Is It Recommended to Have a Mommy Makeover in 3 Separate Surgeries?

Not only will this result in three operations, three times the (minimal) risks, and three time the recovery, it will cost you LOTS more. I hope that greed is not the motivation of your surgeon, but let's assume it's not. Why would a surgeon with proper training, board-certification (American Board of Plastic Surgery), experience, and skill recommend three separate operations when one can be safely performed with one set of risks and one time off work for recovery?

Depending on your size, a tummy tuck should take no more than 3 hours, perhaps less. This includes umbilical transposition, entire breast bone to pubic bone muscle plication, and layered closure with dissolving sutures beneath the skin (no staples or external sutures to leave marks). A full Wise pattern breast lift with similar closure technique should take no more than 3 hours, and implant placement adds another 45 minutes. With proper OR table padding, urinary catheter (removed before you wake up in the recovery room), Bair Hugger warming in the OR, and pneumatic boots to keep the blood moving in your legs (decreases the risk of blood clots), you are at extremely low risk for any operative-time-related complications. Three operations simply triples these same risks! I routinely do 6,7, and occasionally up to 8 hour-long operations as OUTPATIENT procedures, but this requires expert anesthesia and use of IV general anesthesia rather than inhalation gas anesthesia. It also requires enough surgical skill, experience, and celerity (speed) to do all of these operations expertly with minimal blood loss

Some plastic surgeons are uncomfortable doing full breast lifts AND implant augmentation at the same time. If his justification for doing the breast surgery in two operations is to decrease the risk of double bubble formation, perhaps this betrays a history of bad outcomes that stimulate this way of thinking. I accept nothing less than the best outcomes possible, and I must say that MOST plastic surgeons are not only capable, but prefer doing both parts of breast lift plus augmentation surgery at the SAME operation. (There IS a way to minimize double bubble formation, but this technique is not the way most of us were trained to do this (lift + implants) operation). I would be happy to discuss this technique with anyone interested--it's not magic, just good planning and technique.

In short, I sense extreme conservatism in your doctor, perhaps because of speed (slowness) of operating, lack of experience with one or more of these procedures, difficulty with anesthesia management for longer operations (sometimes out of the surgeon's control unless he/she own their own surgical facility as I do), or perhaps restrictions of the operating facility (some outpatient surgicenters require shorter procedures, or restrict the surgeon to specific "block times"). If your surgeon operates out of a hospital, perhaps he's trying to reduce the possibility of overnight admission, which increases the costs substantially (and makes the patient angry at the surgeon). Perhaps it's simply greed (the charges for three separate operations are invariably MORE than one combined operation). Perhaps it's truly a fear for your safety if there are complicating health issues, such as Factor V Leiden, diabetes, or cardiac issues.

My best advice: get at least one more opinion (two is better yet) from well-trained, experienced, board-certified (American Board of Plastic Surgery) plastic surgeons, and ask them about multiple procedures at the same time. Virtually all of us do things that way because it is safe, effective, and best for the patient overall.

It totally depends on each individual and what the surgeon recommends. Of course, combined surgery is cheaper and easier for patients. However, in some cases longer surgeries are more risky. I recommend you consult with couple of different surgeons and decide afterwards. Best of luck to you.

The mommy makeover is one of the most popular operations performed by plastic surgeons.  The procedure is a combination of cosmetic breast surgery, liposuction and abdominoplasty.  It has been designed to correct changes that occur normally with pregnancy.
There are multiple advantages in performing these procedures in combination.  These include an improved overall result, lowered cost and a single recovery.  Patients typically report increased self-esteem, self image and an overall improvement in the quality of their lives. For these reasons, the mommy makeover is one of the most popular operations that is currently performed in plastic surgery.
If you are in good health otherwise, there is no reason to stage the procedures.  This will ultimately result in more expense and more downtime.  Safety should be everyones priority.  If the procedure is done in an accredited facility, with a board certified anesthesiologist and plastic surgeon the risk should be low.
Every patient is unique and there may be other factors that have impacted the decision to stage your procedure.  If you have questions, don’t be afraid to get a second opinion.

Assuming you are in good health and there are no extenuating circumstances, it is "possible" and many times desirable to perform these surgeries in one setting. I frequently and safely perform "mommy makeovers" in an outpatient setting using one anesthetic. This allows mom to undergo one time off of work/child care, one anesthetic and certainly less costs. However, not all patients fit this description and not all surgeons are comfortable with this approach. Ask your surgeon for patients that you may contact to discuss their experience.

Dear Silverdale in Silverdale,

To accurately  answer your question a plastic surgeon would need to examine you, go over your health history, and understand your goals.  This would help assure what the safest options for you.

As far as ' what is possible' in general terms regarding this combination of procedures the range of options is to combine all three of the procedures, to do them all separately, etc.

I typically perform the breast lift (Mastopexy) either as a separate procedure (typically a 2 hour procedure), or combine it with a breast augmentation (augmentation Mastopexy)- with the clear understanding that the risk is increased, in certain cases, when these two particular procedures are combined. 

As far as the performance of the abdominoplasty (tummy tuck), it can be combined with either of the two procedures. 

My patients often prefer to undergo the Mastopexy as the initial procedure.  Allow time to heal (usually a few weeks), choose their implant size now that the breasts have been reshaped, and undergo the breast implant surgery combined with the tummy tuck (around 3 hours combined).  This combination seems to be very well tolerated, and I feel leads to a predictable and well tolerated final result.

I hope this helps,

Sergio Pasquale Maggi, M.D., F.A.C.S.

Some breasts need to be staged but the breast lift should be done first usually and then the augmentation.   The tummy tuck can be combined with either depending on your social schedule to recover.  I usually suggest the TT with the lift because the lift has minimal discomfort and the TT requires recovery (as does the augmentation).  Your choice.