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Is It Safe Combining Breast Reduction, Tummy Tuck, and Liposuction?

asked 2 years ago by nikki2626 in livonia,mi
Latest answer by Joseph M. Perlman, MD
Question viewed 850 times
Tags: breasts, belly, breast size, fat reduction

I am getting a Breast Reduction, Tummy Tuck, and Liposuction under my breasts and under my armpits.

I am overweight and I am really scared. Is it safe? The surgery should last 5 hours . I will stay over night at the hospital. I have had a stress test and a chest x-ray all seemed ok. But I have poor circulation in my left leg. But seem ok other wise.

19 answers to Is It Safe Combining Breast Reduction, Tummy Tuck, and Liposuction?

No problem combining procedures

I have many patients who undergo combined procedures that aren't actually related to each other. The determining factors include the general health of the patient, the type of procedures being considered, the length of time to do all the procedures, patient safety should always be the primary concern more than saving a patient recovery time or cost. It sounds like your physician is doing things correctly, keeping overnight for observation as well as ordering preoperative tests and... more

Joseph M. Perlman, MD
Houston Plastic Surgeon

2 things to reduce risk from multiple procedures

1. Risk of general anesthesia overall, and blood clot to the lungs in particular. a) There is risk related to the use of general anesthesia. Risk of general anesthesia increases rapidly after 4 hours of surgery. Therefore, multiple procedures are considered riskier. This risk virtually disappears when using IV sedation in combination with tumescent anesthesia. This has been documented in thousands of cases by Dr. Ersek and Dr Mustoe. b) The risk of pulmonary embolus is likewise virtually... more

Ricardo Rodriguez, MD
Baltimore Plastic Surgeon

Risks of multiple procedures

On TV, these combinations of procedures are very common following massive weight loss or in "mommy makeover" combinations. This combination of procedures typcially will take the average plastic surgeon a minimum of 4-6 hours. Surgical time can be reduced by the use of multiple surgeons or assistants or using techniques that cut down on the "sewing" time. The risks of prolonged surgery are well described. As plastic surgeons, one of our most common concerns in clotting... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Can be safe all things considered

You are appropriate in your concern for a longer operation. There are a number of factors to consider; using a board-certified plastic surgeon, having your procedure(s) performed in a fully accredited facility, recovering in a proper health care setting with all precautions taken, and your health to begin with. This is a lot of surgery to undergo at one setting but can be accomplished safely with all proper precautions taken. This is a discussion that you should have with your plastic... more

Michael C. Edwards, MD
Las Vegas Plastic Surgeon

Don't push it

The procedures that you name can all be done at the same time in an appropriate patient - young, healthy and not overweight. The goal should be to have the surgery completed within 6 hours. However, if you have any issues, the operative time may extend beyond this. You also have to factor in the recovery time and emotional and physical impact on your body. Good luck with your surgery.

David Shafer, MD
New York Plastic Surgeon

In a healthy patient who understands what is involved this is a good approach

While combining breast reduction, liposuction and tummy tuck surgery is a lot of surgery, It is a safe combination if safety criteria are followed. I frequently do breast reduction or breast lifts with or with out implants, liposuction of the abdomen, hips, lateral thighs, medial thighs and knees and tummy tucks with correction of the muscle separation. I feel that it is best to do these big multiple procedures in a major hospital and keep the patient over night at least. It is critical to... more

Carl W. "Rick" Lentz III, MD
Daytona Beach Plastic Surgeon

It is very important to individualize.

Hi! If you are young, and healthy, and not overweight -- and if you are talking about liposuction of the love handles only -- then in NYC we would probably do breast reduction and tummy tuck and liposuction together. But if you are not in good shape, or if you want liposuction of several areas, then I would do it in two stages.

George J. Beraka, MD
Manhattan Plastic Surgeon

Safety depends on what is done to whom, not the names of procedures

The procedures you mentioned do not describe the complete nature of the surgery. A breast reduction can remove 250cc or 1000cc. per breast. It might involve just a lollipop type tincision or an inverted-T incision. The same with the tummy tuck. Liposuction is even more variable as to volume and surface area. Certainly surgeons have perfomed all of these procedures at once. One of my patients on Extreme Makeover was such a patient. But the surgeon has to carefully weight the specifics of each... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

It really depends

Certainly, you must be healthy to do this and you must have an excellent Board Certified Plastic Surgeon caring for you. Personally, I do this all the time but I never do any liposuction below the waist in this combination of surgeries. I restrict the liposuction to the flank areas only when I combine breast and abdominal surgeries. The reason I do this is to minimize the risk of blood clots in the veins which can dislodge and travel to the lungs and be fatal. I feel that you need to be... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Multiple proceedures during one O.R session

Your age,health status, and risk factors are important considerations. Depending on the unit and the timing of the proceedures an overnight stay is often advisable. The surgeon's experience and comfort with multiple proceedures also plays a role. finally, an auto transfusion can often make for a smoother recovery.

Barry H. Dolich, MD
Bronx Plastic Surgeon

Have an "out" plan

Discuss your fears with your doctor. I would say that complications rate do go up when combining procedures, but the complication rate can be kept low if several guidelines are followed: 1. you are healthy to begin with 2. your blood count does not show anemia to begin with 3. your surgeon has an assistant to help keep the time in surgery to a minimum 4. pneumatic compression devices are used to minimize your chances of clots in your legs 5. your surgeon has been instructed by you to... more

Francisco Canales, MD
Santa Rosa Plastic Surgeon

Safety and Surgery

Dear Nicky2626, Safety for the patient is the primary concern of good Board Certified Plastic Surgeons. Only your physician can determine if it is safe for you to have combined or long surgeries. In light of your history i would be a bit conservativewith your Surgery.

Trevor M. Born, MD
Toronto Plastic Surgeon

Yes and No

Combining breast, abdominal and liposuction surgery is a common approach to body rejuvenation. I don't think it's risky to do all three of these together as long as you are healthy. A full preoperative evaluation by your primary care physician will help determine that. What does concern me is the liposuction under the breasts. Combining tummy tuck with liposuction of the abdominal flap in patients with more fat is risky. The fat already has poor blood supply so removing it risks... more

Christopher L. Hess, MD
Fairfax Plastic Surgeon

Why push it?

In a young and healthy patient, these procedures can be combined successfully over and over again. There are many surgeons who have done this combination of procedures repeatedly in their 25 or 30 years of practice without ever having a significant problem. But data is increasingly emerging that combing significant procedures simultaneously with an abdominoplasty can increase the risk of severe and even fatal consequences. The occurrence is VERY RARE. But there is no question that... more

Steven Teitelbaum, MD
Los Angeles Plastic Surgeon

Multiple procedures

Combining procedures can be safe. There are many different factors that have to be considered. These are just some of them: the surgery is not to lengthy, there is not excessive blood loss, and the patient is healthy.

Steven Wallach, MD
Manhattan Plastic Surgeon

Depends on multiple factors

If you are healthy and in overall good shape, this procedure can be done safely, even without an overnight stay. However, if you have some medical issues, it may be best to break up the procedure into individual parts. It really depends on you, your surgeon, and his judgement. In the end, it's your body, so if you feel uncomfortable with this approach, your surgeon should understand this and there should be no problem in breaking it up into 2 smaller procedures spaced a couple of... more

Shahram Salemy, MD
Seattle Plastic Surgeon

Multiple procedures can be safe, but can also be dangerous

Tummy tucks combined with liposuction have reportedly higher complication rates. Nonetheless, many surgeons across the country and worldwide do liposuction routinely with abdominoplasty. Adding a breast reduction certainly increases operative time and can increase complications. However, if the patient is healthy, not overweight, the surgery done in a hospital, the patient stays overnight, then the risk is acceptable by many surgeons and many patients. Remember that there are still many... more

Sirish Maddali, MD
Portland Plastic Surgeon

Your surgeon may not have enough experience to answer this question.

Dear Nikki George Bernard Shaw once said that marriage was the maximum of temptation with the maximum of opportunity. As surgeons, we have a significant conflict of interest in how to advise the patient regarding multiple surgeries. Cosmetic surgeons make money by convincing potential patients to have surgery. The more surgery you have, the more money the surgeon makes. So there is a natural interest in encouraging you to have as much surgery as possible at a single time. Supporting... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Surgery

If your health is not an issue, it is not unreasonable to have these surgeries performed together. An overnight stay in the hospital is a good idea.

Edmond A. Zingaro, MD
San Francisco Plastic Surgeon

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