Surgeon working alone without second assist?

In general, the vast majority of cosmetic procedures do not require a second assistant. In my practice, I will use second assistants to help with closure of extensive incisions. This is common in large body contouring procedures, especially when multiple procedures are being down such as in massive weight loss patients. The second assist generally has extensive experience closing incisions. This will cut down on operative times which can lead to easier/better recoveries. However, second assists are not necessary or customary for many procedures, and their presence or absence doesn't alter or affect the procedure that is performed. 

I feel it is the reverse. It is more normal for a plastic
surgeon to work alone and it has nothing to do with how tight you may or may
not have been pulled. The assistant usually only helps with sewing anyway. They
do not do the actual surgery. So it is not usual and customary to have a
surgical assistant in the operating room, it is up to the surgeon and it
usually is a cost to the patient to have an assistant.

It isn't unusual to work alone as a Plastic Surgeon with regard to a First Assist.  It is the physicians preference and usually they only use a scrub tech who passes instruments to the surgeon.  Most patients prefer just the Plastic Surgeon for their procedure.  Hope this helps. 

A first or second assistant is purely surgeon preference.  I have 20 years of experience doing your surgery with a surgical scrub technician only who passes instruments and assists with the procedure.  There are no safety concerns here.  Hope this helps.Dr. Ali Mosharrafa

Thank you for your question. It is not customary to have a second assist during surgery. There is a scrub tech that is there assisting the doctor during surgery. The function of second assist is to assist with closure of the wound under the direction of the plastic surgeon. They would not have been involved in placing sutures for your muscle plication. The fact that your surgeon did not have an assist means that every suture that was placed in surgery was done by someone who has extensive years of training as a plastic surgeon, so it is actually a positive thing.  Hope that helps.

Thanks so much for your question.  It's not necessary to have a second assist to perform any surgery in plastics.  It takes longer if you are working alone but many plastic surgeons work without assists and it's well within the standard of care to do so.  The actual surgery that was performed would be the same wether they had someone there helping or not.

 I am sorry to hear about your concerns. No, it is not necessarily "customary" to have a plastic surgeon assistant. In my practice, for example, I do not have a plastic surgeon assistant for the vast majority of cases performed. I hope this clarifies. Best wishes.

Many PS work alone so this is not out of the ordinary.  If you are unhappy with your results then you need to speak with your doctor. 

Some surgeons prefer to have an assistant, many do not. It makes no sense to me whatever that having or not having an assistant would lead to  not tightening the skin enough. Most patients who have a fleur-de-lis TT have had quite a bit of weight loss and a large amount of excess skin.  Even when closed tightly at surgery, some time later there is often skin laxity.  The skin has lost all its elasticity, and the TT does not restore that. There really is no "standard" for the use of an assistant at surgery. All the best.