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Fat Removal Volume for Breast Reduction and Liposuction?

I'm getting a Breast Reduction of 1 kg done at the same time of Liposuction to upper and lower abs, flanks, and outer thighs. I'm supposed to be under general for 5 hours. Based on the max volume for Liposuction, should my doctor remove less fat from my areas if she is already removing 1 kg from my breasts? Should I split the surgeries to be in a safer side and get more fat removed with the surgery for Liposuction alone? Thanks.

Asked 34 months ago by Danicomia in Littleton, CO

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breasts fat reduction

Combining Procedures Can Be Safe

You are right to ask the question and to be concerned about safety. The parameters you describe do not seem extraordinary and the margin of safety may be fine. This is an area where experts may disagree, because their experience varies. Guidelines point toward fewer than 6 hours of anesthesia and less than 5 liters of lipo-aspirate. Many surgeons will restrict the lipo-aspirate to 3 liters when combined with another procedure, such as breast reduction. The most... more

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Paul C. Zwiebel, MD

Denver Plastic Surgeon

ASAPS ASPS

Breast reduction and liposuction

Breast reduction and liposuction together have higher complication rates than if both surgeries are performed separately. However, there are recent studies suggesting that the complication rate may be acceptably low. It is certainly a judgment call and an issue for the patient to weigh carefully, the slightly increased risk vs. getting the surgery done at once. The age, general health of the patient and experience of the surgeon will all also weigh heavily in the equation. Obviously, a... more

Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Breast Reduction and Liposuction?

Thank you for the question. You are wise to be concerned about the extent of surgery that can be done safely in one session. It is more so the blood loss as opposed to the adipose tissue removal that is of major concern. It would be best to break the procedures into 2 stages if you feel that the aesthetic results of the liposuction procedure will be compromised because of safety concerns. Best wishes.

Tom J. Pousti, MD

San Diego Plastic Surgeon

ASAPS ASPS

Breast reduction surgery and liposuction

It is typically safe to perform a breast reduction surgery at the same setting as a liposuction procedure. The breast reduction will directly excise that and breast tissue. The liposuction surgery will remove fat from a wider area in your body. Discuss with your plastic surgeon how much volume they anticipate removing with the liposuction surgery. If they recommend extracting a very significant amount, such as more than 5 L of fat, it may be in your best interest to perform... more

B. Pat Pazmino, MD

Miami Plastic Surgeon

ASAPS ASPS

Liposuction and Breast reduction

It is perfectly reasonable to perform a breast reduction and liposuction at the same time provided that you are healthy and the surgery will not be too long.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Time for surgery

Dear Ms. Danicomia The length and extent of your surgery needs to be dicsussed with your surgeon. You have to make the decision based on the information that is given and move forward with conficence. As you can see from the replies there is not one correct answer. Sometimes you have to go with your gut. Most practitioners have your best interests in mind and will offer the safe course. In my practice the combination of procedures you are describing is a reasonable option. If you do not... more

Trevor M. Born, MD

Toronto Plastic Surgeon

ASAPS

If you are fairly young and healthy overall, it is probably safe

The safety of any surgery depends on many factors, including but not limited to, your general level of health, your weight, the procedures performed and the skill of the surgeons and anesthesiologists etc. Generally, a well-trained meticulous surgeon can safely perform the liposuction and breast reduction provided you do not smoke, have no additional risk factors or family history of blood clots, you are not morbidly obeses and are generally healthy. If you are a smoker or extremely heavy... more

Lane Smith, MD

Las Vegas Plastic Surgeon

ASPS

Your fat removal concerns are justified

I try to limit surgical time to four hours or less. I use this number for several reasons. 1. Any human being starts to get tired and in my own hands, I start to rush after that time. 2. As the length of the case goes up, so does your risk for blood clots in your legs. The risks go up even higher after four hours. 3. Although the two procedures together may have some added risks, as described above, It sound like you are looking for significant results for the liposuction, which may not be... more

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

Breast Reduction with Multiple Area Liposuction

I agree with your surgeon's goal of trying to limit the duration of surgery to 5 hours. The amoun of fat removed refers only to the volume of lipoaspirate. 5 liters is the at the upper end of what is generally considered safe for a single anesthetic. Although with proper overall patient management, especially fluid management, lipoaspirates of greater than 5 liters can safely be remove at one setting. The amount of tumescent fluid infiltrated should not exceed the maximum safe dose... more

James C. Grotting, MD

Birmingham Plastic Surgeon

ASAPS ASPS

If your OK to wait, I think it is a good idea.

Most often, we combine procedures for the convenience of the patient. Part of the cost of the procedure is the time off from work and all of your normal activities. So we often do as much as we feel is safe to give you the most benefit from your time off and let you recover one time instead of having two separate recoveries. If you don't mind waiting for the liposuction, by all means do so. One thing about the breast reduction is that it is exhausing for the body. Although it is not... more

Thomas T. Nguyen, MD

Orange County Plastic Surgeon

ASPS

Total Volume is What Matters

Studies have shown that liposuction is safe with aspirates up to 5 liters. This is based on infusion volumes and the medications that are put into the tumescent solution. So it's safe as long as the amount of local anesthetic is in the safe range for the case. It is possible that your surgeon will get close to that safe range. But as long as she does the math you'll be just fine.

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

These combined procedures are acceptably safe for most patients.

Hi! 1) If you are young, healthy, and of reasonably normal weight, you can have these operations done together. Five hours is acceptable, and of course, the surgery should be done either in a hospital or an accredited facility. 2) The amount of tissue removed during breast reduction is not a separate risk factor like the volume aspirated during liposuction. 3) The only thing that troubles me is that your questions suggest less than full confidence in your surgeon. Trust in your surgeon... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Procedures combined with major liposuction compound risks

It is well known that longer procedure times do increase the risks of cosmetic surgery, such as higher infection rates, and risk of venous thromboembolism. Also in the case with liposuction the fluid shifts due to swelling in treated areas also pose significant risks to a smooth recovery. In the state of Florida regulations were passed preventing liposuction in combination with other procedures because of poor outcomes and and an overwhelming concern in the state for patient safety. In... more

Peter E. Johnson, MD

Des Plaines Plastic Surgeon

ASAPS ASPS

Are you thin, or not so?

So much about the safety of combining these procedures depends upon how much fat will be removed during the liposuction phase of the procedure, and how much blood loss occurs during the excision. If you have a lot of fat to remove from the abdomen/flanks and thighs, you should think about doing the procedures separately. I'd have to assume that your plastic surgeon has taken this into account before recommending the combination. Of course, if you lose a lot of blood (not usual) during the... more

Brian K. Brzowski, MD

Salt Lake City Plastic Surgeon

ASAPS ASPS

Liposuction safety

You are very intuitive as it concerns your surgery and I wish all patients were as like-minded with as much attention toward safety as you are. In general, most surgeons should, and do, put a patient's safety as a top priority but each has his or her own criteria to judge safety. Length of surgery is one criteria with most reputable surgeons comfortable with elective surgery under 6 or 7 hours. Volume of liposuctioned fat is another criteria whereby a guideline of 5000cc. max. is recommended... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

Culture of safety

Dear Dani, I like your thinking. You are obviously safety minded and believe me, a surgeon REALLY appreciates it when the patient is the one concerned about their own safety. However, you should not mix apples and oranges. Fat removal from breast reduction is not the same as fat removal from liposuction and is probably less traumatic, gram for gram. Be sure that your plastic surgeon is board certified. If she is, then she has already determined the amount of surgery that is safe for you... more