How Much Surgery Can Be Done at Once?

Who doesn’t like the idea of one-stop shopping? It’s quick and a time-saver, a truly precious commodity in our very busy lives. While this can be a great thing when it comes to groceries, it’s not always a good idea when it comes to combining plastic surgery procedures.

Many patients, especially mothers and those who have undergone massive weight loss, need more than one procedure in order to achieve their desired outcome. And while there is certainly a benefit for the patient in having everything done at once, not all procedures can be safely performed during a single operation. Dr. Brian Brzowski of Utah discusses how much surgery can be done at one time, and why it is so important to see a board certified plastic surgeon who will always place your safety above convenience.

Head to Toe Surgery 

Plastic surgeons today are routinely seeing patients who come into the office after having had multiple children or losing a massive amount of weight with bariatric surgery. Their bodies have undergone a significant amount of change in more than one area. Even though they may have lost the excess weight, their skin, muscle and tissues have been stretched. When they look in the mirror, they no longer recognize themselves. And in the case of massive weight loss patients, they’ve worked so hard to take off the weight, but are still sometimes left with anywhere from 10 to 25 pounds of excess skin. Consequently, these patients really require “head to toe type surgery,” explains Dr. Brzowski in order to achieve their goal.

How Much Surgery at Once?

The first step in any plastic surgery consultation is for the surgeon to listen to what bothers the patient and then perform a thorough physical exam. Determining an appropriate treatment plan is about figuring out your problem areas, and then choosing the right procedures for your individual anatomy. When this treatment plan includes multiple procedures, such as in a Mommy Makeover, the next step is for the surgeon to assess how much surgery can be done safely at one time.

In cases where the procedures can not be performed safely at once, such as in body contouring after massive weight loss, it is vital for your surgeon to sit down with you and prioritize. We all have an area that bothers us more than others. Typically, a surgeon will start here. The goal, explains Brzowski, is to figure out which procedure is going to give patients “the biggest bang for their buck”.

Safety is Number One Priority

There is “tons of motivation on the part of the patient and tons of motivation on the part of the surgeon to get as much done [at once as possible],” says Dr. Brzowski. For the surgeon, he or she wants the patient to be happy. For the patient, combining surgeries:

• often saves money as you only pay one anesthesia & hospital fee
• requires less overall downtime as there is only one recovery
• less anesthesia/surgical risk

That said, surgeons know for a fact that increased surgical time does increase risk. Most then strive to keep the overall surgical time under a maximum of 6 hours. For the most part, if your combination of procedures can be completed within this time frame, then it’s safe to go ahead. There are a few exceptions.

High Volume Liposuction

High volume liposuction is an exception to the safety = time rule. It is a known fact that only a certain level or volume of liposuction that can be performed at one time before the surgeon runs the risk of taking out so much fat that the patient experiences the kind of blood loss that can adversely affect their health. If your treatment plan includes a long procedure and high volume liposuction, your surgeon will really need to analyze the safety of performing both at once.

A Plastic Surgeon is Your Physician

Patients will often come into a plastic surgeon’s office really pushing for more procedures at once that the surgeon may think is safe. “One of my primary roles when working with these patients is to be their physician,” explains Dr. Brzowski. “And so many times, being that physician means that we have to tell them ‘no’.” It is up to the surgeon to to talk you down from anything that is not going to be safe, and reel you back towards something that is realistic.

This is one of the hallmarks of a really great, committed board certified plastic surgeon. It’s important to see one because he or she will, “really try to make certain that whatever we are gong to allow the patient to go through is something that is in their best interest” says Brzowski. “Our job is to make sure that whatever we recommend to them is, number one, going to be safe and number two, is going to make sense for them in terms of the aesthetic result.”