Can I have two plastic surgeries at the same time?

In the following text, we will discuss the question “Can more than one surgery be performed at the same time?” from different perspectives. We will try to explain the subject in technical details but in a language that everyone can understand. However, we would like to share with you, without boring you, what this process entails and what advantages or difficulties it may bring you. It is important to remember that each patient’s situation is unique and the most accurate assessment is made by a doctor’s examination.

What is more than one surgery at the same time?

The term “multiple surgeries at the same time” is often referred to in the medical literature as “combined surgery” or “simultaneous surgery”. It basically means that one or more surgical procedures are performed in the same session while a person remains under a single anesthesia. For example, it is quite common to perform a tummy tuck (abdominoplasty) and liposuction in the same session. Or combining facelift and eyelid surgery (blepharoplasty) in the face area is also considered under this heading.

This application attracts the attention of patients with the thought of “let me get it all out of the way at once, instead of having one by one surgery and getting narcosis over and over again”. Sometimes it can be applied not only in plastic surgery but also in other branches. For example, we can see that different surgical procedures such as rhinoplasty and auricular correction surgery and even hernia repair are combined in the same session.

Several key factors have contributed to the popularization of combined surgeries. Today, thanks to increasing medical technology, surgical equipment and anesthesia safety, it has become more possible to perform surgeries that take longer but are completed in a single session. In addition, the acceleration of social life and people’s desire to achieve their “new look” in a shorter time are among the factors that support this approach. Of course, as every good thing has a price, this application also has its pros and cons.

Why Do We Turn to Combination Surgeries?

Nowadays, when people are considering surgery for various aesthetic or reconstructive reasons, they often favor the idea of “multiple solutions at once”. There are several reasons behind this approach:

• Saving Time and Workload: Especially those who work at a busy pace, have family responsibilities or do not want to be separated from their social life for a long time may prefer to have different surgeries out of the way by enduring a longer recovery period for once. For example, instead of having abdominoplasty and breast prosthesis surgery at separate times, it may be practical to have both in a single session and stay away from work or daily life only once.
• Cost Advantages: In combined surgeries, hospital costs, anesthesia fees and other fixed costs are evaluated as one-time, so the total cost can be more affordable than single surgeries. Moreover, postoperative care and medication costs can often be considered under a single package.
• Technically Complementary Interventions: Sometimes two surgeries performed in the same session create synergy with each other, allowing for a better aesthetic result. While the excess fat in the abdominal area is removed with liposuction, a tummy tuck at the same time can provide a clearer and more holistic appearance around the navel.
• Psychological Dimension: People often feel stress before and after surgery. Having more than one surgery at different times can cause this stress to remain alive. However, overcoming this stress at once with a combined surgery can be psychologically more relaxing. We have all used the approach of “Let me suffer once, let everything be over” in different contexts at some point in our lives.

These are the main reasons that feed the tendency towards combined surgery. However, important factors such as the general health status of the patient, the duration of the surgery, the risks of anesthesia and the complexity of the recovery process should also be considered. Although it may sound tempting to “finish the job in one go”, it should not be forgotten that this decision should be taken with personalized evaluations.

What are the Advantages of Combined Surgeries?

There are many potential advantages of having different surgical procedures at the same time. To make these advantages more tangible, we can use analogies from our lives. For example, when remodeling at home, having the same craftsmen paint the living room, replace the kitchen cabinets and tile the bathroom all at once can often seem more practical with the logic of “get it all done while the place is dirty”. Of course, as with any renovation, planning and the right craftsmen are needed.

• Time Saving and Single Recovery Process: People who have a busy work life, who need to take care of their children or who have a lot of social responsibilities may say, “Let the time I will spend in the hospital or at home in a state of rest be one, then I will not go through the same process again”. It may be possible to shorten this period with a single surgery, a single recovery period and a single anesthesia intake.
• Economic Aspect: As mentioned above, a single hospitalization, a single use of anesthesia team and equipment can reduce costs for the patient. It is often advantageous to plan a single trip, especially for patients coming from abroad.
• Aesthetic Harmony: In some surgical combinations, procedures in different parts of the body support each other. When procedures such as tummy tuck and liposuction, facelift and eyelid surgery, breast augmentation and breast lift are combined, the result can offer a more “holistic” improvement. Sometimes patients report that the new appearance is much more balanced.
• Psychological Relief: Although the surgery process is stressful, making a decision once and having all the planning done in a single session makes many people feel more comfortable. Since the possibility of lying on the operating table again later on is reduced, the person can experience the peace of mind of “getting rid of them all at once”.

While these advantages sound good, there is also a “flip side”. Just like a major renovation done in one go, the surgical process can be prolonged and require more intensive care. Nevertheless, when carried out with the right planning and expert team, we can talk about an approach with clear advantages.

Are There Risks of Having Surgery at the Same Time?

Of course, every surgery involves risks; this is a fact. Having more than one surgery at the same time can also increase the risk coefficient somewhat, because the body is under more stress when more than one area is intervened, even if it is a single session. We can liken this risk to an automobile journey: Just as the accident risk rates are different between a short journey and a long journey, the risks increase to a certain extent as the duration and number of procedures increase in surgical intervention.

• Prolonged Duration of Operation: The longer the operation lasts, the greater the risk of complications such as blood loss, infection risk, deep vein thrombosis (clot formation in the legs). Staying under anesthesia for a long time brings additional risks, especially for individuals with chronic diseases.
• Difficulty of the Recovery Process: When there are surgical incisions and interventions in more than one area, the energy and time the body needs to heal increases. Factors such as pain management, dressings and restricted mobility can create a more complex picture. For example, a patient who undergoes both tummy tuck and breast surgery at the same time will experience pain and tenderness in both the upper body and abdomen, so returning to daily life requires a little more care.
• Recognizing Complications: When different areas are operated on, for example, a complication in the navel area may be confused with a problem in the arm lift area, or the patient may have difficulty understanding exactly which procedure caused the pain and swelling. Therefore, the physician’s follow-up should also be more meticulous.
• Psychological Burden Although the idea of undergoing many interventions in a single session may seem advantageous for some people, the physical and mental fatigue encountered in the postoperative period may be more intense. Restriction in daily movements, the process of accepting aesthetic changes and the recovery process can add pressure on the person.

Of course, these risks do not mean “horror movie” scenarios, but they should not be ignored. Risks can be minimized by taking into account each patient’s physical health, preoperative laboratory and imaging results, anesthesia evaluation and personal expectations. The important thing is to tell the doctor your complete medical history, any chronic diseases and medication use.

Which Surgeries Are Often Combined?

One of the most popular aesthetic combinations is the duo of tummy tuck and liposuction. These two interventions complement each other like “dry on rice”. While excess skin and muscle laxity are corrected with abdominoplasty, liposuction comes into play to thin the fat in that area. As a result, the abdominal area can have a firmer and smoother appearance.

Another popular combination is the “breast aesthetics” and “abdominal aesthetics” component. Especially after pregnancy and childbirth, problems such as sagging or loss of volume in the breasts, skin loosening and fat accumulation in the abdomen may occur. In this case, so-called “mommy makeover” package procedures are often preferred. Breast augmentation (or lift) and tummy tuck, and sometimes additional liposuction areas (waistline, back, etc.) come into play.

In the face area, combinations of facelift and eyelid surgery (blepharoplasty) are very common. This is because while the cheek and jawline are lifted with facelift, eyelid surgery makes the gaze look younger. Performing two procedures at the same time can create a more holistic and youthful expression throughout the face.

Of course, it is possible to extend this list: Arm lift and breast surgery, leg lift and butt lift, liposuction and fat injections, etc. The important thing is whether these procedures are suitable to be combined according to the surgical technique, duration of surgery and the patient’s health status. Performing some procedures together may carry a high risk; in this case, your surgeon may recommend performing the surgeries in one or two stages.

How to Manage Combined Surgeries and Recovery?

Having more than one surgery in a single session means “multiple challenges” in terms of recovery. Let’s explain this again with an analogy: Let’s say you have a slight strain in your arm and a sprain in your ankle. When both have to heal at the same time, you have to take care of both the arm and the foot, move carefully and take care to rest at the same time. The situation after combined surgery is similar, only a little more extensive.

• Rest and Movement Plan: In the postoperative period, it is important that you follow your doctor’s recommendations to the letter. If you have had breast surgery with tummy tuck, it may be difficult to lie flat for a certain period of time. It is very important to find the best position, use pillow supports and learn movements to reduce pain. Moving slowly, but not completely immobilized, helps regulate blood circulation.
• Nutrition and Hydration: Think about your body; it has several “construction sites” at the same time and each one needs protein, vitamins, minerals and fluids for repair. Therefore, optimizing your diet before and after surgery can shorten the recovery process. A protein-heavy diet, plenty of water consumption and vitamin supplements, if necessary, may be beneficial.
• Pain Management: When surgery is performed at more than one site, the distribution of pain sensation may also be different. Your doctor will usually prescribe a variety of pain relief protocols. In what we call multimodal pain management, not only strong painkillers such as opioids but also nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetic blocks, etc. are used to make the pain more tolerable.
• Suture Care and Hygiene: Since there are multiple surgical incisions, dressing and wound care should be done more carefully. Issues such as cleaning the surgical sites, dressing with antiseptic solutions and controlling the stitches are points that both the patient and the healthcare team should pay attention to.
• Psychological Support and Patience: Your body is undergoing a transformation. When multiple areas are intervened at the same time, it may take longer for the body to adapt to its new state. In the first days, swelling, bruising and tenderness can be demoralizing. However, these symptoms usually improve over time. Patience and psychological support when necessary facilitate the process.

Although the recovery process is a bit more “complicated” in combined surgeries, it can be managed with proper planning and teamwork. Discussing these issues in detail with your surgeon before surgery will help you set your expectations realistically.

For Which Patients Is It More Suitable?

Combined surgeries are generally considered suitable for patients who pay attention to their body health, whose preoperative examinations do not reveal any significant problems and whose additional risk factors are not too high. What is important here is that the patient is physically and mentally ready for a “multifaceted” surgery.

• General Health Status: Chronic conditions such as cardiovascular disease, uncontrolled diabetes, severe hypertension can increase the risk of anesthesia. In addition, the longer the duration of surgery, the more vulnerable the patient may be to complications that may occur during the operation. Therefore, all these aspects of the patient are evaluated before surgery.
• Body Mass Index (BMI): Risks of surgery increase in overweight or obese individuals. Especially if the BMI is very high, it may be more appropriate to target weight loss first and then proceed to plastic surgery. Because excess weight negatively affects many factors from wound healing to the risk of infection.
• Expectations and Goals: The patient should express very clearly what he/she expects from the combined surgery. A patient who says, “I have some fat in this area, I have some sagging skin here, and my face looks a little sunken,” is at an increased risk of being dissatisfied with the results if they do not specify exactly what they really want. It is very valuable for the physician to clarify the patient’s goals and explain the potential change that each procedure will bring.
• Psychological Preparation: Before the surgery, it is also important whether the person is ready for this change. Some patients may experience low motivation during the recovery process if they are not psychologically prepared for surgery. This can negatively affect both physical recovery and overall satisfaction.

How Long Should Combined Surgeries Take?

Each surgery has its own time frame. In combined surgery, these times overlap and the total operation time may be longer. The longer it takes, the greater the risks associated with anesthesia and the greater the likelihood of surgical complications. Most experts therefore recommend keeping the combined surgery within a reasonable time frame.

• Average Time Interval: Many plastic surgeons take care to complete combined surgeries within 4-6 hours if possible. In longer procedures, the body is exposed to greater surgical stress. However, some extensive procedures (such as body lift surgeries after excessive weight loss) can take up to 8 hours.
• Surgeon and Hospital Conditions: The experience of the surgeon, the success of the anesthesia team, the equipment of the hospital and the facilities of the center where the surgery is performed are also factors that determine the duration and safety of the operation. If the necessary equipment, support units and specialized staff are available, the prolongation of the operation can be managed in a more controlled manner.
• Personal Health Status: If the patient is of advanced age or has additional risk factors, prolonged surgeries may need to be avoided. In such cases, procedures can be scheduled in two or more sessions. The important thing is to prioritize the patient’s health.
• Unexpected Developments: Sometimes an unforeseen situation may arise during surgery. In such cases, the surgeon may prioritize the safety of the surgery by postponing some procedures to a later date. Possibilities such as extra bleeding, structural disorders in tissues or organ damage may also affect the duration of surgery.

How to Prepare Before Surgery?

Combined surgeries require more planning than single surgeries in terms of the preparation process. Because your body will be exposed to procedures in different areas at the same time, the post-operative recovery capacity must be high. So, what should be considered during this period?

• Blood tests and check-up: Routine evaluations such as blood tests, liver and kidney function tests, heart examination and chest x-ray should be performed in the preoperative period. If any abnormalities are detected, it may be possible to reconsider your decision for combined surgery or postpone the surgery.
• Smoking and Alcohol Use: Smoking impairs blood circulation and tissue oxygenation, thus delaying wound healing. Alcohol can also weaken body resistance and interfere with anesthesia. Reducing or completely stopping smoking and alcohol use for at least a few weeks before surgery increases the success of the operation.
• Nutrition and Exercise: A strong metabolism is needed for the body to be ready for recovery after surgery. A balanced diet, attention to protein and vitamin intake, regular exercise (not heavy, such as walking) are important before surgery. If you are overweight, losing a few pounds before surgery can positively affect the surgical results.
• Psychological Preparation: Since there will be major changes in your body, you need to mentally accept this process. Some people may panic when they see bruises and swelling in the first days after surgery. It is important to prepare yourself and accept that these symptoms are temporary.
• Home and Work Arrangements: You may need to rest at home for a while after surgery. Organizing your home for this period, gathering easily accessible items, shopping for groceries in advance, getting support for pet care or childcare can help you recover more comfortably. At work, it is also necessary to plan for things like time off or light work schedules.

All these preparations are important for the combined surgery to go smoothly. Your doctor and team will provide you with detailed information on how to make these preparations. Clarifying everything you want to ask at this stage greatly prevents you from encountering surprises in the postoperative period.

Which Doctor Should be Preferred for Combined Aesthetic Procedures?

Performing multiple surgeries at the same time requires surgical experience and teamwork. Therefore, the points to be considered when choosing a doctor increase. While it can be difficult enough to find a specialist for a single surgery, it is absolutely necessary to carry out a careful research process when it comes to combined surgery.

• Expertise and Experience: It is vital that the doctor you choose specializes in aesthetic surgery and has an experienced background in combined surgeries. If you are considering facelift and eyelid surgery, you should choose a surgeon who frequently performs both procedures and has sufficient patient references in this field.
• Hospital or Clinic Selection: The center where combined surgeries will be performed must also be equipped. In long-lasting surgeries, it is important that blood products are available when necessary, intensive care facilities are available and the infrastructure to respond to emergencies is ready.
• Patient References and Before-After Photos: Examining the photos of your doctor’s surgeries for similar procedures will help you get an idea. If possible, learning the comments and experiences of past patients will guide you in determining which doctor will be more suitable for you.
• Communication and Trust Level: Your communication with your doctor affects the entire surgical process. In an environment where you do not feel comfortable or where you cannot get clear answers to all your questions, it may not be right to decide on a major combined surgery. Your surgeon needs to listen to you, understand your concerns and find solutions to these concerns.
• Teamwork: Managing combined surgeries is often a team effort. A cohesive team with an anesthesiologist, nurses, surgical assistants and even doctors from other specialties, if necessary, increases the success rate. Make sure the surgeon you choose has a well-organized team around him or her.

Considering these factors, choosing a doctor is perhaps the most critical step in the process. Do not forget that if your surgeries are performed in the same session, your chances of reversal are also very small. Therefore, it is of great benefit to conduct a comprehensive research instead of rushing in choosing a surgeon and hospital.

How is the Cost of Combined Surgeries Affected?

Many people, while considering the idea of combined surgery, may wonder, “Will it cost more or cheaper in total?”. Although it is difficult to give a clear answer to this question, it is possible to say that a certain amount of savings can be made in combined surgeries in general.

• Anesthesia and Operating Room Costs: When more than one surgery is performed at a time, anesthesia is taken once and a single operating room is used. If you had separate surgeries at different times, these costs would increase exponentially. Therefore, there is a saving here.
• Hospitalization and Medications: Your hospital stay for postoperative care may be a few days longer for combined surgeries. However, it is usually more advantageous than being hospitalized for each operation separately. Likewise, postoperative medication and dressing materials are also supplied at once.
• Surgeon and Team Fees: Some surgeons offer package prices for combined surgeries. This is because even if the total operation time is long, the preparation, evaluation and follow-up are carried out through a single program. This may be economically attractive for the patient. However, at this point, the surgeon’s experience, hospital quality and the materials used are important factors affecting the price.
• Additional Costs and Risks: In case of complications in combined surgeries, additional intervention or additional treatment costs may arise. Although this situation is not very common, it should be taken into consideration. There may also be a loss of workforce due to a longer recovery period. Therefore, it is important to take into account how long you will be unable to work in the postoperative period when making your financial planning.
• Long Term Gain: If the combined surgery gives you the body or facial appearance you desire and reduces the need for further correction surgeries in the future, you will save money in the long run. Otherwise, it may be a more sensible investment to go for a more comprehensive intervention in a single session rather than dealing with small touches.

What Postoperative Care is Required?

Combined postoperative care requires a “collective care service” in a sense. Since many areas are operated on at the same time, each of these areas needs to be cared for separately.

• Wound Care: When there are multiple incision sites, dressing frequency and techniques may differ. For example, a special corset should be used for a tummy tuck incision, while a special bra or bandage may be used for breast surgery. Wearing these two materials at the same time, or wearing them as recommended by the doctor, requires precision.
• Nutrition Support: In the postoperative period, a nutrition plan rich in protein and balanced in vitamins and minerals is needed. Vitamin C in particular is important for tissue healing as it supports collagen production. Nutritional supplements or protein powders may also be recommended if necessary.
• Movement and Exercise: Since your body will be in more “repair mode” after multiple surgeries, heavy exercise should be avoided. However, being completely immobilized can also increase risks such as thrombosis (intravascular clot formation). Therefore, light walks or exercises recommended by your doctor keep the blood circulation alive.
• Regular Doctor Check-ups: Going to control appointments at regular intervals in the first week, first month and subsequent periods after surgery is very valuable in order to catch possible complications early. Quick intervention in case of the slightest mishap protects the healing process.
• Psychological Support: As different parts of your body are healing at the same time, this can be demoralizing at times. Remember, the edema, bruising and feeling of tension in the first days are not permanent. Support from friends and family and, if necessary, psychological counseling can be very helpful during this period.

In addition, attention should be paid to signs of infection (excessive redness, fever, foul odor, abnormal discharge), signs of bleeding and excessive swelling or pain. When in doubt, it is best to contact your physician for information. This way, you can make the difficult healing process of combined surgery more comfortable and safe.

Overall Assessment: Is It Worth It All Things Considered?

The idea of combined surgery can sound very practical and attractive. Who wouldn’t want to shape their face and body in a single session or get rid of areas that have been bothering them for years in one fell swoop? However, this approach has both advantages and disadvantages, as with any surgical procedure.

• Advantages: Time management, a single recovery process, economic savings, holistic aesthetic harmony and psychological relief make combined surgeries attractive.
• Disadvantages: Longer operation time, higher anesthesia burden, more complex recovery, increased risk of complications and unsuitability for some patients mean that this procedure should be carefully considered.

The final decision is based on a combination of your personal needs, your health condition, your doctor’s assessment and your living conditions. Remember, the decision to have more than one surgery at the same time should not be taken lightly just for the sake of convenience. A thorough examination, risk analysis and clear expectations will help you find the best way forward.

If, after evaluating all these factors, combined surgery still makes sense for you, you can embark on this adventure by choosing an experienced surgeon and a good hospital. A well-planned and well-executed combined surgery can provide patients with high satisfaction in the long term. However, the planning and decision-making phase must be meticulous.

As a result, our answer to the question “Can more than one surgery be performed at the same time?” is “Yes, it is possible; but we need to see if it is suitable for everyone.” The most important step is to draw the right course in line with your health and expectations with a personalized evaluation.

Dr. Erman Ak

Plastic Surgeon Dr. Erman Ak completed his primary and secondary education in Mersin and his high school education at Mersin Science High School. He graduated from Hacettepe University Faculty of Medicine as a Medical Doctor in 2014. He started his specialist training at Istanbul University Çapa Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery in 2014. He performed many successful cleft lip and palate, congenital anomalies and jaw surgery operations at the hospital, which is one of the few jaw surgery centers in Istanbul. These difficult and tiring surgeries helped Dr. Erman Ak create his own concept in facial surgery.