Is 7-8 hours of surgery time reasonable and safe for my combined TT and Breast Reduction/Lift?

Question

I am 52, in good health, 5'7", weigh 165kg, take no medications and have no known medical problems. I am going to have a full tummy tuck, lipo and breast reduction and lift. (From 36E to 36 C/D). Does 8 hours sound about right and can I feel confident that my risk of DVT is low? The surgeon has mentioned that they do take steps to minimise risk. Is there anything I can do also?

Kenneth Hughes, MD · Answer

If you weigh 165 lbs instead of 165 kilograms, the surgery can be performed.  The surgery can be performed in 4 hours in expert fashion and will result in a lower probability for complications.

Larry S. Nichter, MD, MS, FACS · Answer

Breast implants/Breast Lift and Tummy Tuck are often Performed Together SafelyDifferent surgeons will recommend different procedures including doing more than one at a time. Some surgeons also differ in ability, time it takes to do the same procedure and general. It makes this a difficult choice for patients. Based on my own experience I would do all at once as long as it takes 4 or less hours. Surgeons should never perform elective operations that they are uncomfortable performing or feel unwise for them, nor should they be faulted for doing so. However, for me, I typically perform a tummy tuck and breast augmentation and lift (mastopexy) at the same time and usually takes about 3-4 hours so I recommend this be done in one surgery and this is what many refer to a Mommy Makeover.
Not only that,if you did not need a breast lift, I usually place breast implants through the Tummy Tuck incision but I prefer this technique. Tummy Tuck and Breast Augmentation Combination makes sense and is safe. Contrary to some of the answers I have found that the recovery time is not delayed and is the same as the tummy tuck procedure by itself. That is because you are healing simultaneously and not sequentially - both heal at the same time. The procedure only takes me about a half hour to 45 minutes longer than the tummy tuck alone. Best of all, I usually put in the breast implants through the tummy tuck incision so that there are no scars on the breasts.I have performed many of these combination procedures over the past few decades and think it is a great idea without significant increased complications

William Bruno, MD · Answer

The risk of a DVT definitely increases with the length of a surgery, especially an 8 hour procedure involving a tummy tuck. I would recommend discussing this in great detail with you plastic surgeon and consider having two separate surgeries. If you are actually 165 kg (and not 165 lbs) I would recommend weight loss prior to having any type of aesthetic surgery.Best wishes,Dr.Bruno

Dallas Buchanan, MD · Answer

Thank you for your questions. I do not think that for these procedures together, a time estimate of 7-8 hours is unreasonable. This length of surgery can be ok for the right person. If you indeed weigh 165 kg (364 pounds), then I would say that this is too long on an operative table and I would advise you to separate the procedures and do them at different times in the interest of safety. Hope this helps!

Camille Cash, MD · Answer

The procedures that you mentioned are often combined in one surgical day as long as you are in general good health and otherwise a good candidate for the procedures you are considering.  When preparing for surgery you will need to review your medications including prescription, over the counter and supplements with your surgeon who will then advise which you can continue and which need to be stopped.  Eat a healthy, balanced diet and continue regular exercise up to your surgery day.  Do not smoke or ingest nicotine or THC/CBD.  I've included a video on preparing for surgery that I hope you find helpful.

Gary L. Ross, MBChB, FRCS · Answer

I trust you meant 165 lbs rather than 165kg. Personally I don't offer any combination surgery that keeps patients on the operating table for more than 4 hours. In my practice I have a number of surgeons that help to suture so that the surgical times can be kept to around 3 hours for this type of combination. A dedicated team experienced in this combination is required to reduce risk and I mobilise patients immediately postop to reduce the risk of DVT / PE. I would obtain a second opinion if you are planning both at the same time or separate the procedures.

Tom J. Pousti, MD · Answer

Thank you for the question. Generally speaking, these types of combination surgical procedures are done routinely. In many practices, there may be cost advantages of combining procedures. However, you are wise in being concerned about the safety of combination surgery; risks/possible complications do increase with increased length of surgery… Although practices may vary, in my practice, I would recommend that you stage the surgeries (I try to keep the surgical duration under 6 hours).
It is best to evaluate each patient's suitability for combination surgery on an individualized basis. During this consultation process, after a complete history and physical, the SAFETY of combining these surgical procedures becomes of paramount importance. Plastic surgeon, anesthesia provider, duration of surgery, surgery facility all important considerations. Your best bet: choose your plastic surgeon very carefully; everything else including good judgment/advice/planning, anesthesia provider and safe surgery facility will follow.
 I hope this, and the attached link (dedicated to mommy makeover surgery concerns), helps. Best wishes.

Ronald V. DeMars, MD (Retired) · Answer

Surgeons operate at different speeds, but 5 hours or so would normally be adequate for that combination of surgical procedures, unless you are having something more than indicated. Elective cosmetic surgery should not generally go beyond 6 hours or the risks start to climb. I'm hoping the weight you typed is a typo, because at that weight no surgeon should be considering these operations in the first place. 165kg = 360#.

Jon A. Perlman, MD (retired) · Answer

I would advise against a combined elective surgery of 7-8 hours especially for someone weighing 165kg.  There are preventive measures but no guarantees that you might not suffer a PE or DVT.  Think twice about this please.
Jon A Perlman MD FACS 
  
Certified, American Board of Plastic Surgery 
  
Extreme Makeover Surgeon ABC TV 
  
Best of Los Angeles Award 2015, 2016 
  
Beverly Hills, Ca

Richard P. Rand, MD, FACS (retired) · Answer

It is generally recommended that elective surgery be kept to 6 hours or less in one day because of the increased risks of lengthy outpatient surgery. ie DVT and death. If your surgeon cannot accomplish the surgery safely in this time frame, I'd suggest staging it into 2 surgeries. After all, this is entirely elective and needs to be safe.

Is 7-8 hours of surgery time reasonable and safe for my combined TT and Breast Reduction/Lift?

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