i am a 35 year old female 2 children the last one by c-section i need to have a breast reduction and lift due to medical problems so i ask the doctor if is ok to do a tummy tuck at the same time he say is ok but i will be under anesthecia for about 7 to 8 hours that bothers me I am in general good health do you think there is a big risk? should I do the 2 procedures separately the recovery will be long and painfull?
Does it Normally Take 7-8 Hours for Mommy Makeover? Should I do TT and Breast Red. Separately?
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7 to 8 hour money makeover surgery.
Thanks for your question.
As you can see from this forum your safety has to come first. 8 hours is a long time to be on the table for elective cosmetic surgery. It certainly exceeds the guidelines for ambulatory or outpatient surgery.
While we commonly combine breast reduction with tummy tuck If your surgeon does not feel that he or she can accomplish these two surgeries within a shorter time frame I think it would be prudent to separate them.
Surgical time for mommy makeover and safety
Potential complications/risks of surgery increase with a longer surgical time. However, if you are young and healthy and proper precaution is taken before, during, and after surgery, mommy makeover can be done safely. Surgical time to perform breast reduction and TT depends on your surgeon's speed and your body. Please discuss all potential risks/complications/alternatives with your plastic surgeon.
Shortening Surgery Time for Mommy Makeover with same great results
Great question - as there are pros and cons whether it is better to have one long procedure with increase risk vs two anesthesia's, two recovery times and two recovery periods. Remember healing for both procedures at the same time is simultaneous not sequential as the latter scenario would require.. Ask your surgeon specifically for his breakdown of the relative merits of each approach.
Putting aside the issue of slower vs faster surgeons; Here are my personal thouights - You are right, long surgeries especially over 6 hours more or less have the potential for more complications and recovery time. First of all there are ways to minimize the surgical time without influencing the result. For instance, use of an assistant to help sew the final layer (skin edges) can be done by another surgeon, PA or RNFA (nurse first assistant trained to close incisions). This alone can cut down the procedure by 1-2 hours.This is how I do it. For example the surgeries you mention take me about 4-5 hours to complete and I would recommend this approach.
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Length of Surgery Depends on your Surgeon, and After 6 hours, the Risks go Up
The amount of time it takes to complete any operative procedure will depend a lot on the surgeon you choose (some will take a bit longer to complete the same procedure than others).
Also, while there is no "magic number" in terms of the time period which is safe for you to be under anesthesia, it is generally accepted that for healthy people the risks of complications seem to significantly increase after about 6 hours.
If you have selected your surgeon for all of the right reasons (his education, training, experience, skill and talent), then I would say you should divide your procedures into two days. If you are concerned that you perhaps did not choose the best surgeon for yourself, I would take this as another indication it may be good for you to visit other surgeons who may be able to complete both procedures in less time.
Be careful that in the interest of having them both in one operation, you do not compromise your safety and happiness by ending up with a surgeon with less talent and skill... having the procedures done at once is only valuable if you are safe and have a reasonable expectation of a good outcome (which will entirely depend on the skills and talent of your surgeon).
Surgery time for a mommy makeover
7-8 hour mommy makeover too much in one day
If your surgeon is not able to accomplish the full mommy makeover carefully within 4-5 hours, I would advise that you separate them into 2 surgeries or find another surgeon who can do it in one safely. The risks rise after 6 hours of surgery in one day.
Does it Normally Take 7-8 Hours for Mommy Makeover?
If you are healthy, then doing the two procedures can be done as long as precautions are taken to avoid blood clot formation in the legs. When one does surgery on the chest and the abdomen, their ability to move around and even get out of a chair or bed is less because you have pain in your abdomen and in you chest. Having the procedures done separately might be safer, but then you will have two recovery periods too. The combined procedure will likely leave you 4-6 weeks until back to normal activity.
Combined or separate tummy tuck and breast reduction?
There is nothing wrong with combining the procedures and many plastic surgeons would recommend it for convenience and a single recovery.
Personally, my appetite for risk with cosmetic procedures is very low and I would separate a full tummy tuck and breast reduction EVERY time. I separate the procedures by a day or two, breast surgery first. In my opinion this greatly reduces the surgical risk while not adding much time to the recovery. My patients find that separating the procedures makes the recovery from each procedure a little easier (the breasts get a day to recover).
I enjoy my sleep and time with my family. Reducing risks and complications is well worth the inconvenience of separating the procedures.
Surgical time & Risks
Surgical risks are pretty straight forward and are present with every operation. Some include:
- Healing problems
- Clot (DVT / PE)
Of the complications that could actually result in death, blood clots are very concerning. Avoidance is key, as once you develop a clot, it has to be treated with blood thinners, which then makes bleeding more of a problem. The risk of clots increases with time under anesthesia, and every surgeon has their own personal risk-tolerance profile which they use to decide if the risks are acceptable. Personally, I do not perform elective cosmetic operations that I think will take more than 6 hours for clot reasons. For patients with normal BMIs, I can perform a breast reduction and abdominoplasty within those constraints. One reason that the operation could take longer is a high BMI - but that alone would be a good reason not to perform the abdominoplasty. Just like time under anesthesia playing a role with clot risk, surgical complication risk in general (infection, healing problems) are proportionate to BMI. Additionally, if your BMI is high, you would be short-changing yourself with the cosmetic outcome of the operation. Reconsider your situation before proceeding, and possibly get another opinion from a board certified plastic surgeon. Be frank in discussing these issues with your doctors.
Eight hours may be too long for a mommy makeover
Thank you for your question. 7-8 hours seems like a long time for a standard breast reduction and tummy tuck. If you are quite large and this is the reason that your surgeon feels that your surgery will take that long, I would suggest that you lose weight first, otherwise, you may consider breaking it up into two surgeries.