Is It Safer to Have 2 Short Surgeries or 1 Long Surgery?

From your description you wish to have a Tummy Tuck and liposuction of your leg, and an  arm lift. In my practice I try to limit surgeries to less than 6 hours to decrease risks. The procedures that you mentioned can all be done in that time period so I would recommend one surgery. To minimize anesthesia and surgical time but not your results I also use a second surgical assistant (surgeon, PA, or RNFA) to decrease total OR time. It is important to  go over the increased risks associated with combining procedures and make sure they have a complete informed consent prior to doing it in one stage and take special measures to prevent venous clots.In your case, except on rare occasions my total OR time would be less than 6 hours for these procedures that you are considering.

Discuss this with your board certified plastic surgeon.

There are two factors to having two operations.  One is the surgical procedure itself, the second is the anesthetic.  For general anesthesia, the most critical times are induction and emergence.  Therefore, combining two procedures in one, if expeditionally carried out is probably safer than two surgeries.  This may differ by surgeon, profiency of procedures and in fact, anesthesia, personnel and facilities.  Many surgeries performed in small office OR's do not have the monitoring equipment or MDA's present which for for greater monitoring staff and patient safety.  Generally most outpatient procedures shoud be accomplished in approximately five hours to be considered an outpatient procedure. 

The first rule of cosmetic surgery is patient safety. Surgery that is over 5 or 6 hours can have a higher rate of complications and often require an overnight hospital stay. Therefore, trying to squeeze as many operations into one surgery is not a smart way to practice medicine. Secondly, the recovery specifics for one operation may contradict the recovery instructions for a different operation. For instance, a tummy tuck will require the patient to use their arms much more to get up from a seated position or getting out of bed. An arm lift requires a patient to go easy on the use of their arms to limit swelling in the arms or tugging on the incision lines. Therefore, combining a tummy tuck and an arm lift is not wise as the postoperative requirements are contradictory. Patients often think one operation will save them a lot of money, but the bottom line of cosmetic surgery is not cost, its success of the surgery with long-lasting results.

Doing multiple procedures at the same time is a very common and usually safe.  Your surgeon will decide if you are a safe candidate for procedures. This will be based on your health and the surgeons experience. Keep in mind that you need to be a motivated patient.  Obviously you willl be sore in more areas at once.  It is of great importance fo you to be up an ambulating on your day of surgery.  Also make sure that your doctor commonly performs the procedures you will be undergoing and is board certified. Lastly examine the place were the surgery will be done.  Unfortunately Miami has a lot of subpar facilities were people have a highe risk of getting poor outcomes.  Do your homework!

 

Good luck and thank you for your question.

 

Sincerely,

Anire Okpaku MD

If you are healthy and the surgery can be done safely then it is usually OK to combine these procedures together.  It really is a case by case thing, and an exam and medical history are essential.  Good luck.

This is an excellent question! My standard is twofold. First, the total operative length is important because anything over five hours will intrinsically have greater morbidity and risk of complications. I tell my patients that I am not a speed demon and that the goal is to perform an excellent operation, not to see how fast I can operate or how much I can cram into five hours. Second is the issue of recuoeration. It is easier to recover from a more limited operation than one involving the arms and the abdomen. Think about it. After the tummy tuck, you will need your arm and leg muscles to help get you out of bed and moving, which is very important after anesthesia. Finally, despite all the hype about combined procedures, most of my patients, when confronted with the price tag, prioritize. And, there is no greater compliment than a patient who can't book the second surgery fast enough. I know that I always discount the second procedure significantly so the patient isn't financially encumbered and doesn't feel pressured to sign up for a lot of surgery before they've had the experience of undergoing an operation or feeling truly comfortable about the fit between us.

It is very common to undergo several procedures in one setting.   Your surgeon will determine if you are  a good candidate for a combined procedure based on your health status (past medical history) and your physicial exam.   In addition, your surgeon will determine if an overnight stay at the hospital is warranted.   Every surgical plan is unique/different so I encourage you to direct these questions to your surgeon and his staff.   Please visit with a board certified plastic surgeon.  Best of luck.