How many procedures at once?

Question

I had botched liposuction 1.5 years ago, 9 areas/2surgeries. Horrible results. I need to start from scratch and correct. (I know...believe me...I've cried) Can I do an arm lift, tummy tuck and breast implant exchange with lift at the same time?

Gary M. Horndeski, MD · Answer

The safe operation time is 6 hours. The arm lift takes 1-2 hours, the tummy tuck takes 2-3 hours depending on the technique and the breast lift can take 2-3 hours depending on the technique. It may not be possible to do all 3 procedure at the same time. I always recommend doing the breast lift procedure prior to the tummy tuck. If the tummy tuck is done first then it will pull the breasts down lower and make it difficult to elevate the breasts higher.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding combining an arm lift, tummy tuck, and breast implant exchange with a lift to revise your prior botched liposuction. I'm truly sorry to hear about your experience, and I understand your desire to correct these issues.

Combining surgeries like an arm lift, tummy tuck, and breast implant exchange with a lift can often be done simultaneously. However, several factors determine whether it's safe and effective to perform multiple procedures in one session. These include your overall health, the total time you'll spend under general anesthesia, expected blood loss, the complexity and length of each incision, and the efficiency of your surgeon and surgical team.

If you’re in good health, your lab results are normal, and your surgeon is confident in their team's ability to manage the procedures effectively, combining them is often possible and may streamline your recovery process. However, it’s essential to have a quality post-operative care plan and support during recovery, as multiple procedures will require extra attention for optimal healing.

For peace of mind, make sure your surgeon is board-certified and experienced in performing multiple surgeries during a single session. I hope this information helps clarify your options as you prepare for your corrective surgeries.

Sincerely,
Dr. J. Timothy Katzen, MD

Chet Mays, MD · Answer

Thank you for your inquiry!   It would be best to see you in the office to better gauge how involved each procedure would be. Schedule a consult with a Board Certified Plastic Surgeon to help you reach your goals.

Ryan Rebowe, MD · Answer

The arm lift, implant exchange, and breast lift are easily combined within the normal range of time for an elective procedure. However, adding an abdominoplasty will likely put you over the expected time limit for safe cosmetic surgery (about 6 hours). I would stage these procedures in any manner that you see fit, starting with the area that bothers you most.

Carlos Marciales, MD · Answer

Hello, thank you for asking, first in order to know if all the procedures can be performed in a single moment, we need to evaluate the photos, second it is also important to evaluate the previous surgeries to determine the best way to solve the problems you have, thank you

Zoran Potparic, MD · Answer

Considering your current result and dissapointment you should be very careful with planing and, in particular, selection of your surgeon. It would be better if you plan one or two surgeries at the time and let your surgeon guide you. Good luck.

Dana Goldberg, MD · Answer

You can, and occasionally I do, but I normally would do arms with breast or breast with tummy, but not usually all three for several reasons.

1. Healing that much surface area is taxing on the body. Small issues with wound healing become more likely.

2. If you combine all those surgeries you will need more help for a longer time after surgery, for example, when you can’t use your stomach muscles, it’s hard not being able to use your arms to help push yourself or to have someone grip to help you get up out of bed or off the toilet. It’s also difficult to wipe yourself when you can’t move your arms fully and also can’t twist your torso easily.

3. Revision surgeries from “bad” liposuction are even trickier. There is often scar tissue that can increase the risk of bleeding and make surgery take longer. Having increased bleeding and longer surgery times can increase the risk of complications.

If I decide to do all 3, it is usually someone who has a low BMI, is not tightening the abdominal muscles, and is strong and active before surgery.

Connie Hiers, MD, FACS · Answer

You did not discuss anything about your age or medical conditions, so I cannot be specific. You are looking at least 6 to 8 hours of surgery for most surgeons, and this may need an overnight stay. Risks do increase as surgery time increases. I would suggest just doing the arms tuck with the breast surgery and then the tummy tuck at a later time. I would not do all those areas at one time.

James Knoetgen, III, MD · Answer

Combining multiple surgical procedures, such as an arm lift, tummy tuck, and breast implant exchange with a lift, is possible and often done to reduce overall recovery time and anesthesia exposure. However, whether you can safely undergo these three procedures simultaneously depends on several critical factors: 
Factors to Consider
1. Overall Health: Your general health and fitness level are primary considerations. A thorough preoperative assessment by your plastic surgeon will determine if you are a good candidate for combined surgeries. 
2. Surgical Duration: The total time spent under anesthesia is a significant factor. Surgeries that last more than 6-8 hours can increase the risk of complications. Your plastic surgeon will evaluate whether the combined procedures can be performed within a safe timeframe. 
3. Recovery Plan: Recovery from multiple procedures can be more complex. You need to be prepared for an extended and potentially more challenging recovery period. Ensure you have adequate support and resources for post-operative care. 
4. Risk of Complications: Combining surgeries increases the potential for complications such as infection, blood clots, and delayed wound healing. Your plastic surgeon will weigh these risks against the benefits of a single surgery session. 
Advantages of Combined Procedures
•	Single Recovery Period: Combining procedures means you only have to go through one recovery period, which can be more convenient. 
•	Cost Efficiency: There can be cost savings related to anesthesia, facility fees and other associated costs when procedures are combined. 
•	Comprehensive Results: Addressing multiple areas at once can provide a more comprehensive and harmonious overall aesthetic result. 
Common Combined Procedures
It is relatively common to combine procedures in cosmetic surgery. For example: 
•	Mommy Makeovers: These often include a combination of breast surgery (augmentation, lift, or reduction), tummy tuck, and liposuction. 
•	Body Contouring After Weight Loss: Patients who have lost significant weight might have multiple procedures like a tummy tuck, arm lift, and thigh lift done together. 
Consultation with a Surgeon 
A detailed consultation with a board-certified plastic surgeon is essential to: 
•	Assess Suitability: Evaluate your health, surgical goals, and the feasibility of combining these procedures. 
•	Customized Plan: Develop a tailored surgical plan that maximizes safety and effectiveness. 
•	Informed Decision: Understand the risks, benefits, and recovery expectations associated with combined surgeries. 
While it is feasible to have an arm lift, tummy tuck, and breast implant exchange with a lift performed in one surgical session, it is a decision that requires careful consideration and planning with your plastic surgeon. The priority will always be your safety and achieving the best possible outcomes.

Camille Cash, MD · Answer

Combining procedures is common and considered safe but there is a limit.  It's recommended that elective plastic surgery should be kept to about six hours of surgical time for safety as well as to promote optimal results.  Depending on the complexity of your revision for the procedures you mentioned it may be better to break them into two stages.  See a board certified plastic surgeon near you for a consultation to learn more.