Multiple Procedures, Different Answers
Our practice very much is based on patients being well informed and in many cases that means seeing other doctors, getting other opinions and then making a decision the patient is comfortable with. No one surgeon is going to be the right choice for every patient, so it's up to you to find a surgeon, a practice, a staff that you're comfortable with, and that would include making a determination on whether multiple procedures should be combined into one case.
We routinely combine procedures together for the reasons you indicate.The recovery time is minimized, costs are held down, risk is reduced because you're only having anesthesia once instead of multiple times. These factors make it the right decision for us and our patients. Now you have to do what is right for you...and whether that's adjusting your feelings and doing multiple days of surgery or sticking to your guns and finding someone who will combine procedures on one day of surgery, only you can know.
It is very difficult, if not impossible to guess what your surgeon may have been thinking or was concerned about when he/she advised against combining the procedures. It may be that you have a medical condition that would increase your risks with longer procedures, or that he/she thought the technique planned for one procedure may compromise his/her ability to successfully achieve your goals for the second area of concern.
We all have our individual levels of comfort with what we can accomplish safely for any given patient within a given period of time... some surgeons take longer than others to do the same job. That's not a judgement of quality, just a fact.
If having the procedures together is important to you, I do think this may be possible and safe, but to be certain you should visit a few more surgeons- make sure they're Board Certified by the American Board of Plastic Surgery and that the facility where the operation will occur is certified.
After gathering recommendations from a few reputable surgeons, you'll know what is in your best interests.
Reasons Why Some Surgeons Hesitant to Combine Procedures
There are many factors that go into a decision as to whether to combine or stage separate surgeries including length of time of the surgeries and anesthesia, but also on the comfort level of the surgeon which at times is based on their training. For example although I most often combine a tummy tuck with a breast lift in a single surgical procedure there are safeguards that I use. For example, I use a surgical assistant to help with the final skin closure which saves significant time and take measures to prevent clotting in the legs by using TED stockings and pneumatic stockings in all my patients, etc. In general these surgeries take between 4 to 5 hours and I have not seen any increase in risk in the more than two decades that I have been combining these surgeries. On the other hand I fully support surgeons who feel it is safer to stage these procedures and respect their careful decision making process based on their individual experience.
Multiple procedures at once lengthens surgery time
Trying to do a breast lift and a tummy tuck in five hours will in many cases be inadequate in my opinion. There will likely be things to fix later unless you are really a small case in both categories. It is the amount of surgery to be performed that determines the operative time. Much of this is a matter of style and opinion of course.
It is common for surgeons to perform multiple procedures at the same time provided that it is safe for the patient. If the patient has medical conditions that preclude this, then they are staged. If the surgery is going to take too long, then they are staged. These are just some of the reasons.
Mutiple Procedures at once
First, it is important that you are a good candidate for each of the procedures that you want. You must understand the expected results and the complications that ae possible.
Second, your surgeon needs to evaluate your overall health issues.
Third, your surgeon has to be comfortable with the likelihood you will get good results and a reasonable and safe recovery for the combination that you have choosen.
Fourth, I try to limit cobined procedures to a total of 6 hours.
And last -- get a second opinion. A different plastic surgeon may be more comfortable with the concept of doing multiple procedures.