Laporoscopy and Fat-reducing Procedure in One Surgery?

Question

I need to have an IUD removed (placed 2005) which has somehow gone through my uterus into the abdominal cavity. The doctor wants to perform a laporoscopy. Since I will be paying mostly out of my pocket and will be under anesthesia, I wanted to know, is it safe to have liposuction or any fat-reducing procedure/surgery done at the same time?

Steven H. Williams, MD · Answer

Most plastic surgeons hesitate to combine cosmetic procedures of any length with other medically necessary treatments.  There are several potentially complicating issues:
1.  Longer operative time - While modern surgery is a generally safe experience, there is a clear correlation with longer operative time being associated with a higher complication rate.
2.  Longer recovery - Of course have multiple surgeries increases your recovery time.
3.  Higher risk of complications - In addition to a longer operative time other factors like multiple surgeons, multiple sets of instruments and lack of full control of the operation (obviously your general surgeon or gynecologist controls there part of the operation and your plastic surgeon would control his or her part).
4.  Specific negative procedure interactions -  What I mean here is that there are some procedures that are not great together.  The most common one I am asked about is getting an abdominoplasty at the same time as a scheduled c-section.  All of the above apply but in addition my abdominoplasty results likely won't be as good because the additional surgery (the c-section) at the site of my abdominoplasty can cause additional risks and the patient's swelling and body habitus reduces the effectiveness of the abdominoplasty.
In your case laparoscopic surgery usually involves filling your abdomen with air that will give the surgeon more room to work.  Possible complications from this necessary part of the laparoscopic procedure include - increased risk of penetrating the abdominal cavity with the lipo cannulas, not being able to assess the treated areas effectively in the abdomen is still even slightly distended with gas, etc. etc.
There are some benefits to combining operations (a single recovery time, a single episode of anesthesia, usually more cost effective).  It is very important to be extremely cautious in pursuing these benefits with the above incomplete list of risks.
I hope this helps.
Steven Williams, MD

Toby Mayer, MD · Answer

It is probably safe to do the two together unless the gynecologist has a specific reason not to. This will save you money as long as it is safe.

Steven Wallach, MD · Answer

I would refrain from having liposcution performed at the same time as an inra-abdominal procedure. It may complicate things for you.

Pat Pazmino, MD, FACS · Answer

Liposuction is a safe, popular, and effective way to contour the body. Although it is very commonly combined with other procedures, in your case I would not recommend performing liposuction at the same time. Keep in mind that the laparoscopy surgery must be done by adding gas to your abdomen to help distend the abdomen so that the surgery can be performed safely. Once the abdominal surgery is completed, the abdominal wall must be repaired. When performing liposuction, fluid must be added to the area treatment and you do not want to have does fluid enter into the abdominal. For your safety and best results, be sure that you're working with a board-certified plastic surgeon who has a great deal of experience in liposuction abdominal contouring. In your case you should wait for your body to heal from the laparoscopy and then received the liposuction at a later date.

Peter A. Aldea, MD · Answer

GYN procedures are frequently combined with cosmetic procedures BUT such combinations are NOT risk free. While liposuction and tummy tucks are considered "clean" cases NOT all GYN cases classify as such.
In my opinion, it may be risky to view a perforated IUD which requires removal as a clean case.
IF in the opinion of your GYN, the IUD can be removed through a separate incision without contamination of the field where the Plastic surgeon would be operating, I would not have a problem with doing both at the same time. However, if the endoscopic procedure could be an open procedure and if as a result the field may be less than "clean", I would not combine them. There is no reason why the bacteria now present around the IUD would need to be spread around your tummy by liposuction.
Dr. P. Aldea

Sirish Maddali, MD · Answer

It is extremely important to have your plastic surgeon and gyn doctor discuss your case specifically. If the laparoscopy is a minor procedure to remove an IUD, then the surgical risks already listed should not be greatly increased. 
I would personally perform the liposuction first to make sure I can provide an even result before the abdomen becomes distended (blown up) for the laparoscopy.  
Talk to both doctors and have them talk to each other. If you are young and healthy and have no risk factors for general anesthesia and surgery, then your overall surgical risk would likely be only minimally increased.

Robin T.W. Yuan, MD · Answer

Both surgeons have to be comfortable with the combination. It is common to perform simultaneous cosmetic and abdominal or pelvic procedures but the risks may be increased under certain circumstances. Also, be sure that the laparoscopic needs, such as insufflation, do not distort the areas that your plastic surgeon will be working on. Good luck.

George J. Beraka, MD (retired) · Answer

Hi.
In New York City, we have done liposuction together with a laparoscopic procedure several times without difficulty.  Just make sure your gynecologist is used to working together witha plastic surgeon.

Laporoscopy and Fat-reducing Procedure in One Surgery?

Answers (8)

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