Interested in a MACS facelift and abdominal lipo with tummy tuck. According to PS facelift is a major operation. Opinion?

It is theoretically possible to perform a facelift and abdominoplasty with liposuction at the same time. The bigger question is whether this would be a wise thing to undergo. Most plastic surgeons will tell you two separate these two procedures. There are a number of reasons for this. Usually one would perform the abdominal surgery first, logistics the other way around make it more difficult especially with the monitoring needed by the anesthesiologist to perform your facelift first. Abdominoplasty is a bigger procedure which takes time and also involves a fair amount of swelling. A facelift is a very delicate slow tedious procedure. Issues include possible swelling from the tummy tuck point of view that could interfere with the facial part of the surgery. Probably also one would need to consider is both the time under anesthesia and also the fatigue of the surgeon. Personally, I would find it difficult following especially the liposuction portion of the procedure to comfortably perform a facelift. If your surgeon has qualified assistants, that could possibly alleviate some of the issues. But also remember the postoperative care. The abdominoplasty will probably require more pain medication which could influence the proper taking care of facelift incisions. Personally, I would separate the procedures.

I agree with your surgeon that facelift is a major operation, and staying put for 7-10 days is beneficial.  In part it is beneficial for you, as you will have social downtime during this period, and as well, rest during this period will promote healing and may help avoid wound healing problems.The tummy surgery you describe is also considered a major procedure. Understand that the advice below is general advice, as without photos or examination in person it is impossible to know just how involved your surgeries will be.  Some facelifts and tummy tucks can be done in a short time. There are pros to doing the surgeries together:1)  One recovery period.  This is a major factor.There are also cons to consider when doing them together:1) A longer operation puts you at higher risk for a deep vein thrombosis, which can be a serious problem.2) You are asking your body to do a great deal of healing at the same time.   The psychological aspects of these surgeries cannot be ignored.   You may feel very washed out by the surgeries, and potentially struggle to stay on top of the care that is required for both sites.  For example, excellent care of your facial incisions is required.   It will be difficult to lean in to a mirror, wash the incisions well and apply topical antibacterials if you have just had a tummy tuck/liposuction abdomen.  Some people feel down or even slightly depressed or anxious in the early stages of recovery, and wonder why they put themselves through an elective procedure.  You will need a good support system in place if you do two major procedures together. 3) You actually may enjoy your results less in the short term  - instead of two quicker recoveries you will have one longer more involved recovery.  4)  The length of the surgery may become too long to allow you to do the procedure as an out-patient.  You do not want your surgical team to feel rushed and compromise on the attention to detail required in these surgeries.  (Having a second surgeon is an excellent option if available to you).Finally, and again, without having examined you  I am not sure if this is an option for you, however, you may consider a lesser procedure, such as face lift and liposuction of your tummy, and then go back and have your tummy tuck at a later day.  Set your goals to optimize both your result and your safety.All the best to you,Dr. Nancy de Kleer

Dear skychick,Thank you for your question. To address your 2nd statement first - I have to agree with your plastic surgeon - the facelift is a major operation and should only be performed by a trained plastic surgeon. Similarly, patients should also understand the risks and complications associated and factor the right amount of time for recovery after a facelift. Many patients underestimate the significance of the surgeries or the recovery that is required after the procedure. There are many different types of facelifts and they each have their pros and cons. Some techniques are shorter and have a faster recovery but the results may not last as long compared to other techniques. Being able to stay for 10 days is good advice so that you have the right amount of time for recovery and your surgeon is able to remove the stitches for you before you return home. Combining surgeries always seem to be a convenient option to the patients and usually leads to cost savings. However, do note that combining surgeries does prolong the surgery time and this may lead to potential complications of long surgery and long anaesthetic times. Longer surgery times also do increase the risk of infections and bleeding, etc. Depending on your age and the extent of surgery that you would want, it may not be safe to combine the surgeries. As for blood loss, both face lift and lipo-abdominoplasty should not have significant amounts of blood loss. I work in a group practice with 2 other plastic surgeons and one of the ways that we help to improve the outcome of surgery is to have more than one attending doctor on the case, especially when you are having multiple procedures. This will certainly help to shorten the surgical time as well as the operative costs. I hope this answers your question and all the best !Rgds,Dr. Terence GohAZATACA Plastic SurgerySingapore