Combined procedure: can laparoscopic hysterectomy and tummy tuck be done at the same time?

Having a laparoscopic hysterectomy and tummy tuck under the same anesthesia is possible, and many women who are considering both procedures like the idea of having only a single recovery.In a combined surgical case, typically the gynecologist would perform the hysterectomy first, and the plastic surgeon would follow with the tummy tuck.  If the hysterectomy is being done for large fibroids, the muscle tightening part of the tummy tuck becomes much easier and more efficient afterwards.That said, I strongly caution my own patients against having the procedures at the same time.  Although the gynecological part is not significantly affected by the plastic surgery that follows, there is a higher risk of complications (particularly infection) with an elective, cosmetic tummy tuck after gyn procedures.Have a good discussion with your gynecologist as well as an experienced plastic surgeon who is board certified by the American Board of Plastic Surgeons.  The idea of having to take time off only once for two big procedures is very appealing, but you want to make sure that the risks are worth it.Hope this is helpful, and take care.Dr. Lim

Yes, they can, but NO, they shouldn't.Furthermore, although combining elective and insurance cases may seem that you can get "part" of the elective procedure "covered" by insurance, this does not work any more, and the total costs will be hugely higher than if you separate the cases. This is because you pay hospital prices for what could be substantially less costly at an accredited outpatient surgical center or in-office accredited facility. Sure, that means two operations and recoveries, but the financial downside can be unbelievable (PLEASE check this out before you decide to go this route, as it is "too late" once the hospital bills start rolling in--the deed is already done and you have no ability to say"Wait, they didn't tell me about this!"). And that is not the only concern.Others have commented on the favorable aspect of "combined" surgery, but hysterectomy is not a completely sterile case, as it involves the genital tract, which has bacterial contamination. If the laparoscopic access ports become contaminated, and that contamination infects the widely-undermined abdominoplasty flap, you could end up losing the entire flap, which would be a disaster of truly epic proportions for you. No matter how good your plastic surgeon is, s/he cannot overcome a slightly sloppy (bacteriologically) GYN procedure, regardless of antibiotic use. This could lead to a devastating complication, all to save a few bucks (probably NOT), and to combine two recoveries into one. Still possible, but separate your surgeries by at least a couple of weeks to ensure there are no complications from your hysterectomy.It's an unusual scenario that I'm suggesting as a possibility, for sure, but so is it unlikely that you will be in an automobile accident on the way to surgery--should you go without your seatbelt? Even though an accident is "unlikely?" Please consider this--elective surgery should be as safe as possible, and combining these two procedures does have a higher risk of complication (and that complication can be loss of your entire abdominal skin flap). Be safe and best wishes! Dr. Tholen

This is a very common procedure to undergo, and makes sense to utilize one anesthesia setting if possible.  Usually, the gynecologist will go first with their part, then the abdominoplasty is completed.  This creates one recovery period, and since the limitations after surgery are very similar between each procedure, works very well.  I hope this helps.