Most plastic surgeons would have several concerns with what you are planning. Combination procedures may be performed together. Whether you are a reasonable candidate, however, for the combination of procedures you listed depends on your anatomy, the extent of the abdominoplasty (tummy tuck) , the complexity of the BBL, the amount of liposuction, your medical history, medical clearance from your primary physician, realistic expectations of the outcome and an understanding of the pros and cons of the various procedures. Most patients prefer undergoing one anesthesia and one recovery period which is usually more cost effective, but many surgeons would prefer performing these procedures in 2 separate operations to diminish the potential for complications. Having stated that, most ethical experienced surgeons would feel that the combination of procedures that you listed would be excessive to perform at the same time. Safety should always be the main concern. It is generally recommended that the length of elective surgery be less than six hours. The procedures should be performed in an ambulatory facility that is accredited by one of the nationally recognized accrediting organizations like the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF) or if it is outside of the Unite States an international organization like the the American Association for Accreditation for Ambulatory Surgery Facilities International, (AAAASFI) or in a licensed hospital. Having surgery at a reduced rate in a foreign country sounds appealing, but there are many concerns that you should consider. Generally, there is no preoperative direct discussion with the surgeon who is going to perform the surgery in order to establish any reasonable doctor/patient relationship. There are often language barriers that can interfere with your care. Even if your surgeon speaks English, the ancillary personnel like the nurses and the anesthesia provider who are involved in your care, may not. The quality of hospitals outside of the U.S. varies tremendously. Some are accredited and inspected, others are not. Even if the hospital has reasonable facilities and the surgeon has training, which may not be up to the quality of training of a plastic surgeon certified by the American Board of Plastic Surgery, the quality of the nurses and others involved in your care may be very different from that in the United States. They may have little or no formal medical education, training or credentialing. There is usually little follow-up care. In addition, the general sanitary conditions often increase the risk of infections, including some that are generally rare in this country. There are also major potential problems that may occur with traveling long distances just before and after surgery, like dehydration and fatigue, but more importantly complications including clots in the legs called deep venous thrombosis and clots to the lung which may be life threatening. In most countries, if a problem develops, you will have little legal recourse and no ability to file a complaint either against the hospital or about the surgeon. If complications.,develop after you return home, it may be difficult or impossible to obtain care from your local physicians. If problems do occur, the cost of subsequent care can be far greater than the reduced cost of the original surgery. While there are well-trained physicians in many other countries, I would suggest that you travel for pleasure or business and have your surgery closer to home.Flying home a few days after extensive surgery adds a significant risk of severe complications. Robert Singer, MD FACS La Jolla, California