I have a history of difficult airway and difficult intubation, is it safe to have a tummy tuck and breast reduction?

Question

Hi I have a History of difficult airway and difficult intubation.And a Mallanpati score of 4 with adequate mouth opening. Is it okay if I have a tummy tuck and breast reduction with implants done?

Erik Miles, MD, FACS · Answer

I commend you for addressing this prior to surgery.  Many patients do not.   This information is very helpful for the surgeon and anesthesiologist.  When a difficult airway is anticipated, the anesthesiologist can be prepared with specialized equipment. It also may be an indication to have the surgery done in a hospital setting. Keep in mind that many office-based surgery centers have adequate equipment to handle difficult airways as well.  This is something you need to discuss with your surgeon. Best wishes to you.

Robert M. Tornambe, MD · Answer

esme001.   I appreciate your concern, however a history of difficult intubation does is not necessarily a contraindication for mommy makeover surgery. However, it is imperative to tell your plastic surgeon about this difficulty and be certain that your surgeon discusses your case with the anesthesiologist prior to surgery so proper precautions can be taken. Be certain to consult with a board-certified plastic surgeon. Good luck!

Ronald Schuster, MD · Answer

These are importan questions to ask. Yes you can have them both done but you should make sure that the facility can take care of you. The safest place would be in a hospital (or ambulatory center within the hospital). Sometimes special instumentation is needed in difficult intubations. This is not usually an issue in properly equiped facilities and experiences anethesia teams. Your choice of facility should be just as imporant as the surgeon. Good luck.

Camille Cash, MD · Answer

I encourage you to begin by visiting with a board certified plastic surgeon near you to discuss your interest in the procedures and to review your medical history.  Your surgeon may wish to have you evaluated by the anesthesia team before proceeding with the procedure.  Additional interventions may be suggested, such as having the procedure in a hospital setting versus a surgery center.

Bernabe Vazquez, MD · Answer

First of all, I would make sure the anesthesia personnel is a board certified MD anesthesiologist with plenty of experience in office surgery if that is where the surgery is to be done. Second, the office and anesthesiologist need to be advised of your planed procedure and have all the equipment necessary for a difficult intubation, I.e.,fibro-optic equipment. I do congratulate you for having your condition forefront in plans to have cosmetic surgery. Good luck.

David A. Lickstein, MD · Answer

in cases such as yours, it is important to ensure that an anesthesiologist is present and that you're in the setting that is appropriate.  Often this will be a hospital.  A glidescope may be needed. You want  To be in the best possible position if anything were to happen.

Tom J. Pousti, MD · Answer

This is an important question that cannot be determined online. You will be best off seeking previous anesthesia records if possible.

Then, careful selection of plastic surgeon and anesthesiologist (working in a fully accredited surgery facility) will be key. You may also benefit from preoperative anesthesia assessment (preferably prior to the day of surgery).  Tools such as video laryngoscope (AKA glidescope) may be very helpful for patients with challenging airways.

Best wishes.

I have a history of difficult airway and difficult intubation, is it safe to have a tummy tuck and breast reduction?

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