There are a number of variables to take in the consideration for this combined procedure. There are certain variables that can increase or decrease the risk of serious complications. Some plastic surgeons choose to do these as separate procedures to decrease the risk of tissue necrosis. The complication when it happens, can be pretty devastating. General variables that lean towards safety include healthy patients who are young and are not obese. Any history of nicotine use seriously increases the chance of complications and active cigarette abuse is the absolute worst culprit. Most plastic surgeons will place the implant below the pectoralis muscle. This is considered much safer than above the muscle when a lift is done in conjunction. You should confirm this. the amount of lift needed also adds risk. A small lift is very safe in comparison to someone whose breast sit down by the bellybutton. The last variable is the size of implants used. Especially implants with a wide diameter . It’s generally not a good idea to change things last minute. If you’re having concerns about your procedure, then first ask yourself if this is just general anxiety and talk to your surgeon regarding the overall risk and especially the risk variables. If you are a young, healthy non-smoker, who has grade one droopiness with modest size implants placed below the picture, Allis muscle, the chance of you having devastating tissue necrosis is highly unlikely. On the other hand, if you have more than a couple of the above risk factors, especially if you’re an active cigarette user, then choosing to do this as a split procedure may be wise. My best guess is the great majority of these procedures are done as combined procedures. It’s also probably true that most people who have significant medical complications. Don’t talk about it or post about it on the Internet so these complications do happen, but there is a strong correlation, between risk factors and having the complication. Without knowing more variables, we can’t really give you any good advice. Stress up to the day of surgery regarding decision-making isn’t going to change your outcome and it is probably uncomfortable and unproductive. If you did a good job of choosing providers, and you feel comfortable with that provider Having a high degree of confidence then you should be all set. A good plastic surgeon would know when to encourage patients to do split procedures. In the end provider selection is by far the most important variable Best, Mats Hagstrom, MD