Safety should always be the main concern. It is generally recommended that the length of elective surgery be less than six hours. The procedures should be performed in an ambulatory facility that is accredited by one of the national organizations like the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF) or in a licensed hospital. Most patients prefer undergoing one anesthesia and one recovery period which is usually more cost effective. Having said all of that, most ethical well trained plastic surgeons would feel that any combination of procedures that take 9 1/2 hours is excessive and has significant risk factors if performed in one stage. Keep in mind that following the advice of any surgeon on this or any other web site who proposes to tell you what to do without: examining you, physically feeling the tissue, assessing your desired outcome, and taking a full medical history, as well as discussing the pros and cons of each operative option would not be in your best interest. I would suggest you find a Board Certified Plastic Surgeon certified by The American Board of Plastic Surgery who is ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with, and discuss your concerns with that surgeon in person. That way, you can have a better idea what is safe and makes the most sense for you. Robert Singer, MD FACS La Jolla, California