Dear Mossie,
As you can see, everyone has their favorite approach. I like to keep my operative time less than 6 hours, so two combinations work well for me. Certainly patient preference and body type is the deciding factor, but thinking about all patients, these are the combinations:
One (most chosen by patients)
- Body lift (circumferential abdominoplasty)
- Breast lift & brachioplasty
- Facial rejuvenation (face, brow, eyelids) & breast augmentation
- Medial thigh lift
Two (my preferred method)
- Breast lift & extended abdominoplasty
- Posterior body lift & breast augmentation
- Facial rejuvenation & brachioplasty
- Medial thigh lift
I tend to take a conservative route by keeping the breast lift and augmentation separate, but this allows me to achieve a more "perky" result as I am not so worried about complications when doing the augmentation component. In the same light, separating the tummy tuck from the posterior body lift in my second combination allow us to achieve a more significant lift. This is because I do not have to worry about putting too much tension on a fresh incision on the other side of the body (something we must contend with when performing a one stage body lift.)
Lastly, I like to keep the medial thigh lift as an isolated procedure and do it last. In my mind, it truly is the icing on the cake, and should only be performed once everything else is perfect. (This operation has a very high complication rate due to being close to the genitals.)
You need to speak with your surgeon about your overall goals, and come up with a plan that make sense to you.
Good luck!
Dr.B
