Is this a safe combination of procedures following a 170 lb weight loss?

Question

I'm turning 40 this year and have lost 170lbs after RNY 8 years ago and maintained the loss. I had an ETT 3 years ago and am looking to have a few procedures done this year. The surgeon I saw a month back said he coule combine an extended arm lift (to remove side breast skin), a revision to FDL, and a thigh lift in one go. He said it would be a rough recovery but doable and would take 6 hours. My ETT took 6 hours alone. I don't have an apron belly, I mainly wanted to torso skin addressed so maybe that part isn't as "big" as it sounds, like a typical "full" FDL if that makes sense? I have a good deal of bicep and thigh skin as ny starting weight was 393 and I am 230 as of now, 5'10". I keep wondering if I should tell him I'd rather break it up and maybe do like, the FDL and arms, then a few months later do the thighs and maybe the bra line since I'd be booking a second surgery? Or should I run for the hills? Is this a red flag? Just curious! Thank you so, so much in advance, any advice is greatly appreciated!

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  An exam is needed to know for sure, but from your description of the procedures that interest you it's likely best to have them broken into two stages.  This is for your safety as well as to give your surgeon the opportunity to maximize your results.  I've included a video on plastic surgery after major weight loss that I hope you find helpful.

Ajaya Kashyap, MD · Answer

Thank you for your query. Surgeons vary in their approach, experience and speed. While the procedures mentioned can be combined, i dio not do a thigh lift with an upper body lift. The upper body and arm procedures can be combined with FDL abdominoplasty and this would make your recovery and mobility easier. You can come back and do your thighs later as you have suggested. All the best.

Jeffrey M. Darrow, MD · Answer

If your surgeon is working alone, an extended arm lift with a revision to FDL would be a long procedure. If your surgeon is working with an assistant doing both may be possible within a 6 hour period.  Adding thigh lifts to that would, of course, extend the time you are on the operating table. Another consideration would be if your arms are going to be taken up with the arm lift, and your legs are going to be taken up with a thigh lift, how does the anesthesiologist maintain adequate IV access and monitor you?  For safety reasons, and for you to have a reasonably comfortable recovery, it may make sense to have them broken up into two procedures. Best wishes.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided any photographs.  A safe operation time is 6 hours.  If you have had a previous extended tummy tuck then you may not need a fleur de lis.  Sometimes I will do a breast lift using The Bellesoma Method that lifts the upper abdomen and can eliminate the need for the fleur de lis.  I would need photographs to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

In my hands, I would break it up into 2 procedures, and I would not do the legs with the arms, or you cannot get out of bed by yourself .

Is this a safe combination of procedures following a 170 lb weight loss?

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Is this a safe combination of procedures following a 170 lb weight loss?

Answers (5)

Answer: More information needed

Answer: More information needed

Answer: Surgery

Answer: Surgery

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