How many hours for breast implant lift and TT with lipo together?

Doctor Answers 17

Time for Combined Procedures

While all of these procedures in our office are completed together at one time, I do not want to presume what your surgeon's practice would be in completing these three for you. You would be safest to take this question directly to your surgeon and discuss any concerns with him. Good luck to you. 


Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Doing both procedures at once

I usually do all of these procedures at the same time unless there is a compelling reason not to. Using your tummy tuck incision is great to place saline and silicone implants. Not only is it possible to place your breast implants through your tummy tuck incision, it is my preferred method in that it does not take extra time and leaves no scars on your breasts. I have been using this approach for more than 25 years with great satisfaction from my patients. You might consider using the fat from your Lipo rather than buttock implants.

Duration of surgery

A breast augmentation with mastopexy can take anywhere from 1.5 to 2.5 hrs depending on the type of lift and skill of surgeon. A tummy tuck with liposuction (of the flanks) can take anywhere from 1.5-3 hrs depending on the size of the patient and skill of surgeon. Try to limit all your procedures in one day to less than six hours total. Consult with several plastic surgeons in person for more information.

Best wishes,
Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 335 reviews

Reconsider this combination

The two combinations that you are suggesting, lift/implant and lipo/tt are the most controversial subjects in plastic surgery.  Having all 4 in my mind is a mistake.

Abdominoplasty treats the skin excess and muscle weakness of the abdomen, as well as any fat that is between the belly button and the pubic hairline. Liposuction treats only fat. It can be used to thin out the abdomen, but the skin must be in good condition with no excess, and there should not be muscle weakness. I do not like to combine abdominoplasty with liposuction because of the added risks of fluid collection under the skin, and wound healing problems.

Aggressive liposuction with tummy tuck is dangerous. A full tummy tuck with liposuction at the same time will certainly put you at a high risk for fluid under the tummy tuck skin (seroma). The literature is complete with this information. The science is the science. This is a risky combination.

The incidence of seroma formation is about 16.0 percent in the abdominoplasty-alone group and 31.2 percent in the abdominoplasty with liposuction group.

The combination of abdominoplasty and liposuction procedures can still overwhelm the body's ability to resist these shear forces by the fact that more surface area is available to “shear” and thus produce seroma fluid. Not so much as an additive effect but synergistically, such that the seroma fluid from the flanks flows into the adjacent abdominal space and resists the ability of the upper abdominal flap to close over the abdominal wall. Patients must be counseled about their risk for seroma formation and treatments aimed at resolving them including frequent postoperative visits for needle drainage and the rare case requiring operative drainage in the face of a persistent seroma.

A full tummy tuck with aggressive liposuction at the same time will certainly put you at an unacceptably high risk for a potentially fatal pulmonary embolism (PE), venous thromboembolic event (VTE) as well as fluid under the tummy tuck skin (seroma), loss of the skin of the tummy tuck (necrosis) wound failure (dehiscence) and hematoma, among other things. The literature is complete with this information. The science is the science. This is a risky combination. Furthermore, you look like a candidate for a tummy tuck alone. The only way to tell is to feel the skin and determine how much fat vs. skin laxity there is.

Some study outcomes in the Plastic Surgery Literature:

Results: One hundred twenty-five patients underwent abdominoplasty with flank liposuctionand 75 patients underwent abdominoplasty alone. The incidence of seroma formation was 16.0 percent in the abdominoplasty-alone group and 31.2 percent in the abdominoplasty with liposuction group (p < 0.05).

The combination of abdominoplasty and liposuction procedures can still overwhelm the body's ability to resist these shear forces by the fact that more surface area is available to “shear” and thus produce seroma fluid. Not so much as an additive effect but synergistically, such that the seroma fluid from the flanks flows into the adjacent abdominal space and resists the ability of the upper abdominal flap to close over the abdominal wall. Patients must be counseled about their risk for seroma formation and treatments aimed at resolving them including frequent postoperative visits for needle drainage and the rare case requiring operative drainage in the face of a persistent seroma.

A lift with an implant is controversial for two reasons. First, when you perform a lift you are making everything tight and closing the wounds under tension. It you add the expansive forces of the implant at the same time, you are fighting against yourself. There are forces on the wound which try to make them separate, which results in wider, thicker, more irregular scars. In the worst case, the wounds will open. So compromises are usually made in the operating room by the surgeon because they cannot close the lift wounds over the appropriate sized implant. Either less of a lift is performed so that the skin is not as tight and therefore there is less tension on the closure. Or a smaller implant than would be appropriate is used so as to decrease the expansive forces. Either way, you are compromising the aesthetic outcome. Often the outcome is so compromised that a second revision surgery is required. If however, you plan to have the lift first and then the augmentation after everything has healed, then you have two operation that are planned, both with much lower risk than the combined mastopexy/augmenation. The outcomes of the two meticulously planned operations are much better and a more aesthetically pleasing, and a safer outcome is achieved.

The second reason the combination of mastopexy and augmentation is controversial is because of the risk of nipple necrosis (death of the nipple). By making the skin tight for the lift, you are putting external pressure on the veins that supply the nipple. By putting an expansive force on the undersurface of the breast with an implant, you are putting pressure on the thin walled veins that supply the nipple. If the pressure by squeezing the veins between the implant and the skin is greater than the venous pressure in the veins, the flow will stop. If the venous outflow stops, the arterial inflow is stopped. If the arterial inflow is stopped, there is no oxygen for the healing wounds and the tissue dies.

Placing the implant on top of the muscle in combination with a lift puts the blood supply to the nipple at a much higher risk because in addition to the issue of pressure on the veins, you have to divide the blood vessels that are traveling from the pectoralis muscle directly into the breast (and to the nipple) in order to place the implant between the breast tissue and the muscle. This adds a third element of risk to an already risky operation. Mastopexy/augmenation with sub glandular implant placement is by far the riskiest way to address your anatomic question.

Time

Determining the time for a breast augmentation mastopexy and tummy tuck with lipo can vary greatly and is dependent on the surgeon as well as the extent of the procedures being performed. For example, if you have lipo on your arms, legs, back and tummy rather than just your tummy you will need more time. On average, when I perform a breast augmentation mastopexy and tummy tuck with lipo I usually need about three and a half to four hours. I would recommend asking this question when you are interviewing doctors so you will have a good idea of how long you will be under anesthesia for.

Still Need More Info

You did not mention what body area you intend to have liposuction. Repositioning, prepping, and draping the patient often takes just as much time as the liposuction itself. You also didn't mention your height and weight. This impacts surgical time because the abdominoplasty incision is typically hipbone to hipbone and this can vary drastically in length depending on patient size, and with 3 layers of sutures, this can go by quickly or take a while. Assuming you're average height/weight, and having liposuction on the flanks, I would estimate about 6 hours. Hope this helps, and best of luck!

How many hours combination procedures last ?

Thank you for your question. Asuming your with good health and with an ideal BMI for surgery, these combination procedures could take from 4 to 6 hours depepnding on a few factors like how much liposuction needs to be done and the extend of the breast lift and tummy tuck. Combination procedures are safe and very effective in the right hands. The surgeon HAS to be an expert in EACH procedure and must have a lot of experience in performing combination procedures and can minimize the operative time. You definitely have to choose your surgeon correctly and make sure that he/she has the training and experience to meet your goals with absolute safety. Don’t settle for less than a Board Certified Plastic Surgeon with specialized expertise in this procedure. 

Dr Derby

It depends on the extent of the Breast lift and TT /lipo. Maybe it is wise to add some photos to your question. In general we take around 4-4:30 hours to be able to perform this type of procedure. But this is only an general number without seeing your exact situation.

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 62 reviews

Surgical hours

The answer to your question will depend on several factors such as the extent of the breast lift you desire (full lift or mini lift) and how much liposuction needs to be performed. 
The best place to begin is with a visit to a Board Certified Plastic Surgeon in your area who can discuss your surgical goals, examine you and provide you with an estimate of surgical time.

Camille Cash, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

How long is your surgery?

This depends on several factors that can only be determined after a formal consultation. Generally speaking a tummy tuck with breast augmentation/mastopexy will take anywhere between 3 and 4 hours. Liposuction can add more time if it requires turning the patient (such as liposuction of the back). I hope this answers your question, it is best that you meet with a board certified plastic surgeons for the most accurate determination.

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 28 reviews

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.