Will combining several procedures impact the quality of my results?

Question

I've been quoted for several procedures that can supposedly be done in one go: rhinoplasty, chin implant, breast aug with lift, lipo 360, lipo on arms, and body contouring. This seems like a lot to do at once but a two surgeons have assured me that I'll be fine. I've read that combining too many procedures at once can result in suboptimal results. is this true?

Thomas A. Mustoe, MD, FACS · Answer

There is some data and personal experience that extending elective surgery beyond 6 hours increases the risk of complications. Doing multiple orocedurs at once may make efficiency a higher priority than optimal aesthetic outcomes which can take time.  In my practice I would be cautious about doing all that is being proposed in one operation.

Emmanuel Mallol Cotes, MD · Answer

Thanks so much for your inquire,

Your surgeon will assess your overall health, goals, and medical history to ensure you’re a good candidate for combined procedures. Working with a surgeon experienced in combined procedures can make a big difference in both your safety and the quality of your results.

In short, the decision to combine procedures should be based on your unique anatomy, goals, and health. A qualified surgeon will balance these factors to give you optimal results.

Sincerely, 
Dr. Emmanuel Mallol

Daniel Barrett, MD · Answer

Dear _Risas,
I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ira H. Rex III, MD · Answer

Many surgeries that are performed consist of multiple procedures.  Each plastic surgeon has to determine what combinations of surgeries can safely be performed.  Depending on the health of the patient and extent of the individual surgeries, multiple procedures surgery safety is determined by the surgeon.  Factors that are considered are the length of time it takes to perform multiple procedures and the extent of those procedures.

Christopher V. Pelletiere, MD · Answer

Based on the procedures that you listed, that would be a very long surgery and have increased risks.  The general rule is to try and keep any elective cosmetic procedure to 5-6h at the most.  Around that time the risks really climb as it relates to anesthetic risks, blood clots, infection, etc.  I would consult with another board-certified plastic surgeon ( american board of plastic surgery) if you are seeing surgeons who are recommending this to you all at once.  I hope this helps

Azita Madjidi, MD, MS, FACS · Answer

There are a few procedures that can be combined safely. Some are in the same anatomical location like nose and chin. Some even in the same location, add two variable results and opposing forces, like breast augmentation where a volume is added and the skin stretches  and breast lift where skin is tightened so scars get stretched. Some take a long time, like body contouring so it would be better to focus on that alone. Some add risk of bacterial spread like combining rhinoplasty and breast implant ( one dirty and one clean surgery). Most surgeons stage surgeries.

Matthew C. Camp, MD · Answer

You have 6 procedures listed. There are a couple problems. 1) operative time is too long- unless these surgeons have magical powers, there is no way that this can all be accomplished in less than 6 hrs. We try to keep surgical time to less than six hours in order to reduce risk of DVT, fluid shifts, and pressure injuries due to immobility. 2) Extensive liposuction combined with all these other procedures is not advised due to the large amount of fluid injected during the liposuction process. I suggest breaking this up into one day of surgery above the neck, and another day a couple months later addressing the other issues. Generally I limit cases to two procedures at a time - breast and tummy for instance.

Guler Gamze Eren, MD · Answer

Hi from Istanbul,Thank you for your question.A combination surgery might be right if you're busy and limited time off.Combination surgeries may carry some risks due to the duration of surgery, Patient's safety is the priority of all the doctors. I prefer to combine surgeries which can be done in less than 5-6 hours. I would recommend you to divide those surgeries in two sessions to reduce the risks and it will be easier to recover.

Emmanuel De La Cruz, MD · Answer

Combining several procedures, including liposuction with other cosmetic surgeries such as a tummy tuck or breast augmentation, can impact the quality of your results in several ways:

Surgical Complexity: Performing multiple procedures at once increases the complexity of the surgery. This may require longer operating times and more extensive surgical techniques, which can potentially affect the outcome.

Recovery: Combining procedures can result in a longer and more challenging recovery period compared to undergoing each procedure separately. Your body will need time to heal from multiple surgical sites simultaneously.

Risk of Complications: There is an increased risk of surgical complications when multiple procedures are performed together. These can include infections, bleeding, adverse reactions to anesthesia, and poor wound healing.

Aesthetic Outcomes: While combining procedures can achieve comprehensive aesthetic improvements, it requires careful planning to ensure that each aspect of the surgery contributes to a harmonious and balanced final result. Rushing or overloading the surgical plan may compromise the aesthetic outcome.

Patient Suitability: Not every patient is a suitable candidate for combined procedures. Factors such as overall health, medical history, and individual anatomy play crucial roles in determining candidacy. Your surgeon will assess these factors carefully during the consultation.

To ensure the best possible outcome when considering multiple procedures, it's essential to:

Choose a Qualified Surgeon: Select a board-certified plastic surgeon with experience in performing combined procedures. They should have a thorough understanding of the complexities involved and be able to provide personalized recommendations.

Have Realistic Expectations: Understand the potential benefits and risks associated with combining procedures. Discuss your goals and expectations with your surgeon to ensure they align with what can realistically be achieved.

Follow Pre-operative and Post-operative Instructions: Adhering to pre-operative guidelines and carefully following post-operative care instructions will help optimize your recovery and overall outcome.

Ultimately, while combining procedures can offer comprehensive results, it's crucial to prioritize safety, thorough planning, and open communication with your surgeon to achieve the best possible outcome for your cosmetic goals.

Luis Suarez, MD · Answer

You can combine multiple cosmetic procedures in one surgery, it's crucial to evaluate your health first carefully. Health conditions such as heart disease, diabetes, and obesity plus longer surgeries can create a risk. Your board-certified plastic surgeon will ensure that your body can safely handle the anesthesia and the recovery process.

Will combining several procedures impact the quality of my results?

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