Multiple facial procedures during the same operation?

Question

I am planning to travel to Europe for a rhinoplasty and want to see if I can combine it with other procedures. Does this sound doable during the same operation? Rhinoplasty (I have thick skin), blepharoplasty (upper with fat transfer to lower, hopefully), and either a mini-facelift or cheek/chin liposuction. My main concerns with the latter procedures are excess fat on the lower part of my face as well as drooping/sagging - nasolabial folds, a drooping crooked mouth, and asymmetrical cheek fat.

Lexie Wang, MD · Answer

It is absolutely possible to do this but will depend on your health and what your surgeon/surgical center/anesthesia feels comfortable with.

William Portuese, MD · Answer

More information is needed such as a full set of facial photographs to make sure you're even a candidate for all of these different procedures. Multiple procedures can be performed under one anesthesia with one recovery. Best to limit the general anesthesia to five hours to be considered done as an outpatient procedure. Also, very important to understand if you have thick skin in your nose, you're going to most likely require steroid shots in the tip of your nose multiple times in the postoperative period, so make sure you have adequate follow up.

Mats Hagstrom, MD (license on probation) · Answer

I’m not sure what your actual question is.
It’s definitely possible to have multiple small procedures done at the same time. This tends to be a very reasonable thing to do since each procedure is not particularly stressful on the body.
Having multiple facial procedures is very different than having multiple body contouring procedures. Generally speaking elective surgical procedures should ideally be kept for under six hours, but each plastic surgeon will have their own opinion regarding the appropriateness of doing multiple combined procedures.
I love that said, I generally do not recommend people travel long distances for elective surgical procedures. I recommend people have multiple inperson consultations with local plastic surgeons in their community to help find the right provider and be able to get appropriate, long-term and postoperative care, which is often very important for all of the above procedures, you described. The number of patients who will have questions and issues after these procedures is probably the majority.
I suggest having in person consultations with local plastic surgeons in your community. During each consultation, ask each provider to give you an assessment regarding the areas of concern on your face. Ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who had similar facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before, and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like or how many of these procedures anyone surgeon has actually done.
Personally, I don’t think you can vet plastic surgeons using your computer or cell phone. I think it requires meeting providers in person and asking very important questions and asking to see sufficient quantity and quality of before and after pictures to get a clear understanding of what each surgeon is capable of achieving. Understanding you and candidacy for the procedure is also very important in maintaining a high degree of long term patient satisfaction.
I generally recommend patients have multiple consultations before choosing a provider or scheduling surgery.
Being board-certified in plastic surgery with years of experience, and overall good reputation, does not mean that somebody has mastered any one single procedure, especially complex facial aesthetics.
There may be good reasons to travel for surgery, but generally speaking patients are better off getting medical care close to home.
The importance of having in person, consultations and access to inperson, long-term follow up, cannot be over emphasized.
Best,
Mats Hagstrom, MD

Multiple facial procedures during the same operation?

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