Recently I was completing a consultation with a young lady who wished to have her nose reshaped. As we were concluding our discussion, I asked her if she had any additional questions. She paused and then asked if I thought that this might be a good opportunity to have liposuction on her thighs. After examining her, she appeared to be an excellent candidate with definite discrete bulges on the lateral thigh. She was in excellent general health and by combining the procedures, she was not only able to accomplish two goals, but saved a fair amount of money in the process.

Frequently patients will choose to have several procedures at the same time. There are many combinations that are common such as facelift and eyelid surgery; rhinoplasty and chin augmentation, breast reduction and abdominal liposuction, to name only a few. While there are often good reasons for this strategy, it is important to realize the potential down side of this practice as well. The case of the famous entertainer, James Brown’s mother, is an example of how good intentions can go wrong. Recently discharged from a healthcare facility, she underwent a number of procedures at the same time lasting an inordinate amount of time, ultimately resulting in her death. While certainly an extreme example, it points out the importance of considering this issue carefully.

Surgery, in any form, represents an injury to the body. While the healthy human body has great capacity to heal, there are always limits. It stands to reason that the greater the injury, the more challenge to the ability to heal. Some procedures, such a abdominoplasty, are more prone to complications. In this case, it may be wiser to avoid additional major surgery at the same time.

Additionally, consideration must be given to anesthesia time. The longer the patient remains under anesthesia, the greater the risk of post anesthetic complications. Some surgeons may work faster than others, thus permitting additional surgery without unduly extending the risk of anesthesia.

The patient’s age and general health also play a part. While age itself is certainly not a determining factor, older patients should be carefully screened for underlying cardiac, vascular or metabolic diseases that might interfere with the ability to undergo surgery or anesthesia, or that might interfere with overall recover.

Improvements in cosmetic surgery now allow us to greatly reduce the trauma of surgery. Bleeding has all but been eliminated in many procedures. Operating time has been greatly decreased. All of this has fueled the trend toward combining procedures. When properly considered and undertaken these combinations can greatly enhance the overall result of surgery.

Unfortunately, there has also be a trend on the part of some surgeons to promote added procedures by suggesting additional procedures to patients during consultation. With the heavy marketing that has become commonplace in cosmetic surgery, often there is more emphasis on closing the deal than on meeting the patient’s goals and desires. Combining procedures can offer a great opportunity to enhance the results of cosmetic surgery. Just make sure that it is done to satisfy your goals with a full understanding of both the risks and benefits.