39 yr. old. Do I need a lower lift and breast lift again? Arms Thighs too? Uplift? (photo)

Thank you for your pictures and questions. In general, because of the stretched nature of the skin, liposuction is going to be a poor option for you. You might need a revision of your prior procedures, but these types of repeat surgeries can be complicated and I would suggest you only see plastic surgeons who are board certified by the American Board of Plastic Surgery to discuss your options.Best of luck!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Thank you for your question regarding whether you need to redo your body lift, breast lift, and perhaps breast implants. Thank you also for your questions about whether you need an arm reduction and possibly a thigh lift. Overall, I think you look great. However, if you want my professional opinion for optimal results after gastric bypass and several pregnancies, I suggest a revision tummy tuck or abdominoplasty. During this procedure, excess skin and fat on your abdomen can be pulled flat, and the tummy will have a better appearance. This can also be combined with liposuction of the superior iliac crest or the love handles. This will give your more of an hourglass shape. Regarding your arms, I would strongly suggest an arm reduction or brachioplasty.
During your arm reduction or arm lift, arm liposuction and an incision from the armpit to the elbow would be performed. This can be combined with before mentioned tummy tuck. In regards to your back, I would suggest a horizontal torsoplasty. Another name for horizontal torsoplasty is the bra strap lift or braplasty. During this procedure, an incision is made across your back, and excess skin and fat on the back are significantly reduced. I often combined this with the arm lift. This can also be incorporated with the tummy tuck. A thigh lift is another surgical option in your case; I would suggest liposuction of the thighs be combined with an incision from the groin to the knees.
I suggest you do this as a separate procedure as the recovery is slightly more complex than the abovementioned procedures. I would suggest you not combine the thigh lift with the arm lift. In regards to the breast, I think they look excellent. However, if you would like a touchup, I would do that last because there are other areas of your body that perhaps take more priority. The areas of focus are entirely up to you, not me. Regarding your breast, you may Consider increasing the breast implant size slightly. Overall, you look great; these revisions would be totally up to you; I hope this helps answer the question of what to do with your arms, breast, back, abdomen, love handles, and thighs after gastric bypass pregnancy and a prior lower body lift. Good luck.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

hello thank you for your question and provided information as well. based in your question its recommended in your case 2 rounds: first round : full tummy tuck , breast lift with full back liposuction second round : back lift and inner tight lift.

Dear BlueBird79,it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Based on photos, you would benefit from an Abdominoplasty /and Beltectomy , Brachioplasty , axillary lift removing the excess skin under the arms-this could be extended into the back to improve the rolls at that location. Inner thigh lift at separate surgery- may be of benefit. I suggest that you seek an experienced Board Certified PS with experience and interest in post-bariatric Body Contouring 

Hello and thank you for your questions and your pictures.
You would be best served with an in-person examination to appropriately asses your areas of skin excess, the quality of your skin, as well as your fat distribution. From your pictures, it appears you have a moderate amount of loose skin in your thighs, abdomen, mid back, and arms. You would likely benefit from a revision of the procedures you have previously undergone along with some liposuction and a thigh lift.
To get a much more specific answer and a personalized surgical plan, I recommend you consult with a board-eligible or board-certified plastic surgeon who specializes in aesthetic plastic surgery. In your consultation, be sure your surgeon addresses all your concerns and discusses the surgery details including the type of incision, the risks and benefits of the procedure, recovery time, and postoperative course .
I believe one key aspect of the consultation is to establish a good connection with your plastic surgeon. If you don't feel you have a good connection with your plastic surgeon after your consultation, then they may not be the best surgeon for you.  
Best wishes!
Olivier A. Deigni, MD, MPH
Houston Plastic Surgeon

Hello thank you for the question and for the pictures, because of those pictures is easier for us to answer your question.Based on the pictures, i think you'll need a liposuction; to remove all the fat that you gained, a tummy tuck; to reconstruct your abdomen area, a BBL (Brazilian Butt lift); to make that part of your body look better and a breast revision. I also recommend a very important thing, that is to aboard a certified plastic surgeon for a personal consult and in that way he can evaluate you better and determine what is actually what you need.I hope this helps!Dr. Jimenez Toribio.Plastic and Reconstructive Surgeon.