Is full TT (w muscle repair), lipo of abdomen, flanks, inner thighs/knees plus fat transfer to breasts too much in one surgery?

My plastic surgeon said I would be a great candidate for the procedures. He thinks he would get 2-3 liters of fat from my abdomen, flanks, inner thighs and knees via liposuction, then do the tummy tuck and transfer the fat to my breast. He thinks it would take 6-7 hrs. I am 41 yrs old and in excellent health. I'm concerned about the length of the surgery. Should I be? Is there any way that he could do the liposuction under local anesthesia then give me general anesthesia for the tummy tuck?

Doctor Answers 10

.....Too much in one surgery?

The time allotted for the multiple procedures which you have listed varies considerably from one practice to the next. I my experience, the combination that you seek would take about 5 hours under general anesthesia. Most plastic surgeons agree that to keep the total duration of surgery under 5-6 hours is more important than the actual procedures themselves. Be prepared to discuss your concerns with your surgeon and make certain that the Board Certified plastic surgeon with whom you choose to work can demonstrate plenty of experience with this combination/duration of plastic surgery.


Norfolk Plastic Surgeon
5.0 out of 5 stars 11 reviews

Is full TT (w muscle repair), lipo of abdomen, flanks, inner thighs/knees plus fat transfer to breasts too much in one surgery?

This is not too much in one surgery, but I would recommend having the procedure completed in 4 hours.

I would try to find a board certified plastic surgeon who has performed hundreds of these procedures and who has pictures and reviews you like.

Kenneth Hughes, MD

Los Angeles, CA

Combining a Mommy Makeover with Additional Surgery Sites

It's difficult to suggest without a in-person one-on-one consultation. The Mommy Makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.  

#Combined operations are often performed with our #Gynecology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries included with a #MommyMakeover. If you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your physician and board-certified plastic surgeon. Also, combining these #procedures may decrease anesthetics, costs, and recovery time.
In addition to a one-on-one consultations with a board certified Plastic Surgeon, patients always need to be seen by their primary care doctor prior to such procedures.  We screen every patient and their medical records for risks of blood clots (DVT) and then take appropriate measures.  MWL (massive weight loss patients of  75 lbs or more) tend to have poor skin elasticity and will frequently need additional tightening even after 6 -12 months regardless of who or how their surgery is performed. This is simply the nature of such body tissues and the ability to heal with the lack or limited elasticity. 

Your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Is full TT (w muscle repair), lipo of abdomen, flanks, inner thighs/knees plus fat transfer to breasts too much in one surgery?

Generally speaking, combination surgical procedures are done routinely.  However, you are wise in being concerned about the safety of combination surgery; risks/possible complications do increase with increased length of surgery…  


 It is best to evaluate each patient's suitability for combination surgery on an individualized basis. During this consultation process, after a complete history and physical, the SAFETY  of combining these surgical procedures becomes of paramount importance.  Plastic surgeon, anesthesia provider, duration of surgery, surgery facility all important  considerations. Your best bet: choose your plastic surgeon very carefully; everything else including  good judgment/advice/planning, anesthesia provider and safe surgery facility will follow. Best wishes.

Is full TT (w muscle repair), lipo of abdomen, flanks, inner thighs/knees plus fat transfer to breasts too much in one surgery?

As long as you are healthy and cleared to undergo elective plastic surgery, you should be fine. ~6h is the max that most PS want to put a patient under anesthesia for elective surgery. I don't think it is a good idea to do part of the surgery awake and then part asleep. Hopefully your PS can do everything in 6h. I think this is a realistic time for the procedures that you listed. I routinely do cases such as this in my practice on the right patient.

Length of surgery

Combination of liposuction and a tummy tuck may have increased risks.  However, your surgeon should work with you, understand your medical history, and what his surgical plan is, to determine if the length of surgery is an issue.  A qualified ABPS surgeon should be able to combine these procedures safely.

Steven S. Carp, MD
Akron Plastic Surgeon
4.5 out of 5 stars 28 reviews

Mommy make-over - all at one sitting?

Thank you for your question about your mommy make-over.

  • If you have an experienced Board Certified Plastic Surgeon doing your surgery and are in good health, this is reasonable.
  • It is a little over the ideal time but surgery may take less time than expected - assuming your BMI is 30 or lower.

Always consult a Board Certified Plastic Surgeon. Best wishes. Elizabeth Morgan MD

Is it too much surgery at one time?

Your surgeon has the advantage of having met you and examined you and so we should respect their opinion on this matter, but for a similar patient in my practice I would recommend two shorter procedures rather than one long 6-7 hour procedure. The primary disadvantage of breaking it up in to two procedures will be the inconvenience of two recovery periods. Some of the advantages will include:

  • More total liposuction with two separate procedures. Safety guidelines suggest that we should limit liposuction to a smaller amount when it's performed in conjunction with surgery, especially with an abdominoplasty. With two separate procedures the total volume of liposuction may be greater. 
  • The recoveries won't be quite so intense with 2 shorter procedures.  
  • The risk of DVT, a blood clot in the leg, is lower with a shorter procedure 
  • With two separate procedures, separated by 3 months or more, the second procedure provides an opportunity to make any adjustments to the first procedure (ie. scar revision etc)

These are some general considerations that may or may not apply to your situation. I recommend that you discuss these and other related issues with your surgeon and come to a consensus. 

Owen Reid, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 8 reviews

Anesthesia time for mommy makeover

It won't make a difference whether a portion of the anesthesia is local/IV sedation and general. If your surgeon is comfortable with the estimated time then it is probably reasonable, though my preference is to keep surgery times for this type of procedure under 6 hours.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 47 reviews

Length of surgery

Thank you for your question. These procedures can be done together and I frequently do them together in my practice.  I tend to not allow patients to go longer than 8 hours for cosmetic surgery.   That being said, I always check lab values, EKG, and do a thorough History Physical on my patients.  Your anesthesiologist will want to be sure you are healthy enough to have such a lengthy procedure as well.  Best of luck to you!

Shahin Fazilat, MD, FACS
Mountain View Plastic Surgeon
4.8 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.