Combining cosmetic plastic surgery procedures is not uncommon. Whether you are a reasonable candidate for those procedures depends on your anatomy, your medical history, realistic expectations of the outcome and an understanding of the pros and cons of the various procedures. 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. Many surgeons would recommend an overnight stay at an appropriate facility where you can be appropriately monitored. Most patients prefer undergoing one anesthesia and one recovery period which is usually more cost effective. Having said all of that, many ethical well trained plastic surgeons would feel that the combination and length of surgery you are asking about is excessive and has significant risks 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 that your plastic surgeon should be 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 that you should 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. Before proceeding with a combination of these procedures, you should have medical clearance from your primary care physician and a discussion between him or her and your plastic surgeon. Robert Singer, MD FACS La Jolla, California