The answer is: Sometimes.

There are downsides too. Combining procedures increases the surgery time and that carries several risks. These risks include the possibility of blood clots in the leg. A piece of this clot can break off and go the lung and block the blood vessel as it gets narrower than the clot itself. That can suddenly cut off a vital amount of lung tissue from it’s blood supply. This can cause breathing difficulties, and even be fatal. This risk increases with longer surgeries, where the blood circulation is slow and blood clotting naturally increases. Prevention is much better than treatment, which is long and complex. One way to avoid this problem is to control the length of time you are in surgery. Sometimes it is better to be cautious and split the procedures up into more than one surgery.

So how long is too long?

Most people agree that out patient cosmetic surgeries should be kept to 6 hours or less, if possible. This time limit varies with the procedure and the patient.

Here are some conditions which increase the risk. Overweight patients have an increased risk – body mass index (BMI) greater than 30 is a warning sign. Smokers have a significantly increased risk. Older patients have a higher risk. Having diabetes carries extra risk. Having a tummy tuck is slightly riskier that other procedures. Taking hormones, such as birth control pills, can arguably increase the risk. Having certain diseases at the same time can increase the risk so much that you probably should not be considering cosmetic surgery at all – cancer, heart disease for instance.

There are several things that can be done to minimize the risk, in addition to shortening the surgery time. These are designed to increase the rate of blood flow in the legs, or lessen the amount of blood in the legs. Wearing a tight (TED hose) stocking during and after surgery minimizes the volume of blood in the legs. Wearing a device that massages the blood along the legs works well during and after surgery. Walking about frequently starting right after surgery helps. Never sit with your feet hanging down and don’t stand still. Elevate your legs when at rest and wiggle your toes and ankles as much as you can remember and never cross your legs, is also good advice. Lastly, there are blood thinners that can be administered.

Other risks from longer procedures includes more blood loss. So it is important not to start the procedure already anemic.

… and don’t forget – 6 hours continuously with no breaks is a long time. What about surgeon fatigue?

The combination of liposuction and abdominoplasty has produced the best results for this procedure that I have ever seen. In addition complications are much less. Recovery is much quicker for Modesto liposuction patients.

I am continually surprised to see how great the results of liposuction abdominoplasty are.

1. I make punctures to create very small holes. I do not make any cuts. I do it with a round awl (a pointed object)

2. I use a metal cannula to inject quite a lot of intravenous fluids using a special pump. The fluid contains epinephrine to make the blood vessels smaller and lessen bleeding. It also contains some xylocaine to relieve the immediate pain afterward.

3. Then I move an ultrasound emitter over the skin. The skin is covered with a lubricant like KY jelly. This also helps conduction. This process pushes the injected fluid through evenly and softens the fat.

4. I suction using special cannulae attached to large syringes. When I pull the syringe plunger it locks open and creates a vaccuum. This is how I do the suctioning. There is no machine.

5. When finished BandAids are placed over the punctures, and a support garment. There are no stitches. There is likely to be some drainage for 24 hours. This lessens bruising.

6. Recovery is quick. I like my Modesto liposuction patients to be asleep for this procedure.

It has a couple of problems that make this method rather risky. There may be insufficient blood getting to the lower central skin after the procedure and this can result in an area of dead skin which can create a hole. This might take weeks or even months to heal up with intensive wound care. Liposuction at the same time as this technique makes this problem worse. As a result we avoided liposuction at the same time. This resulted in residual abdominal fat that would need liposuction as a second procedure. The second is that there is a large space under this flap that needs prolonged drainage tubes and often drainage fluid will accumulate there after the drains have been removed. This is called a seroma, and the fluid needs to be removed by new drains or needles.

I have been doing a better technique recently which seems to have solved these problems. Research has shown us that the blood supply for the lower abdomen comes through deep blood vessels in the upper outer portion of the abdomen. If this area is preserved then healing problems become rare or non existent. Liposuction can be done at the same time and healing still remains very good. So now we can do complete liposuction of the abdomen and then go ahead and do a modified tummy tuck to preserve these blood vessels.

The results have been amazingly good. The fat is gone. The stomach is tightened more than we could before. Healing is great. Drainage tubes come out in a week or less. Recovery is quicker. Pain is less. We use a pain pump to automatically numb the surgical area with local anesthetics for about four days. Skin numbness is less. Seromas have all but been eliminated. Return to normal activities is much quicker.

If you are extremely thin and you do not need the liposuction we can omit it and do the rest of the new and improved technique.

I have been very encouraged and excited by these results. If you are thinking about getting a tummy tuck done please make sure that you find out more about this technique first. I would be happy to schedule a consultation to tell you all about it. Please call our liposuction Modesto facility at (209) 323-2979 for an appointment.

My practice is in Stockton, but many patients come from all the surrounding areas, such as Lodi, Modesto, Manteca and Tracy and beyond.