Combined surgery - is it safe to get liposuction, facelift, breast implants and rhinoplasty at once?

Question

Is it safe to get liposuction facelift breast implants and rhinoplasty at once. Is it fatal?

Semih Yildiz, MD, FEPOBRAS · Answer

Combining that many procedures in one operation is usually not the safest plan for most patients. It is not automatically fatal, but the risk rises as the surgery becomes longer and more complex, especially with liposuction, facial surgery, breast surgery, anesthesia time, fluid shifts, blood loss, positioning, swelling, and blood clot risk all added together.

A safer approach is often to stage the operations, commonly separating facial surgery from body or breast surgery. Whether any combination is reasonable depends on your health, BMI, lab results, smoking status, surgical time estimate, amount of liposuction planned, anesthesia plan, and whether the surgeon has an accredited facility with appropriate monitoring.

If you are being offered all of these at once, ask specifically about expected operative time, blood clot prevention, fluid management, overnight monitoring, and what would be staged if safety becomes the priority. For many patients, two shorter, well-planned procedures are safer than one very long combined operation.

Daniel Barrett, MD · Answer

Dear Azmera11,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Chad Deal, MD · Answer

I would not professionally recommend having all these at one time. Particularly the rhinoplasty with body procedures. This specific because blood can build up and the breathing passages and cause aspiration if you were laid supine for the body portions. Also the longer you’re under anesthesia the significantly increase the risk of complications such as Venus, thrombosis and pneumonia as well as others. Also, when there’s any device implanted increase the risk of becoming infected the more areas of the body you work on, particularly the face where it’s difficult to stay strictly  sterile. Overall in my opinion, all cosmetic procedures should be four hours or less planned and certain procedures should be done together. But this opinion can vary from surgeon to surgeon.

Andrew Ray, DO · Answer

Great question. It is often common to get multiple cosmetic surgeries in the same session. This helps to decrease anesthesia time and limit recoveries to as soon as possible. However, it is my personal opinion that I would only combine rhinoplasty with maybe one other surgery, such as a Breast Augmentation or liposuction, and have the rhinoplasty done as the last procedure so that there is minimal chance of bleeding or large changes in blood pressure after the rhinoplasty has been completed.

Dev Vibhakar, DO, FACS · Answer

Hello,Thanks for your inquiry and I am glad you are asking this question. As much as we would like to do everything in a single setting it is often best to stage multiple procedures. You have to consider the risks of prolonged anesthesia and then complications during the post operative recovery period. My suggestion would be to do these in 2 stages, you can decide which one to do first based on what bothers you the most. One stage would be facelift and rhinoplasty and another stage would be liposuction/breast augmentation. I personally do not advocate the placement of breast implants and you can consider/discuss the option of fat transfer to the breasts with your liposuction. This is something to review with your board certified plastic surgeon.Hope this helps Dr. Dev

Gary M. Horndeski, MD · Answer

Combined surgery should last approximately 6 hours or less. Going past 6 hours puts your at higher risk for complications such as pneumonia and blood clots. I recommend doing these procedures in 2 stages.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Elective surgery on healthy patients is rarely fatal. However, I would suggest not doing a rhinoplasty with a breast augmentation because of the increased risk of infection to your implants. It could be done with the facelift.

Camille Cash, MD · Answer

Combining procedures is common and considered safe, but there is a limit.  For elective plastic surgery it is recommended to limit surgical time to six hours.  This is both for safety as well as to prevent diminished results.  With the procedures you mentioned it is likely best to break them into two stages.

Mats Hagstrom, MD (license on probation) · Answer

There are advantages and disadvantages to doing combined procedure from both the patients and providers perspective.
Quality plastic surgery takes time and the best plastic surgeons are going to be detail oriented.
I’ve never met a great plastic surgeon who operates fast.
I’ve seen plastic surgeons do facelift and less than two hours and the results typically leave something to be desired. I’ve also seen a plastic surgeons take over 12 hours to do a festive which is unnecessary and does not lead to better results.
I would say a typical timeframe of very high-quality caliber plastic surgeons is about 4 1/2 to 5 hours for a facelift.
 Likewise plasty take multiple hours as well.
The same is true for each of the procedures you’ve listed.
In regards to safety generally want to keep elective surgery to six hours or less, but it’s not uncommon for procedures to go a bit longer than that.
Any plastic surgeon who’s going to do that much surgery in one session is going to be cutting corners.
Is that What you want for your outcome?
I suggest you try to find out about how long each of the procedures typically takes most plastic surgeons to do and then you can do some comparison for yourself.
To find the right provider, I usually recommend people have multiple in person consultations with plastic surgeons in their community.
I generally recommend people avoid a virtual consultations whenever possible.
 During each consultation, you can ask each provider what they think is appropriate in regards to combined procedures.
The list of operations you’ve described is about two or three times more than I would recommended doing in one operation if you want quality work done. A facelift and rhinoplasty is a good combination of surgery to do together.
Liposuction doesn’t mean anything unless you include what areas are being treated and how much fat is going to be removed.
Large Liposuction procedures can take many hours and sometimes Liposuction is done in conjunction with many procedures only for a just a few minutes. 
I think two surgeries would be better for you
Best,
Mats Hagstrom MD

Combined surgery - is it safe to get liposuction, facelift, breast implants and rhinoplasty at once?

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