I know lipsuciton is easily performed with miminal risks ans complications while under local anesthesia. I am having breast reduction surgery and my surgeon says he can combine the liposuciton during the same surgery. Does this increase my risk of a complication because the liposuction will be performed while under general anesthesia? Should I have the procedures done at different times?
Is It More Risky to Have Abdominal Liposuction During Breast Reduction Surgery Under General Anesthesia?
Doctor Answers (12)
There are added risks to doing liposuction and breast reductions together but trust your doc's recommendation.
It is better to do them as separate surgeries but many of the docs who don't keep up with the best techniques in liposuction will still do them under general anesthesia and still get fair to somewhat decent results. Get a few consultations and then pick the doc you trust the most to give you the best results. You don't want to end up with perky breasts and an ugly stomach. Sincerely,
Web reference: http://www.TheBestLipoDoc.com/drdavidhansen/landing/
Breast reduction and liposuction
Performing liposuction and breast reduction at the same time is generally safe. However any prolonged procedure under general anesthesia can be associated with a higher risk of venous thrombosis.
Web reference: http://www.bodysculptor.com/
Cosmetic Surgery Under Local Anesthesia
Your health, the techniques used, the size of the reduction, and fat removed, decide if you are a good candidate.
Each patient has to be evaluated individually. If you are healthy with a normal blood count (not anemic), and the liposuction is less than 5 liters. I would consider doing both procedures at the same time under general anesthesia. Under general anesthesia much less local anesthesia is used and thus becomes the safer way to go.
Definitely not with local anesthesia, These are both large areas that will require massive amounts of local anesthesia. This will bring you dangerously close to the toxic level of local anesthesia. Not a good Idea. if you are set on doing the procedures with local anesthesia, please split them up.
I don't believe that moderate to large liposuction should be performed under local anesthesia. Many non-plastic surgeons are taught to do liposuction with only local, This technique is fine for small areas. When moderate to large areas are treated, the levels of fluid and anesthetic increase, placing the patient in danger of fluid overload and lidocaine toxicity.
Many practitioners performing liposuction under local do not have formal training, or the right facility to perform surgery safely. They buy a smart lipo machine, take a weekend course in lipo, learn how to mix up the local anesthesia, and go at it. Not having a full understanding of the toxicity of lidocaine, and the fluid shifts that will take place while performing moderate, to large volume, liposuction. This is the dangerous scenario.
The cosmetic surgery under local scenario is fueled by the fact that, if a doctor performs procedures under local anesthesia only, there are no state, or federal regulations that must be met by the facility, That means no inspections, that the doctor may or may not have monitors, or emergency equipment, pretty much no accountability, Yet that doctor saves a lot of money by not having to pay for an anesthesiologist, extra staff, the credentialing process, equipment etc,
When you shop around and get that really low price, you have to ask yourself, why is it so much cheaper here? Where are they saving money, and at what expense?
Every year the headlines tell us of another cosmetic surgery disaster. Do your homework. and do not become a statistic.
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Undergoing multiple procedures under general anesthesia increases your risk. You might consider having your breast surgery first and then having liposuction performed. The safest way of performing liposuction has been proven to be tumescent liposuction performed with local anesthesia. This eliminates the risks associated with general anesthesia.
Liposuction can be safely performed under both general and local anesthesia. Since you will already be under anesthesia for your breast surgery, this is an ideal opportunity to perform an additional procedure as long as it does not lengthen the procedure time significantly. In general, combined procedures have the benefit of reducing cost and isolating recovery time to one period rather than two. If your surgeon is well trained, this is a perfectly acceptable combined procedure.
Liposuction and breast reduction together
I think if you are healthy it is perfectly fine to have a breast reduction and liposuction performed at the same time. As for anesthesia, i think that patients are more comfortable under general.
Safety of breast surgery and liposuction
With general anesthesia the safety of having both liposuction and breast surgery diminishes as the length of the procedures increase beyond six or more hours. Abdominal surgery such as a tummy tuck and liposuction may be more risky even under these hours of duration as there may be an increased risk of a fat embolus. See a board-certified plastic surgeon in consultation to ask this question.
Abdominal Liposuction During Breast Reduction Surgery Under General Anesthesia
I think you are mistaken in your statement that it is safer to do ANY larger area of liposuction under local anesthesia than a light general anesthesia. In most cases larger surface areas require more local infused causing the possibility of an overdose of lidocaine that can cause seizures and even death (occurred in Ft. Lauderdale Florida 1 year ago). I frequently combine these 2 operations without any increased risks. It is a personal decision of the patient if they should have 2 operations or one. Remember in Florida there are limits to amount of lipo aspirate allowed too be removed.
Liposuction and General Anesthesia
The simple answer is you can have both done at same time under general anesthesia. General anesthesia does not independently increase the risk for liposuction. Poor outcomes with liposuction occur from inadequate technique and lack of recognition of complications as well inadequate management of complications. Please give pause that general anesthesia is used across this country and the world daily safely and effectively for patients that have extremely complex medical problems. Secondly, some physicians that constantly taut negative opinions about general anesthesia and liposuction usually DID NOT have the diverse SURGICAL training and DO NOT offer general anesthesia as an option because they DO NOT have surgical privileges at a hospital or accredited surgical facility. The patients must try to understand the differences in training and expertise of providers offering these services.
All surgical risk is relative.
Recent studies in the plastic surgery literature have attempted to answer this question. There is a study as recent as 2009 that looked at complication rates for thousands of patients having breast surgery and abdominoplasty with a large number of patients. Unfortunately that study did not look at those having combination surgery which is really the question you are asking. A much smaller study published by Grant Stevens and co-workers and also published in 2009 looked at this question. Unfortunately this study only included 268 patients but the authors concluded that the practice was safe.
However, how reassuring is this study? Unfortunately, this study is not really large enough to answer the question it proposes to answer. Death and serious complication are fortunately rare with these surgeries. That is good but it also makes it more difficult to answer this question. The risk of mortality associated with general anesthesia varies greatly and depends on the procedure and the health status of the individual. Overall, the mortality rate has been estimated at one in 30,000 cases. This means to reliably measure a doubling in the death rate the study size has too be much larger than this. Practically it is impossible to conduct such a study.
So is combination surgery risker than having two separate surgerie?. The answer most likely is yes. The more difficult question to answer is this increase risk worth taking? This has to be answered on a personal basis. Your surgeon will likely encourage you to do everything at once. This does have the advantage of a single recovery period, and compared to two separate surgeries, lower anesthesia costs where the first hour of anesthesia is traditionally priced higher than subsequent hours. However, the trade off is likely increased but difficult to quantify increased risk. To better understand this, I would not encourage a loved one to do everything at once and to give themselves an opportunity to heal between surgeries. How you evaluate this relative risk will very much depend on your perception of risk and your comfort level with your potential surgeon.
Web reference: http://www.lidlift.com
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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