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Let's face it– life is impossibly busy. There are a million things we want to do or take on but rarely feel we have the time for. Many people have tossed around the idea of plastic surgery in their heads for months or years, but the idea of finding the perfect time for recovery– free of obligation– is fleeting. To maximize recovery time, many patients interested in multiple cosmetic surgery procedures consider combining procedures into a single surgery with a singular recovery. While this is often convenient for patients, there are certain aspects to consider when planning your plastic surgery procedures. In this post, I will take you through the factors that I, as a Plastic Surgeon, take into consideration when evaluating patients and devising the optimal surgical plan.
Benefits of Combining Plastic Surgery Procedures:
Cost
The pricing for plastic surgery procedures typically can be broken down into three basic fees– surgeon fees, facility fees, and anesthesia fees. Surgery is an expensive endeavor to take on– it involves a team of people, an operating room, medications and tons of expensive equipment and supplies. The cost of these things is typically part of what is considered a “facility fee”. When multiple procedures are performed in the same setting, the facility fee is usually less than performing each procedure on its own, since the staff, equipment, Operating room, etc. are already in use. Once these key pieces are already in motion, it takes less energy (and thus less cost) to keep them going for a longer period of time.
The second financial benefit of combining plastic surgery procedures is anesthesia fees. Typically, anesthesia charges based on time in the operating room. The most expensive time being the first hour of anesthesia, and typically a lesser charge per hour after that. Thus, adding additional surgeries in the same setting will increase the duration of time under anesthesia, but you won’t be paying for that most expensive first hour multiple times.
Lastly, analogous to the facility and anesthesia fee’s above, the surgeon’s fee is typically discounted slightly for additional procedures performed at the same time. Just as above, the cost for me to “show up” is already there, I just need to be there for a longer duration of time.
Recovery
Recovery is the biggest driving factor I see in my plastic surgery practice for patients combining surgical procedures. Time is of the essence, and down time after surgery can be nearly impossible to carve out with busy work and family obligations. The idea of a “one and done” is appealing and for good reason. I see this especially in my patients with young children or those who are self-employed-- two scenarios almost impossible to carve out recovery time from.
Synergistic Surgeries
Combining cosmetic surgeries is not just about convenience but also about achieving harmonious results. Certain procedures just make sense to do together in order to achieve a certain aesthetic outcome. Common combination procedures include trunk liposuction with a tummy tuck, a breast augmentation with a breast lift, eyelid surgery with a face/neck lift, and breast and tummy procedures post baby (aka a “mommy makeover”). Getting great results often means taking a step back to look at the bigger picture and the bigger goal, such as rejuvenating an aging face or restoring a body to its pre-pregnancy condition.
When To Consider Staging Plastic Surgery Procedures:
Duration of Surgery
Despite all the benefits I have outlined above, there are times where combining plastic surgery procedures should really be avoided. The duration of surgery is an important safety consideration in plastic surgery, since most surgical procedures do not include a stay in the hospital. Longer surgical procedures without proper postoperative monitoring can lead to catastrophic and even deadly consequences for patients. Outpatient surgical procedures (i.e those that don’t require overnight medical observation) are typically limited to a maximum duration of 5-6 hours to reduce the risk of post surgical complications. When a patient desires numerous procedures that would take us far past this time limit, surgeries will be staged in a way that works best with the patient’s goals and recovery.
Length of procedure is often a consideration in patients who have undergone massive weight loss and are looking at the realistic possibility of multiple skin tightening procedures throughout the body. In these instances, since we know that multiple surgeries and multiple recoveries are inevitably required, we often consider combining procedures based on anatomical location in order to help with recovery. A classic example is combining upper body procedures in one surgery (breast lift or reduction with a brachioplasty or back lift) and lower body or torso procedures (tummy tuck or full body lift combined with thigh lift) in a separate procedure. Isolating surgeries to the upper body in one setting gives patients a strong core to assist them in recovery in the same way that isolating lower body surgeries in another procedure will allow a strong upper body to assist them in recovery.
Antagonistic Procedures
Some surgical procedures actually work against one another, and performing them simultaneously may lead to compromised aesthetic outcomes. One classic example of this would be gluteal fat grafting and a breast augmentation or lift. Pressure should be avoided at all cost to areas of fat grafting postoperatively. Similarly, a patient is restricted from sleeping on their side and stomach after a breast procedure for a minimum of 4 weeks. If you perform these two procedures together, how is a patient supposed to position themselves postoperatively without compromising either the fat grafting or the breast? The answer is they really can’t.
Another example is when two procedures produce opposing vectors of pull that, in some instance, might detrimentally work against one another. Think a very tight tummy tuck–with its vector of pull downward towards the groin–with a tight breast lift, pulling the breasts upwards. Now, oftentimes these two particular procedures are performed simultaneously without compromise, but in certain patients, staging is necessary.
Conclusions
Combining plastic surgery procedures can offer significant benefits in terms of cost, recovery time, and achieving cohesive cosmetic results. However, it is imperative to thoroughly evaluate potential risks and incompatibilities when determining your long term plastic surgery goals. With the right planning and professional guidance from your Plastic Surgeon, a surgical plan that safely meets your individual aesthetic goals is achievable.
Dr. Megan Dreveskracht is a Female Plastic Surgeon in Seattle, Washington who specializes in Aesthetic Surgeries of the Breast, Body & Face. To schedule your consultation, call 206.860.5582 or fill out a contact form here.
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