What PS would you (or did you) have first?

Hi all! I am within 7 pounds of transitioning to maintenance. I feel and look sooooo much better than before my RnY! What a tremendous gift to myself that surgery has been!

However, the reality is that as of today I've lost 218 pounds (yay!), and that simply doesn't happen without leaving behind extra skin. I would like to have a LBL, a thigh lift, a tummy tuck/mons lift (though I think that's part of a LBL, right?), a breast lift, an arm lift, and a face lift.

I've been trying to figure out which of these areas bothers me the mosta. Since my arms can be easily covered and my thighs can be too, those are ok for me to not have first. I don't have a horrible degree of abdominal sag, considering how much I've lost, but some does exist, and it's visible in slacks as a bit of poochiness between crotch and waistline; I want that gone and flat, flat, flat. I also really, really want a breast lift and more fullness to be restored to them. Fat or thin, I always had a pretty amazing bust. Not now though, and I miss the girls! So I'm leaning towards having those two procedures done first.

I know that in some cases multiple procedures can be safely done at the same time, depending on a variety of factors.

For those like me who are or were considering having multiple surgeries, what did you decide to have done first, and why?

If you talk to a surgeon they will tell you which procedures can be safely combined. I know my surgeon took into account both the duration of surgery (he wouldn't operate more than ~11 hours) and also the way the incisions pull on the body (ie: you wouldn't want them pulling opposite directions, as you're more likely to have issues with openings).

I had my LBL and BL during the same surgery. In my case, I did not have any other surgeries. I know other people have combined the arm lift with the upper body/BL before. I also personally think that combining the thighs with pretty much anything else is insane since that seems to be the hardest procedure to recover from.

That's what I've heard, too. I do want my thighs done but they can wait a bit - what's one more year as a shar-pei?

I had the LBL and arms done at the same time. 2nd was thighs and BL w/ implants. My surgeon wouldn't do the thighs and LBL together or the BL w/ the LBL. So he kind of dictated the combination. I probably would do the LBL first and see what your surgeon recommends to go along with that.

Thank you Sonnie! I am inclined towards the LBL too, or a breast lift - I may actually do that first, perhaps along with my arms. I'm not sure about implants. I do want them for the recovery of upper pole fullness, as now there is none! I don't want to look like a Barbie, but I do want to be happy with my looks in tops which are a little lower cut. The maintenance, however, gives me pause. I'll have to discuss this with the surgeons i will consult with, once I am a bit more ready.

I think the two key factors in deciding order and combinations are a) what your surgeon will do and b) what annoys you the most. :) My surgeon was the same as Erin's, so the same concerns of time and suture direction pull.

In your case, it seems like doing the LBL (which, yes, tends to include diastasis recti repair and mons lift, but ask your surgeon to be sure!!) and breast lift first would make sense for you - would you be doing lift only or lift + implants?

I did LBL + brachioplasty; UBL + mastopexy; medial leg lift. Five procedures in three surgeries.

In terms of mobility, from most mobile to least mobile, I'd rank the procedures like this: mastopexy, UBL, brachioplasty, LBL, medial leg lift.

In terms of pain, from least painful to most painful, I'd rank them like this: mastopexy, UBL, brachioplasty, medial leg lift, LBL.

When you're planning combinations with your surgeon, keep in mind that the three things you use most to move, especially for transitions (prone to sitting to standing), are your arms, your core, and your legs. Taking more than one of them out of commission at any one time can be challenging. :)

I, personally, had no problem doing LBL and arms at the same time, but there's no way I'd combine legs with LBL or arms!

Hi Gwen, and thanks for that detailed info! Much appreciated!

I'm not sure about implants, but I suspect they will be necessary from a truly reconstructive point of view. As things stand now, my ribs are on prominent display front and back, and my breasts are pretty darn deflated. Worse than when I stopped breast feeding, for sure! I don't want to have huge "I'm about to tip over" breasts, just attractive ones. I've been a D cup or bigger since forever, and still am, but it's not the same. So I'd like to stay either a full C or a small D, I think. I'm 5'8" and comfortable with that. I also prefer that they don't curve out to beyond my rib cage on the sides; to me that keeps me looking leaner. However, my mom had a bout of breast cancer, which she outlived by 16 years, passing away just shy of her 91st birthday, so I want to ensure I won't be increasing my risk. Lots to discuss in my consults!

I did a LBL, BL, arms and sm thigh, 4 days later a full face lift including upper and lower lids. I did go back 2 yrs later for an upper body lift.

Work was only going to allow me 8 weeks off, I couldn't keep going back into surgery with more time off in smaller chunks.

I was 59 when I had the first surgeries. I took off 8 weeks and had no problems.

Woe! That really is an incredible amount of work to have done all at once! Great to know all went beautifully!

I did three consults, and their recommendations and suggested combinations were a bit different (well, two said they would do the LBL first, and then go from there). None of my consults liked doing surgeries more than six hours long, but some surgeons are fine with going longer than that - and some, much longer). You might want to schedule some consults now...or soon....as they'll clear up some of your questions and get you thinking about what you want to do. I'd suggest going on 3-5. You'll learn a lot from them. Plus I liked having multiple opinions. In my case, surgeon A's and surgeon B's plans were so different from each other that I scheduled a consult with surgeon C, too (who I ended up going with, so it's a good thing I did!) just because I had no idea whose plan was "better", so I wanted yet another opinion...

some surgeons don't charge for consults, and some charge a nominal amount - like $100 or $150 - and those who charge usually apply it to your surgery cost if you end up going with them.