Dear summerii in Los Angeles:
You are asking all the right questions. Frankly, we have done some sequential
operations one day apart. Yes, it is
ideal to have both surgeons operate sequentially on the same day. Are you sure there is no way that can be
worked out? Generally, it is feasible,
even if you do not work in the same surgical facility, exceptions can be made. I would definitely look into that before
committing to two separate sessions because it is not economical of time and
probably costs more. Generally, when you
combine procedures, you save on the operating room and the anesthesiologist fee. Now those two operations do not interfere
with each other so the only question about the interval is how short can it be.
The one rule would be to have the breast augmentation
first. The reason is, if you have the
rhinoplasty and then they are putting you to sleep for the breast augmentation,
there are going to be issues with the anesthesia which involves the mouth and
face. The anesthesiologist has to put an
oxygen mask on your face, and there are other reasons why it is not a good idea
to have any kind of manipulation of the face when you are having another
If in the end there is no way to avoid having these done
sequentially, then check with both doctors and see what they think would be an
adequate interval. You could even speak
to the anesthesiologist about that, but I do not think that will be an issue. I would recommend doing the breast
augmentation first. Below the collar
bone is one territory, and above the collar bone is another, and hopefully all
will go well for you.
Robert Kotler, MD, FACS
Over 4,500 nasal procedures performed
It's often best to do both procedures combined at the same time so you undergo one anesthesia session and recovery. It is also usually more cost effective. Your surgeons should be able to coordinate having this procedure done simultaneously on the same day.
It is best for the patient to have just one anesthetic and recovery. If you prefer to have 2 surgeons do the work there is no reason that both cannot do the surgery in one facility. It will be safer and also cheaper for you. In our clinic we believe in specialization; the rhinoplasty expert would do the rhinoplasty and another surgeon who focuses on body surgery would do the breast augmentation.
Since both a breast augmentation rhinoplasty procedures are performed under general anesthesia, it probably good idea to separate the 2 procedures by one month, to avoid any anesthetic complications. The only other option would be to have one surgeon perform both procedures, or 2 separate surgeons performing the procedures under one anesthetic.
Thanks for your question. Many ABPS board-certified plastic surgeons perform rhinoplasty and breast augmentation at the same time under one general anesthesia. If there is a specific reason to have two different doctors performing the procedures then I would make every effort to arrange for them to work together under one anesthesia or if absolutely necessary I would choose to separate the anesthetics by a one week time period. This is not based on any scientific study but just general good advice to allow you some time to commence the recovery and restore circulation to your calves. If you are young and healthy and absolutely need to separate the procedures into two anesthetics only days apart, I suspect you will do well. Anesthesia is now so much safer and easier to recover from compared to in the past. This assumes that you have no unusual medical issues and are not a smoker.Good luck and best wishes. If you have any doubts you might wish to discuss them with your own internist and be certain that the anesthetists from both offices are aware of your plans.
Dear summerli, In my practice these procedures are done together at the same time allowing one anesthesia and one recovery period. Perhaps the surgeons would work together in one of the offices so that the procedures could be done together? On occasions in my practice another local surgeon will perform a secondary procedure in my surgical facility at the same time. Since I have a fully accredited operating facility the joining physician must have privileges and meet the requirements of the accrediting body of my facility. If this is not a possibility then I would suggest speaking with your surgeons regarding the order they are most comfortable with. I would assume the breast augmentation would be done first and the nose second due to manipulation during anesthesia. Best regards, Michael V. Elam, M.D.