I recently had a patient that messaged me through Facebook messenger about performing multiple procedures. I’ve operated on her before so I was comfortable interacting with her via social media. Because of the number of procedures she wanted, I suggested that she should “stage” the surgery so that some procedures would be performed in the first stage, some in the second stage of surgery. She then asked me how long she should wait for the second stage and I realized, that’s a great blog post!
Not all surgery needs to be staged. Multiple procedures during the same operation are very common and very appropriate. There are the financial considerations. For example, doing two procedures at the same time is typically less expensive than two procedures in separate operations. If you separate the operations, then there are twice the anesthesia fees. Twice the operating room fees. Whereas when you combine a procedure, those fees will be combined and be less.
However, safety is the primary concern for the doctor, even if finances are the primary concern for the patient. My typical rule of thumb is one procedure to the back and one procedure to the front at the same time. An example of this is a Brazilian Butt Lift (BBL)(to the back of course) and a tummy tuck to the front.
But if you want to add a breast reduction to that BBL and tummy tuck, then maybe it’s best to just focus on the front and do the breast reduction and the tummy tuck. Or just a BBL and removal of upper back skin rolls. So I guess my other rule of thumb is just the back or just the front.
Another rule of thumb I abide by is separating the head from the body. It’s reasonable to do an eyelid and face lift but not an eyelid lift, face lift and tummy tuck.
Timing of the Second Stage of Surgery
So if you can’t do all of your “wishlist” procedures at once, when should you plan your second stage of surgery? I’ve come to realize that this is totally up to the patient. Think about it. If you just had surgery, you’re probably not “jonesing” to go back to surgery.
I leave it up to the patient unless I can think of a medical reason they need to wait longer. So if a patient has a breast reduction and tummy tuck, I encourage them to have the BBL during a second stage of surgery.
I don’t want to do all of these procedures at once for several reasons. It’s a long time to be under anesthesia. But I’ll also be removing lots of fat during liposuction. And since I try to avoid removing more than 5000cc of fat at a time, I don’t want to remove 4000cc from the abdomen and then do a substandard job on the back because I can only remove 1000cc from the back before hitting my limit. Better to remove 5000cc from the front and then wait till another operation to remove 5000cc from the back.
And since they’re so snake bitten by the first operation, they’re more than happy to wait for the second stage. By the time they’re ready, I’m ready. In other words, it’s up to you, the patient.
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