What Order Are the Procedures Performed in Operating Room for Mommy Makeover?

I usually perfrom the breast procedure first and apply sterile occlusive dressings if there are implants before proceeding to the body.  The two reasons I do it this way is to reduce implant infection by contamination from the groin and pubic region and I have to sit the patient up for the tummy tuck and part of the breast procedure is done easiest with the patient lying flat.

Basically, you are having hip liposuction, tummy tuck, and a breast augmentation.  Each surgeon has his or her own technique.  That being said, at the Mommy Makeover Institute of Hawaii, we do the liposuction of the hips first since you are lying prone on the table for this procedure.  We suture up all liposuction incisions, turn you over, and then do the breast surgery.  The breast surgery is done second because in a well done abdominoplasty, the patient is sat up at least at 30 degrees if not more, and this makes it very difficult to position the patient correctly for the breast surgery if it is done in the 3rd position.  The breasts are then dressed to decrease the chance of any infection, and also to lock in the desired position of the implants with ace wraps and bras.  Finally, the tummy tuck is done last because this surgery will determine which position the patient has to lie in for the next 3 days, and certainly how the patient has to be positioned in the recovery room. 

There are some variations of the order per the surgeon, and this would be an appropriate question to answer your plastic surgeon. Here is the order I pick to do these procedures


Back Lipo - once done you will be turned to a supine position, skin prepped and sterile drapes reapplied

Breast Surgery - when finished this area will be covered with a sterile cover to keep you warm.

Any liposuction on the upper tummy or hips if needed

Abdominoplasty (tummy tuck) - which includes bringing the muscles together and hernia repair if appropriate.


The reason for the order makes sense as you have to be flexed for the tummy tuck and flat for the other portions.

 

The order of procedures may vary from doc to doc but I start wih implants as these are the most sterile part, ie it's best to exchange implants first and then close them up safe and sound before moving to the abdomen. I would the start with lipo of the flanks, the raise the abdominoplasty flap, repair the hernia and tighten the muscles and then close the tummy tuck. Hope that helps, Dr K

Hi there-

To some extent, the order the procedures are performed will depend on your anatomy, the details of your particular procedure, and your surgeon's preferences, so your best bet is to ask your surgeon what his plans are.

Generally speaking, if all other things are equal, I prefer to complete the breast enhancement procedure first, then follow with the tummy.

 

Thank you for your question. 

The order of the surgeries that are performed in mommy makeover is mainly affected by the tummy tuck. When the tummy tuck is completed patients are usually sitting almost upright and kept in a bent position to take tension off the lower abdominal scar. Because of this final awkward position it is usually best to do do the other surgeries first.

For example: if I'm going to do a breast surgery with tummy tuck and posterior flank or other sites of liposuction, I usually do the liposuction first because it may involve turning the patient from side to side or flipping the patient over.

I usually performed the breast surgery next (unless we're placing breast implants through a tummy tuck) because of this point the patient can then be lying flat.

Usually the last step is the tummy tuck.

Each surgeon may have his or her own variation and the order is usual determined by how we best position our patients while they're asleep.

I hope that this answers your question.

For significant liposuction of the flanks, I start with the patient prone and do the lower back/flank liposuction first. Next, you can be turned into the supine position and the rest of the procedures, redo breast augmentation and tummy tuck with hernia repair can be done.  Either order is fine for the procedures on the front; however, I like to start with the tummy tuck and do the breast procedures second.  I have done it both ways with equally good results. I hope this helps.

In my experience, I perform the breast augmentation and/or lift first followed by the tummy tuck portion of the case for a complete Mommy Makeover!

Congratulations on your upcoming surgery! This is dependent on the surgeon and the surgeons specific plan. I recommend talking to your plastic surgeon to figure out what his plan will be for your specific surgery.Best of luck!  

It really the surgeon's preference as to which procedure to perform first, but I can tell you what makes most sense for me.  If we are doing flank liposuction, I start with that first, as it is done in the prone (face down) position.  We then flip back to the supine (face up) position and re-prep / drape everything.  I next proceed with any breast surgery (augmentation, lift, reduction) before completing with the tummy tuck.

Dr.B