Key Cosmetic Concerns

Dear Dr. Kelly:

I want to do a complete makeover and do my breasts and tummy, and lipo of my thighs and back all at the same time. I saw another plastic surgeon who said it was fine to do it all at once. Do you agree? My husband is worried about so much surgery at one time.

Response: Patients frequently come to me asking to do all of their surgery in one setting. In most cases, this is not a good idea. Multiple studies have shown that the length of surgery is correlated with the risks of complications. In layman terms, this means that the longer your surgery is, the more likely you are to have a blood clot, wound infection, prolonged recovery or other devastating problem afterwards. In particular, I think that blood clots are the problem that worries me the most. Despite taking all known precautions, such as compression stockings, blood thinners and early ambulation, blood clots (known medically as a deep vein thrombosis) can still occur. In a few cases, these clots can subsequently travel to the lungs (called a pulmonary embolism) and can even cause death after surgery.

My feeling is that if we can reduce the risk of clots and other problems by limiting the time of surgery, we should definitely be doing that. My personal standard is that if a surgery is going to take more than about 4 hours, I will recommend that we break it up into 2 procedures separated by at least 6 weeks apart. While it is legal in Florida to operate as long as the surgeon wants, and there are many plastic surgeons who would be happy to do everything you want in one setting, I would never do that.

At the end of the day, this is elective cosmetic surgery and while quite rewarding for the patient, is not medically necessary. As a responsible physician, we have an obligation to make these procedures as safe as possible. In your case, listen to your husband. His gut instinct was right on the money.


About Dr. Kelly

Dr. Kelly is a board-certified Plastic Surgeon and partner in both Miami Plastic Surgery and MPS MedSpa. He has been in practice over 25 years and has been recognized by his peers both nationally and internationally as one of the best plastic surgeons in the United States. In addition to being an expert on Cosmetic Surgery, his practice encompasses the entire spectrum of non-invasive treatments such as Botox, fillers, CoolSculpting, ultrasound, lasers and radiofrequency. He also believes in giving back to our community, having served on the Village Council for eight years and volunteering as a coach for our youth sports programs. You can email him questions at mkelly@miamiplasticsurgery.com.

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