Having Lipotuck Done, is 7 Hrs too Long with the Use of Sedation?

I am neverous about the amount of time I will be under sedation. I know sedation is more safer than a general but it still worries me

Doctor Answers 19

How long should a tummy tuck take?

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Lookng at our photos, I think you may be mistaken about the time it will take to do a tummy tuck. The average time is 2-3 hours. A total body lift may take 7 hours if huge amounts of skin are removed, but that is not your case. If you don't have overlapping skin, a traditional liposuction may be all that is necessary. If you are having a true tummy tuck, and the muscles need to be tightened, that can be quite painful. I expect that you are only having a liposuction with removal of excess skin. You should discuss this with your surgeon to get a clear pictures of what is being done and how long it will take. If your answer is 7 hours, a second opinion may be in order. If it is a tummy tuck with muscle tightening, called plication, then a general anesthesia would be my choice for you. This may even be safer, as less local anesthetic will e necessary, and excess local anesthetic can be toxic.

Sedation vs General Anesthesia for Liposuction/Tummy Tuck

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Sedation is not necessarily more safe than general anesthesia, expecially if high doses of lidocaine are being used over a long period of time to complete the surgery. Whether seven hours is actual surgery time or this factors in the time used for tumescent fluid to be infused and allowed to work is immaterial. That is a very long time for any version of a tummy tuck with or without liposuction and it is unnecessarily so. You have good reason to question this amount of needed time and I would recommend you seek other consultations to get additional views of what type of surgery is right for you. Under general anesthesia, this type of surgery would take no more than 2 or 3 hours.

Lipotuck and 7 hour surgery

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A surgeon may coin a term, but it is important to find out what it means. There is no defined procedure called a "lipotuck." This may just be liposuction done at the time of a tummy tuck.

Although the safety profile of sedation/intravenous anesthesia versus inhalation/intubation general anesthesia is generally better, it depends on the procedure being done, what the surgeon is most comfortable with, and your medical history.

The main factor for anesthetic safety is length of procedure. I personally will only do minimal liposuction at the time of the tummy tuck for various safety and outcome reasons. For me, a tummy tuck typically takes just under 2 1/2 hours, as the no-drain progressive tension technique that I use takes a little more time. As surgery length increases, so do potential risks, the most dreaded of course is a DVT or PE, clots in the legs or pelvis that travel to the lungs. If a surgical procedure is anticipated to take too long, it very well may be best to split it into multiple procedures.

This information is for educational purposes only and is not a substitute for a consultation with a plastic surgeon certified by the American Board of Plastic Surgery.

Length of Surgery, Anesthesia and Patient Safety

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I concur with my colleagues regarding their concerns.  First, I am not aware of a technically defined procedure called a lipotuck.  I'm assuming its a marketing term applied to a case that involves a tummy tuck (abdominoplasty) and liposuction of the waist/flanks and other areas.   Depending on what procedures are exactly being done and how much excess skin/fat needs to be removed, the length of surgery for a tummy tuck and lipo of the waist can range from 2 to 4 hours for most surgeons.

Now let me address the safety concerns.  Again, as my colleagues have underscored, it is essential that you be evaluated by a board certified ASPS (American Society of Plastic Surgeons) member plastic surgeon.  In addition, it is critical your procedure is completed in an accredited operating room facility (accredited for instance by AAAASF) or a hospital accredited by JCAHO or AAAHC).  Tummy tucks and limited liposuction can be safely performed with TIVA (total IV anesthesia) with proper monitoring (that is ensured if your procedure is done in an accredited environment) or under general anesthesia.  I defer these decisions to my board certified anesthesiologist.   
IV sedation is not always safer than general anesthesia.  The choice of anesthesia depends on your anatomy, your health status, and length/type of procedures being performed.

In my opinion, I think a 7 hour procedure simply may be too long for just IV sedation.   Furthermore, if indeed your procedure will take 7 hours, you may require an overnight stay.    Please visit with a board certified plastic surgeon to learn more about your options.  You are doing the right thing asking these questions.  As the ASPS patient education campaign states: "Do Your Homework".

Best of luck.

Dr. Basu

Houston, TX

Red Flags?

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Thank you for the question.

Your question brings up “red flags” that are concerning in regards to the safety of the planned procedure. Most well-trained well experienced board-certified plastic surgeons will  perform this type of procedure under general anesthesia ( where issues such as airway control can be managed most safely).  The duration of the planned procedure also raises concerns.

I would suggest that you check the credentials/certification/training background of your surgeon as well as his/her safety record with the medical board in your state.

Best wishes.

7 hours of sedation

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Sedation can be given comfortably for many hours, but so can general. The type of anesthesia used for any surgery is something discussed with your anesthesiologist.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

7 hours under sedation

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IV sedation is not necessarily safer. I would not be at all comfortable doing such a procedure under IV sedation.

I assume you saw a Board Certiied Plastic Surgeon (one certified by the American Board of Plastic Surgery Surgery). If you did not, please seek another consultation.

Ann F. Reilley, MD (retired)
Baton Rouge Plastic Surgeon

Sedation for 7 Hours of Surgery

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This depends on the type of sedation, level of sedation and who is providing it. Discuss this with your surgeon and ask if an anesthesiologist or nurse anesthetist is involved.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Liposuction with abdominoplasty

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First of all sedation is not safer than general anesthesia and if someone told you that they are not being truthful. The choice of the best/safest anesthesia for a given patient depends on the procedure, the patient, the surgeon and the anesthesia staff. In some cases it is more dangerous to do a procedure under sedation than general anesthesia. I had one patient who required liposuction years after head and neck cancer surgery and the safest anesthesia for that patient was a spinal block. Sedation is not usually recommended for procedures that take a long time because the patient cannot sit still and the sedation medications are mostly short acting.

Lipotuck is just liposuction added on to a tummy tuck and the same procedures are performed together by plastic surgeons every day all around the country/world. Squeezing the two words together or trademarking the term does not make the procedure different.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

7 hrs for 'lipo-tuck' under sedation - questionable

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You should be nervous. A properly executed abdominoplasty requires for your muscles to be relaxed in order to plicate fascia (suturing that makes your abdomen flatter and brings your waist line in). Please make sure your PS is truly a Board Certified Plastic surgeon. The state of Florida passed a law that no cosmetic procedure should take more than  6 hrs.This was/is to ensure patient safety. Take care, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.