Combined procedures: Advantages of performing several operations in one sitting

CEBU, Philippines - One of the most commonly asked questions in my practice is whether it is possible and safe to have two or more operations done at the same time. The main concerns of the patients are the following:

Is it safe?

When safety is the issue, the operation that worries the patients most   nowadays is liposuction. Some doctors, especially non-surgeons like dermatologists, are not comfortable with large volume liposuction and perform liposuction piecemeal or by body part. This technique is also adopted by doctors who do not have the complete equipment or the training to perform safe suction of the whole body. These practices made the public think that whole body liposuction could not be done or is dangerous. If a lot of patients are already scared of whole body suction, imagine how scared they are when we tell them that we can do bustlift or facelift in addition to their lipo. Real surgeons would always weigh the benefits over the risks involved and they never take unnecessary risks. If the patient is healthy and can withstand several procedures with a single exposure to the risks of anesthesia then it becomes safer to combine them rather than perform each surgery separately and expose the patient to the risk of anesthesia several times.

Is it more painful than when you do it one by one?

“Masakit ba doc?” is perhaps the most common question patients ask their surgeons. Majority of these patients also erroneously think that the more surgery you have, the more painful the experience is during the recovery. They think that with 2 operations, the pain is doubled and with 3, the pain is tripled and so on. Fortunately this is not the case. Our body and mind is wired in such a way that in cases of multiple sources of pain stimuli, the mind registers only the most painful source. For example, patients who have whole body suction, complain more about pain in their backs than the other areas. Or patients who have lipo and breast augmentation complain of the more painful breast surgery rather than the lipo. Most if not all surgeons would give their patients an honest answer when asked about post~op pain. Personally I think telling the patient to expect pain in cases of really painful operations help them prepare for it. With the advent of the Erchonia laser for lipo, the pain and discomfort has been reduced by as much as 80 percent. This pain control device is so effective that we have started using it for pain control in other operations, as well.

Can I tolerate more than one operation?

A good surgeon will always evaluate the patients’ surgical risk. This is the reason why we request for several laboratory checks and heart and lung clearance for patients who are 35-years-old and above. If the patient has a history of hypertension, diabetes or any other medical condition, then the surgery is deferred until these medical problems are treated or controlled. Depending on the health condition, the surgeon and the anesthesiologist would decide if the patient could tolerate one or more operations in a single sitting.

What are the advantages of doing the surgery at the same time?

It may appear paradoxical but often times it may be safer! The nature of most cosmetic operations is that it is not life threatening. The procedures can be classified as “minor surgery.” For example the blood loss involved in noselifts, or eyebags or facelifts or breast augmentation is very, very minimal and will not impose any danger on the patient’s life. Accidents involving these procedures usually have something to do with reactions to medication or are anesthesia-related. With current anesthesia techniques, better drugs and more advance monitoring equipment, the risk of anesthetic accidents is very low, but the risk is still there. Therefore combining operations, which a healthy patient can tolerate, reduces the risk of multiple anesthesia exposure.

Another advantage is that the recovery period is shortened. If it takes about 2 weeks recovery period for a noselift and 2 weeks for eyebags surgery then, doing both operations in one sitting will take only 2 weeks and not 4, for recovery. In other words both operations will recover during the same time.

Still another practical advantage of combining operations is the reduction in cost. A good example would be liposuction. Whether we remove one liter of fat from the abdomen or 10 liters of fat from the whole trunk and arms, the equipment used is the same, the amount of drugs used are more or less the same and the operating room charges are the same.  

Safety with Practicality

In summary, Board Certified surgeons are trained to save the patient money without compromising their safety. Combining two or more operations in one sitting saves the patient time and money and is an advisable practice as long as the surgeon is not taking any extra unnecessary risks. Trust your surgeon. If he is a Fellow of the Philippine College of Surgeons, he knows what is best for you.