Amazing Makeovers

Posted Friday, August 31, 2007 to PROCEDURES > Body

Posted by The Original Anti-Aging & Cosmetic Surgery Magazine

Many patients are choosing to combine one or more procedures at the same time. Kate Barry talks to Michael J. Brown, MD, about what types of surgery can be joined safely.

Lately it seems no facet of life can escape from becoming a reality TV production. Cosmetic surgery is no exception. When two participants are offered an array of cosmetic procedures without the high price tag, results are invariably breathtaking. “We’ll stop at nothing to turn ordinary into extraordinary,” is one show’s motto. The hype surrounding these makeovers á la extreme is driving many patients into surgeons’ offices with a litany of improvements they’d like. But how safely can surgical procedures be combined? Is it possible to achieve amazing results without going to the extreme?

Washington, D.C. area aesthetic plastic surgeon, Michael J. Brown, MD, agrees that in the right hands combining procedures can deliver incredible results. He does, however, believe in exercising some degree of conservatism with many requested multiprocedure makeovers, since it is entirely possible to overdo it. “Some patients are prone to seeking perfection,” he admits. “I have seen patients who have had a combination of too much surgery with less than desirable results.”

Determining which procedures are suitable in combination depends on the individual patient. “Some patients come to see me with a list of four or five areas they want to address,” explains Dr. Brown. “I tell them to prioritize the areas that bother them: breasts, tummy, buttocks and arms, for example.” Once the patient has a “wish list” in place, Dr. Brown incorporates the overall health of the patient into analyzing if she or he is a candidate for certain surgeries. “If someone is going to invest time and money in a breast lift and tummy tuck, they need to ensure they are at or near their ideal weight and are unlikely to fluctuate greatly in the future,” cautions Dr. Brown. He then assesses which procedures can be combined safely for that individual. Age and medical history are important factors in determining how much surgery a patient can safely undergo.

“I may decide against performing two procedures at once. I will proceed with a tummy tuck and closely monitor the patient’s recovery. In approximately three to six months, I will proceed with an additional procedure,” he says. “For other patients, I will consider their wish list and combine the procedures that work well together in the operating room and the recovery.” Combining some surgeries may not be appropriate in any one session. As Dr. Brown points out, “If the patient is lying on their back, I can easily perform surgery to their breasts and stomach. It would be difficult to then turn the patient over and liposuction their backside during the same procedure.”

Safety is paramount when planning combination surgery. As a general rule, you don’t want to be on the operating table much beyond six hours. The longer a patient remains under anesthesia, the greater the risk of postanesthetic complications.

“A routine surgery for me is one to four hours for the body,” adds Dr. Brown. “Three to five hour facial surgeries are typical.” Dr. Brown often combines a face, neck and eyelid surgery, and may even incorporate a rhinoplasty as well. He seldom joins face surgery with body surgery. “Most people are and should be particularly sensitive about their face,” he says. “I will combine face surgery and body surgery only in certain cases.”

Each type of surgery carries its own risks and certainly some procedures carry more risk than others. An arm lift for example has less inherent complications than a tummy tuck, so the two surgeries can work well together. Depending on how much fat needs to be removed, some cases of liposuction are more extreme than others. It is important to educate yourself about all facets of each operation before making any decisions.

“I spend a lot of time with my patients. They need to know what is involved with the various surgeries before they commit to anything,” Dr. Brown stresses. “A lot of patients will say to me, ‘I saw that I could have all these things done at once on television.’ In the real world, the risks may not be worth it. You can still achieve an amazing makeover without going to extremes. Safety dictates the quality of care and outcome from the surgery. Patients should aim to achieve the best possible result.”

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