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Note: ASAPS cannot give advice about specific medical problems nor should answers provided by responding surgeons be substituted for a complete medical history, work-up and an in-personal medical/surgical consultation. Sorry we can't answer all questions. We try to select questions that have the widest general interest.
My doctor is sending me home after surgery, is this normal?
It is very common and reasonable and probably the safest way to treat a patient by sending them home after a tummy tuck, liposuction and a breast lift. I do that almost once or twice a week. It is important that the patients general medical health allow this to be done safely. It is also important to limit the amount of liposuction that is done at the same time. I personally limit to the hips and abdomen. If I extend the liposuction to the medial and lateral thighs and knees then I will do the surgery at the hospital and keep them over night.
Safety of Discharge the Day of Surgery.
Discharge the day of surgery after a tummy tuck, liposuction and a breast lift depends on your health and the amount of liposuction. An abdominoplasty is a fairly large operation by itself. Adding a breast lift increases the metabolic shifts slightly. However, adding any significant amount of liposuction can markedly increase the fluid shifts within the body, significantly increasing the risks. Liposuction, though having very little external sign of injury, is like having a significant burn below the surface. If the only liposuction you will have is some in the central abdomen and around the hips to get the lateral scar to lay down with a shorter scar, then a same day discharge is usually quite safe if you are healthy with no medical conditions. If, however, you are also going to have multiple areas liposuctioned not a direct part of the tummy tuck, especially several thousand cc's worth, I would suggest an overnight stay with observation and a continuous IV access.
Although it is possible if you are in good health, do not have a large volume liposuction, are under general anesthesia less than 4 hours and feel well enough post op to go home, it can be safe to do so. However I almost always encourage may patients who have multiple procedures in 3 different body areas to stay overnight in the hospital. There is no question that patient comfort is better, IV fluids, medications and nursing care are a great advantage and I can see the patient early in the morning, remove drains if necessary, change dressings and send the patient home. If you develope any issue such as bleeding the hospital is the safest place for you to be.
I would not send a patient home after multipeprocedures. I screen patients acrefully to be sure they are in good health prior to elective sugery. However, I am more comfortable, and I think patients are more comfortable if they stay in a medical facility with overnight medical observation the first night after surgery.
It is common to perform the mommy makeover combination you are planning as an outpatient, provided that the patient is healthy and the total surgery time is reasonable, which I believe to be about 5 hours total. The amount of liposuction you are going to have is the most important variable.
As you already know, its absolutely safe to go home after your procedures. You should ask your surgeon about what you can have ready at home and what kind of help you will need to facilitate your recovery. If you're prepared, its even easier.
Combining a tummy tuck, liposuction, and a breast lift procedure is not uncommon. Whether you are a reasonable candidate for those procedures depends on your anatomy, your medical history, the extent of the procedures, volume of liposuction, realistic expectations of the outcome and an understanding of the pros and cons of the various procedures. Safety should always be the main concern. It is generally recommended that the length of elective surgery be less than six hours. The procedures should be performed in an ambulatory facility that is accredited by one of the national organizations like the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF) or in a licensed hospital. While some surgeons would have a patient undergoing the listed combination of procedures go home after the procedures with appropriate help, many surgeons would recommend an overnight stay at an appropriate facility where you can be appropriately monitored or performing the procedures in 2 separate sessions.
Most patients prefer undergoing one anesthesia and one recovery period which is usually more cost effective.
Keep in mind that following the advice of any surgeon on this or any other web site who proposes to tell you what to do without: examining you, physically feeling the tissue, assessing your desired outcome, and taking a full medical history, as well as discussing the pros and cons of each operative option would not be in your best interest. I would suggest your plastic surgeon be board certified by The American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person. That way, you can have a better idea what is safe and makes the most sense for you. Before proceeding with a combination of these procedures, you should have medical clearance from your primary care physician and a discussion between him or her and your plastic surgeon. Robert Singer, MD FACS
La Jolla, California