Why are mommy makeovers outpatient? It seems like pretty big procedures.

Question

I am concerned, I will be having a mastopexy with aug, full tummy tuck and lipo to my stomach, flanks and Submental. Some Dr.s have the patients stay in outpatient facility over night. I'm scared to have these procedures and be sent on my own ( with my very supporting husband). I don't have a selected Surgeon yet and would like to know how important it is to go to one that will keep me over night after the procedures. Thank you before hand.

Thomas McNemar, MD, FACS · Answer

This is an excellent question, and kudos to you for being proactive
about your health. Indeed, most mommy makeovers are relatively major procedures
in terms of length. Whether or not it's performed as an outpatient procedure
depends on a few different factors, including your overall health, the
significance of your surgery, and your doctor's own preference. An overnight
stay in a hospital or specialized surgical center can be beneficial for some
patients. Others, however, may return home to rest just a few hours after
surgery. Most surgeons approach aftercare on a case-by-case basis rather than
making claims that mommy makeover is always
an outpatient or inpatient procedure. The techniques we use for mommy
makeovers are extraordinarily safe and reliable, so although it is a
"major" procedure in the sense that in involves more than one area of
the body, it's not typically medically complex. As you consult with plastic
surgeons while you plan for surgery, be sure to ask about their individual
approaches for recuperation.

Miguel Delgado, MD · Answer

Actually, in my practice, mommy makeover surgery is not an outpatient procedure. I require my patients to stay overnight at the surgical center at which the mommy makeover was performed, so as to keep a close eye on the early stages of recovery and to provide maximum comfort directly following surgery. In fact, I have found that the majority of surgeons prefer to have the patient stay at least one night and that this guideline can truly reduce the risk of complication. Still, the surgery is personalized on an individual basis and may be possible that your surgeon is not stressing an overnight stay for your mommy makeover because your treatment is relatively less intensive. However, if you feel more comfortable moving forward with a surgeon who does stress this overnight stay, I recommend consulting with another surgeon in your area to get a second opinion.

Vincent N. Zubowicz, MD · Answer

I prefer to keep most of my mommy makeover patients overnight for observation. This is not a requirement but certainly not every mommy makeover patient is discharged after the operation.

Andres Taleisnik, MD · Answer

Even though a mommy makeover can be a somewhat long procedure, it usually doesn't result in much shifting of fluids into and out of the vascular (blood vessel) system, so the anesthesiologist doesn't need to give the patient too much fluid via the IV. That means that this surgery is much less stressful for the body (heart, lungs, etc.) than a surgery that involves entering the abdominal cavity (like intestinal surgery). As others have mentioned, the biggest risk is deep vein thrombosis ( blood clots in the legs). There are several things that can be done to decrease the likelihood of this problem, including frequent walking after surgery. Almost all of my patients go home after mommy makeovers. There are options for overnight stays or home nursing care, but patients with attentive family care at home don't necessarily need those options. I call my patients at home and stay in close communication. Ultimately, you need to do what makes you most comfortable, and what your surgeon of choice recommends. If you'd feel better having a nurse or staying overnight at a care facility, that can be arranged.

Richard Baxter, MD · Answer

Assuming you are in good health, not overweight, and the surgeon can complete the procedure in under 5 hours or so, it is reasonable to do a mommy makeover as an outpatient. Several things contribute to making this a safe procedure including advances in anesthesia which enable you to wake up quickly, long-acting numbing agents such as Exparel which reduce the need for post-op pain medications, and better surgical techniques. Most mommy makeovers are done as an outpatient and the cost for an overnight stay is prohibitive for many.

Paul E. Chasan, MD, FACS · Answer

Most "mommy makeovers" are fairly large surgeries, and I usually keep them over night for a 23 hour stay at my facility. It is not absolutely necessary, but it makes the initial postoperative discomfort, nausea, etc less and the overall experience better.

Kenneth Hughes, MD · Answer

This will depend upon the experience of the surgeon and your medical health as well as the ability of the surgeon to keep the surgical time to about 4 hours.  I
would search for the board certified plastic surgeon who you feel is
most likely to give you the best results and who performs hundreds of
these procedures each year. I would look at patient reviews as well as
before and after photos on that surgeon's website.Kenneth Hughes, MDLos Angeles, CA

Robert W. Kessler, MD, FACS · Answer

When doing a Mommy Makeover like you described, I require my patients stay at a dedicated aftercare facility with 24 hour observation by registered nurses specifically trained in post surgical care. These are big operations and I don't care how supportive a family member is, they don't know what to look for and they don't know how to help. In fact, I will even discuss separating these operations to make each individual recovery easier.By the way you asked the question, you already know what the right answer is for you. You would be more comfortable knowing a professional was caring for you in the immediate post operative period.Seek out a board certified plastic surgeon to help you make these important decisions. Good luck and I hope this was helpful.

Michael Zwicklbauer, MD · Answer

Mommy makeovers are safely preformed as an outpatient procedure.  Each patient is different and all medical problems must be considered including Body Mass Index (BMI) in making this decision.  Most patients enjoy being in their own bed and home for recovery and so every effort is made to accommodate this.  Sometimes home nursing can be set up to help in recovery if family is not comfortable.  If however, patients request to stay overnight arrangements can be made to do the surgery at a local hospital for a small fee.   Hope this helped!

William Bruno, MD · Answer

The majority of mommy makeover procedure are performed on an outpatient basis. The procedures you specifically listed can be done in about four hours, which is a safe amount of time for a combination surgery. Some patients will choose to stay overnight at an aftercare facility or in a 23 hour observation unit. If you have a medical condition or lack of family support then it is recommended to stay in such a facility for the first night or two. However most patients who are in good overall health and have some family/friend support during the recovery will be discharged from the surgery center to their homes. Discuss this in detail with your plastic surgeon once your medical history is reviewed and your surgical plan is outlined.Best wishes,Dr.Bruno

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