Patient decisions
Can I Have More Than One Plastic Surgery Procedure at a Time?
More than one plastic surgery procedure can sometimes be performed during the same operation, but the combination needs to fit the patient's health, goals, and recovery resources. New York City board-certified plastic surgeon Darren M. Smith, MD, FACS discusses the benefits and tradeoffs of a combined plan.
In this episode.
Episode summary
More than one plastic surgery procedure can sometimes be performed during the same operation, but the combination needs to fit the patient's health, goals, and recovery resources. New York City board-certified plastic surgeon Darren M. Smith, MD, FACS discusses the benefits and tradeoffs of a combined plan.
Originally published July 16, 2020. The examples reflect his practice at the time; the decision to combine or stage procedures requires an individual assessment.
Key takeaways
🩹 A shared recovery can be convenient.
One period away from work or one trip for surgery may suit some patients, while recovering from several procedures can also be more demanding.
💬 Some costs may be shared.
Dr. Smith discusses operating-room setup, anesthesia, travel, and postoperative support as factors, rather than offering a universal package price.
🔎 Longer operations introduce additional considerations.
Position changes, technical complexity, and clot-prevention planning are part of his discussion.
🎯 The procedures should complement the goal.
Examples include multiple-area liposuction, breast and abdominal surgery, augmentation with a lift, and nose and chin surgery for facial balance.
🔎 Experience with the combination matters.
Dr. Smith encourages a detailed conversation about whether the proposed procedures work together and how recovery will be managed.
Questions this episode answers
Can a breast augmentation and lift be combined?
The episode describes this as an option for selected patients who want both increased volume and a change in breast position or shape. Dr. Smith explains that choosing an implant and planning a lift involve related but distinct decisions.
Will combining procedures always save money?
It may reduce some duplicated expenses, but it does not establish what your own operation will cost. Dr. Smith's examples concern shared setup, travel, and recovery needs. The extent of surgery and support required still need to be defined in an individualized quote.
What should I ask at consultation?
Discuss the goals for each procedure, whether the surgeon recommends combining or staging them, the anticipated operating time, and the help you will need afterward. The episode emphasizes this planning conversation rather than choosing a combination from its name alone.
🔗 Related reading and consultation
Combined or staged mommy makeover | Mommy makeover | Breast augmentation | Request a consultation
Educational information; surgical risk, recovery, and the appropriate combination vary. Show notes updated September 30, 2026.
Original show notes
We hate to use the expression "killing two birds with one stone" in any setting, and especially in reference to surgery... but with well-planned combined plastic surgery procedures you may be able to do just that. NYC board certified plastic surgeon Dr. Darren Smith explains how in this episode.
Read the conversation.
[00:08] I'm board certified New York City plastic surgeon, Dr. Darren Smith, and this is plastic surgery before and after. Your source for the real deal about plastic surgery procedures, news about trends in aesthetic medicine, and candid sessions with industry insiders. We hope you enjoy today's episode. and there may not be one operation to satisfy all of their needs. So there are several different questions that we really need to answer to get a clear picture of whether or not you can have more than one operation at a time. First we'll ask, what are the benefits of having more than one plastic surgery procedure at a time? Then we'll ask, what are the downsides of having more than one plastic surgery procedure at a time?
[01:05] And then we'll look at some popular combinations of plastic surgery procedures and talk about who they may or may not be a good idea for. So let's jump right in with the benefits of having several plastic surgery procedures at once. First of all, and maybe the most exciting thing is you get to see a big change all at one time. And this is something that frankly can just be very satisfying. it's exciting to see a big change all at once and it may be a drag to have to wait to see a bunch of small incremental changes. The next thing that is a little bit more of a practical reason why it might be appealing to have multiple procedures at the same time is it may actually be less expensive overall because if you are combining multiple procedures you will only have to pay for one time in the operating room, one time with an anesthesiologist, one surgeon's fee. If you need to stay in a hotel, if you're from out of town, you'll only need to do that once. And if you need nursing care afterwards, you only have to pay for that once. And while it's certainly true that you'll be spending a longer time in the operating room if you're having two procedures at once, rather than if you're just having that one procedure. The way that operating room fees work, and a lot of these fees work, is they often get less expensive proportionately with time. So for instance, The first hour that you spend in the operating room is always more expensive than the second hour that you spend in the operating room. And that's simply an issue of economy of scale. Once you're in the operating room, the cost has already kind of been incurred of mobilizing the team, of opening the central supplies that you need, and of just getting everything kind of set up and going and getting that momentum for the case started. So in terms of time, it really does work out in your favor.
[03:08] from a cost perspective to have several procedures at the same time. And the same thing goes for the recovery. If you're having multiple procedures at once, you've only got to recover once. Now that recovery may be a bit more difficult than if you were having more than one procedure at a time, but that's a personal decision. If you're someone who can kind of take the recovery in stride, maybe you have a lot of help lined up, it can be a very reasonable choice to decide to have your procedures all at once. So you can just have that downtime once instead of doing it for each individual procedure. And this also can have an effect on the economics of your plastic surgery procedures.
[03:50] And by this I mean if you're combining your operations and you only have one recovery you only have to miss work once. Whereas if you were to have these procedures separately you may have several different recoveries and have to miss out on work several times. So to sum up the advantages of having multiple plastic surgery procedures at the same time you'll get to see a really nice change all at once. You will have only one recovery and the combined procedures will almost always end up costing less than having those operations in separate trips to the operating room. So there are two sides to every coin. So we have to mention the downsides of combining multiple procedures into one trip to the operating room.
[04:38] And the first one, as you can imagine, it is simply more complicated to perform multiple procedures at once than to perform just one operation. So some of the things that can get more complicated are position changes. Maybe you're having part of your operation on your back. Maybe it's a Brazilian buttock lift, or maybe it's a liposuction on your back. And maybe part of the operation is on your front. Maybe it's an abdominoplasty. So that means that you have to be turned over in the operating room, which can be a complicated procedure. There can be more technical variables that have to be accounted for. For instance, in the example of a breast augmentation performed at the same time as a breast lift, We have to now account not only for the change in size of your breasts, but also really for the change in shape and position. You'll also be spending a longer time in the operating room if you're having multiple procedures at once, and longer operating room times can be associated with higher chances of certain risks associated with plastic surgery procedures.
[05:45] and the one risk that we have to be especially careful about in this context is that of VTE or venous thromboembolism and VTE or venous thromboembolism is a condition that occurs when a blood clot forms usually in the legs or in the calf area and that is called a DVT or a deep venous thrombosis and then that blood clot can travel through the circulatory system to the lungs and once it gets to the lungs it's called a pulmonary embolism or PE and that can be very dangerous. And this is an event that we take great precautions to prevent. And fortunately, with modern procedures and protocols in place, it is very unlikely. But by spending a longer time in the operating room, we do have data to suggest that the risk of pulmonary embolism or VTE does go up. So it is important when combining multiple procedures that we are cognizant of the amount of time that we're operating and we need to move.
[06:51] quickly and efficiently, but also make sure we're doing an excellent job at the same time. So the moral of the story here is that it is very reasonable to combine multiple procedures, but you need to do this with a surgeon who is truly expert in doing several plastic surgery procedures at a time. And the reason for that is that they're going to have experience with each of these variables and help get all of these moving parts working together efficiently. to ensure that your operation is performed in a safe manner. Speaking now from personal experience, I do perform a great deal of combined plastic surgery procedures. So I just want to take a few minutes to speak about popular combinations and who they can benefit. Maybe the most popular combined procedure that we're performing in our practice is liposuction of multiple areas.
[07:47] And by performing liposuction on multiple areas at the same time, we can really achieve dramatic full body transformations. And remember that liposuction is not a weight loss procedure, it's a shape change procedure. So I'm not here discussing doing large volumes of liposuction on every body part to take someone who's larger and make them overall smaller. The goal of a combined liposuction procedure where we're doing multiple body parts at the same time is to achieve meaningful changes of shape of each of those body parts so that as a whole they add up to be a dramatic, often full body transformation. Another very popular combined procedure is the mommy makeover and we've discussed this in another recent episode, but essentially the goal of the mommy makeover is to address areas that have changed the most during pregnancy, often the abdomen and the breasts, and perform various combinations of procedures to return a woman back to her pre-pregnancy state.
[08:55] It's also very common to combine liposuction with fat grafting procedures. In fact, you almost have to because when you're performing fat grafting, and we talked about that in our previous episode, you need to get that fat from somewhere. And the way we do this is with performing targeted liposuction. So we can actually do large volumes of liposuction and at the same time harvest that fat and use it for grafting. to different areas of the body and this can commonly be done in the context of fat grafting to the buttocks and that would be something like a Brazilian buttock lift and in fact this combination of procedures fat grafting to the buttocks at the same time as liposuction to several areas of the body has gotten so popular that this has kind of gotten a name of its own and that's lipo 360 and a BBL and the 360 there refers to the fact that liposuction is being performed on 360 degrees of the torso and that usually means the abdomen the flanks and the back but as we've mentioned in another episode you have to be very careful when you're talking about lipo 360 to make sure that both you and your surgeon are on the same page in terms of exactly what areas are included with that liposuction.
[10:10] Liposuction is also very frequently combined with fat grafting to the breasts and this is a good option for people that are looking to increase their breast size or enhance their breast shape with natural fat, but probably isn't the best option that are looking for a very large increase in breast size as there is a limit to how much fat we can harvest during liposuction and how much of it is actually useful in increasing the breast size. And that's something we also went into in a little bit more depth in our previous episode on fat grafting. Another extremely common operation that we're doing a lot of in terms of combining procedures is a breast augmentation and mastopexy, or breast lift, and that's something we referenced a little earlier in the episode. But for a lot of people that are looking to increase the volume of their breasts, they also may be looking to...
[11:04] improve the shape of their breasts. And by this I mean with time or often after pregnancy or breastfeeding the breasts can become droopy or we call this totic. And to really address this a breast lift of some form is often necessary. While we can get a subtle lift by putting in an implant you really can't rely on a breast implant to significantly lift the breast. So for these people who are looking for both an increase in breast size and an improvement in the shape of their breasts, a breast augmentation combined with a mastopexy might be a good option. Another very popular combination procedure that we're performing on the face is a combined rhinoplasty and chin augmentation. So this is a fantastic operation for people who want to refine their overall facial profile. So instead of having a rhinoplasty or nose job and just addressing that one issue in isolation, they can at the same time, have a procedure performed to address the shape of their chin. And this will most frequently take the form of either a chin implant or fat grafting to the chin, but it could even take the form of bone surgery to the chin with something called an osseous genioplasty. And that's where we actually create a controlled fracture in the mandible, the lower jaw bone, and move the chin bone around and plate it back into place in an ideal position. So by combining a rhinoplasty with some kind of chin reshaping procedure, we can really refine the face's balance as a whole. And this is a very powerful combination of operations. And while there are...
[12:50] several other ways to combine procedures. The last one that I'll specifically mention here is body contouring operations for people that have had massive weight loss. So for people that have had very high degrees of weight loss, they may have a lot of extra skin on various parts of their body because when the fat goes away, the skin can only contract so much. So very commonly, these folks have extra skin on their abdomen, on their arms, on their legs, their necks. And we can combine several skin removal operations together to help these folks achieve really stunning transformations. a little more rapidly and efficiently than if we were to do each of these operations separately. But again, you really need to go to someone who specializes in this sort of thing to make sure that your operations are being performed efficiently, safely, and efficaciously. So my overall verdict here is that combined plastic surgery operations can be a great option, but you need to go about this carefully and do your research and speak to your board certified plastic surgeon and ask them if they're comfortable combining operations because there are some surgeons that just prefer not to do this. And if they are comfortable combining operations is the set of things that you're hoping to achieve compatible with combining operations.
[14:21] So like so many other things with plastic surgery, this really comes down to taking a team approach with your surgeon and discussing your goals and having an in-depth conversation to make sure that you can be on the right track to achieve excellent results that you're going to love. Thanks for listening and don't forget to subscribe, share the show, and head over to darrensmithmd.com for more real world plastic surgery talk.
Sources and context.
Original Captivate episode. Original release date: 2020-07-16. The recording is the source for the transcript and episode discussion. Later context in the written summary is identified separately.
Behind the conversation.
Darren M. Smith, MD, FACS