Is It More Risky to Have Abdominal Liposuction During Breast Reduction Surgery Under General Anesthesia?

I know lipsuciton is easily performed with miminal risks ans complications while under local anesthesia. I am having breast reduction surgery and my surgeon says he can combine the liposuciton during the same surgery. Does this increase my risk of a complication because the liposuction will be performed while under general anesthesia? Should I have the procedures done at different times?

Doctor Answers 13

There are added risks to doing liposuction and breast reductions together but trust your doc's recommendation.

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It is better to do them as separate surgeries but many of the docs who don't keep up with the best techniques in liposuction will still do them under general anesthesia and still get fair to somewhat decent results. Get a few consultations and then pick the doc you trust the most to give you the best results.  You don't want to end up with perky breasts and an ugly stomach.  Sincerely,

David Hansen,MD

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 46 reviews

Is it more risky to have abdominal liposuction under general anesthesia??

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Provided that you are in good overall health and not at risk for any clotting problems, it is generally safe to combine breast reduction and abdominal liposuction.  As stated before, any increase in time under general anesthetic does increase your risk for a blood clot, however, if the planned time is under 6 hours, you should be fine. 

Breast reduction and liposuction

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Performing liposuction and breast reduction at the same time is generally safe. However any prolonged procedure under general anesthesia can be associated with a higher risk of venous thrombosis.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Cosmetic Surgery Under Local Anesthesia

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Your health, the techniques used,  the size of the reduction, and fat removed, decide if you are a good candidate.

Each patient has to be evaluated individually. If you are healthy with a normal blood count (not anemic), and the liposuction is less than 5 liters. I would consider doing both procedures at the same time under general anesthesia. Under general anesthesia much less local anesthesia is used and thus becomes the safer way to go.

Definitely not with local anesthesia, These are both large areas that will require massive amounts of local anesthesia. This will bring you dangerously close to the toxic level of local anesthesia. Not a good Idea. if you are set on doing the procedures with local anesthesia, please split them up.

I don't believe that moderate  to large liposuction should be performed under local anesthesia. Many non-plastic surgeons are taught to do liposuction with only local, This technique is fine for small areas. When moderate to large areas are treated, the levels of fluid and anesthetic increase, placing the patient in danger of fluid overload and lidocaine toxicity.

Many practitioners performing liposuction under local do not have formal training, or the right facility to perform surgery safely. They buy a smart lipo machine, take a weekend course in lipo, learn how to mix up the local anesthesia, and go at it. Not having a full understanding of the toxicity of lidocaine, and the fluid shifts that will take place while performing moderate, to large volume, liposuction. This is the dangerous scenario.

The cosmetic surgery under local scenario is fueled by the fact that, if a doctor performs procedures under local anesthesia only, there are no state, or federal regulations that must be met by the facility, That means no inspections, that the doctor may or may not have monitors, or emergency equipment, pretty much no accountability, Yet that doctor saves a lot of money by not having to pay for an anesthesiologist, extra staff, the credentialing process, equipment etc,

When you shop around and get that really low price, you have to ask yourself, why is it so much cheaper here? Where are they saving money, and at what expense?

 Every year the headlines tell us of another cosmetic surgery disaster. Do your homework. and do not become a statistic.

Increased Risk

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Undergoing multiple procedures under general anesthesia increases your risk.  You might consider having your breast surgery first and then having liposuction performed. The safest way of performing liposuction has been proven to be tumescent liposuction performed with local anesthesia.  This eliminates the risks associated with general anesthesia.

Jerome Potozkin, MD
Danville Dermatologic Surgeon
4.2 out of 5 stars 5 reviews

Combined procedures

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Liposuction can be safely performed under both general and local anesthesia.  Since you will already be under anesthesia for your breast surgery, this is an ideal opportunity to perform an additional procedure as long as it does not lengthen the procedure time significantly.  In general, combined procedures have the benefit of reducing cost and isolating recovery time to one period rather than two. If your surgeon is well trained, this is a perfectly acceptable combined procedure.

Jason Hess, MD
San Diego Plastic Surgeon

Liposuction and breast reduction together

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I think if you are healthy it is perfectly fine to have a breast reduction and liposuction performed at the same time.  As for anesthesia, i think that patients are more comfortable under general.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Safety of breast surgery and liposuction

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With general anesthesia the safety of having both liposuction and breast surgery diminishes as the length of the procedures increase beyond six or more hours. Abdominal surgery such as a tummy tuck and liposuction may be more risky even under these hours of duration as there may be an increased risk of a fat embolus. See a board-certified plastic surgeon in consultation to ask this question.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Abdominal Liposuction During Breast Reduction Surgery Under General Anesthesia

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I think you are mistaken in your statement that it is safer to do ANY larger area of liposuction under local anesthesia than a light general anesthesia. In most cases larger surface areas require more local infused causing the possibility of an overdose of lidocaine that can cause seizures and even death (occurred in Ft. Lauderdale Florida 1 year ago). I frequently combine these 2 operations without any increased risks. It is a personal decision of the patient if they should have 2 operations or one. Remember in Florida there are limits to amount of lipo aspirate allowed too be removed. 

Liposuction and General Anesthesia

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The simple answer is you can have both done at same time under general anesthesia.  General anesthesia does not independently increase the risk for liposuction.  Poor outcomes with liposuction occur from inadequate technique and lack of recognition of complications as well inadequate management of complications.  Please give pause that general anesthesia is used across this country and the world daily safely and effectively for patients that have extremely complex medical problems.  Secondly, some physicians that constantly taut negative opinions about general anesthesia and liposuction usually DID  NOT have the diverse SURGICAL training and DO NOT offer general anesthesia as an option because they DO NOT have surgical privileges at a hospital or accredited surgical facility.  The patients must try to understand the differences in training and expertise of providers offering these services.

Dr. ES

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.