast lift, upper arm and thigh lift?

I perform as many combination surgeries as anyone in the US, but that is too much to do in under 6 hours.  You need to make sure that the surgeon is an expert at all of the procedures and has great reviews and great before and after pictures.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Multiple surgeries

I would not suggest doing all procedures at the same time. I would suggest doing them in 2 to 3 sessions. The breast lift could be done with the arm tuck or the tummy tuck. You need to give your body time to heal well between the surgeries.  With all the weight loss you have had, you need to be sure your protein levels are normal. I would suggest meeting with a board certified plastic surgeon and discuss all your concerns.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Combined procedures

Hi.  Congratulations on your impressive weight loss!

I wouldn't recommend doing all those procedures together, for reasons of safety.  We know that complication rates (DVT, transfusion, hospitalization, wound infection, etc.) all increase as the surgical time under anesthesia goes up.  Don't try to do a surgical marathon, especially in an outpatient surgery center.

Six hours or so is a pretty reasonable length of anesthesia - so combine your top two procedures together, and get through that safely first.

Doing more is asking for trouble, IMO.

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 80 reviews

Staging multiple procedures for safety

Thanks for your question and congratulations on losing all that weight! I recommend staging your procedures for safety and to allow the best healing and recovery for you.  I recommend starting with an abdominoplasty and a breast lift first, waiting 3 months, then having arm lift and thigh lift.  I know you are very excited for your new makeover, but your safety is extremely important!  Good luck!

Melinda Lirag Lacerna-Kimbrell, MD, FACS
Sarasota Plastic Surgeon
4.8 out of 5 stars 74 reviews

I've lost 110 over the last 18mths, Can I have a tummy tuck, breast lift, upper arm and thigh lift?

Hi, I congratulate you for losing all those pounds, 110 pounds is a great accomplishment on your part. My opinion is this: I think that all these surgeries together is too much to make them the same day, take into account that if you've lost so much weight, you must have a lot of sagging skin, to remove all the skin the time of surgery is very long in addition to blood loss is great too, I usually divide this surgery in two stages, first Tummy Tuck and arms and then in a second stage breast lift and thighs, this is how I would do it, I think that the safety of the patient is more important. Good luck!

Dr. Marte.

Manuel Marte, MD
Dominican Republic Plastic Surgeon
4.3 out of 5 stars 9 reviews

Multiple surgeries

It can be safe to combine surgeries, provided you have an experienced well trained plastic surgeon operating in an accredited OR with a board certified anesthesiologist. However, the number of surgeries you are describing is excessive for a single day. These surgeries should be staged. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 120 reviews

I've lost 110 over the last 18mths, Can I have a tummy tuck, breast lift, upper arm and thigh lift?

Congratulations on your significant weight loss; you should be very proud of this accomplishment! Although your desire to have all of the procedures listed  completed together is understandable, that course will not be recommended by most plastic surgeons.  Remember, to place the highest priority on safety, rather than any other consideration. There are a variety of different ways to “split them up”; much will depend on your priorities and preferences. I would suggest that you seek consultation with well experienced board-certified plastic surgeons to discuss your goals in detail. You may find the attached link, dedicated to patients who have experienced significant weight loss, helpful to you as you learn more about options. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

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.