How long is too long to be under anesthesia for a breast reduction and tummy tuck?

Question

I am interested in having a breast reduction. My breasts are currently 40H. In addition to a breast reduction, I would also like to have a tummy tuck. My insurance is covering the breast reduction and it will be conducted at a hospital. My dr. Told me that it would be approximately 8 hours to complete both procedures. That seems really long to me. On average how long do you think it should take? Would you suggest doing the procedures separately?

Sean Younai, MD, FACS · Answer

the combination of breast reduction and tummy tuck takes at least 8 hours. the safety of this combined procedure primarily depends on your health and presence of medical conditions. If you are young, healthy, and not extremely obese then this combined procedure would be safe during that time period

Andres Taleisnik, MD · Answer

The main risk with surgeries longer than about 5-6 hours, especially when a tummy tuck is included, is the possibility of developing blood clots in the veins of your legs, which can then also cause respiratory (breathing) problems. I've done 8 hour surgeries many times in my career without health problems, but they are certainly a possibility. There are multiple factors that influence your risk. These include your age, your overall health, you BMI (height vs. weight), and others. You'll need to discuss this further with your surgeon. You may be a good candidate for a longer procedure such as this, or not. If you or your surgeon are concerned, you can always split it into two surgeries. Regardless, it will be very important for you to walk to enhance your circulation after surgery. There are other things that can also be done, like using sequential compression stockings after surgery, or Lovenox to minimize risk of blood clots. As I mentioned, you'll need to discuss these things with your surgeon, and do whatever makes both of you feel most comfortable.

Richard Baxter, MD · Answer

Several things need to be considered in planning combination surgeries:Combining means only one recovery timeCombining typically costs less; however the facility and anesthesia costs may be greater for the cosmetic (self-pay) portion when done in a hospital as compared to an outpatient facility dedicated to cosmetic surgeryThe risk of complications starts to increase with surgery times more than 5-6 hoursFor an 8 hour surgery you should stay overnight in hospital

Gerald Minniti, MD, FACS · Answer

Hello,It really is surgeon dependent.  A typical breast reduction takes on average three hours.  There are some surgeons that do it in half that time, and some that take twice as long. Outcome is more important than time.Similarly, tummy tucks can also vary, not just because of the surgeon, but because of the variability of the procedure.  In my practice, there are some tummy tucks that take 2 hours, some that take 5, but on average about 3 hours.  In the short ones I'm just smoothing and tightening a very thin and small skin flap. In the long ones, I'm performing liposuction of the torso, tightening muscle, directly excising more deep fat, and smoothing and tightening a large skin flap that goes around to the back.  So you see, it really depends.As for combining procedures, if your BMI is less than 30, your age is less than 40, and you don't smoke or have any other medical problems, you'll probably do just fine.Best of luck!

Stuart A. Linder, MD, FACS · Answer

I prefer not to exceed 5 hours when possible. Most studies indicate an increase in morbidly over 5 hours. Stage your 2 surgeries if necessary.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Breast Reduction and tummy tuck are procedures that are commonly performed together.  The length of surgery varies between surgeons.  In my opinion, 8 hours for both procedures seems reasonable to me especially if the you have a lot of tissue to remove for the breasts and abdomen.  Best wishes.

Curtis Wong, MD · Answer

and 8 hours for the procedures is a bit long.  I'm a very average surgeon and I would take 6 hours doing this by myself.  You would have to consider using medications to help prevent clots post-op.  It would probably be safer to find a faster surgeon.  But the fastest aren't always the best... in my opinion, speed kills.

Tom J. Pousti, MD · Answer

Thank you for the question. Generally speaking, combination surgical procedures are done routinely.  However, you are wise in being concerned about the safety of combination surgery; risks/possible complications do increase with increased length of surgery…  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. You will find that there are no "absolute rules" when it comes to your question.  Based on the principle of safety and avoidance of complications first, in my practice, I generally avoid combination surgical procedures that will take longer than six hours in our hands.Your best bet: choose your plastic surgeon very carefully; everything else including  good judgment/advice/planning, anesthesia provider and safe surgery facility will follow. Best wishes.

Arian Mowlavi, MD, FACS (license on probation) · Answer

We perform breast reduction and tummy tucks routinely in 4 to 5 hours. 8 hours is too long for these two procedures to be performed together.

How long is too long to be under anesthesia for a breast reduction and tummy tuck?

Answers (9)

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