Is Extreme Plastic Surgery Safe?

Sept. 8, 2004 -- Extreme cosmetic surgery is safe, a leading plastic surgeon argues.

The finding comes after looking at 248 patients treated by W. Grant Stevens, MD, associate clinical professor at the University of Southern California, Los Angeles, and medical director of Plastic Surgery Associates in Marina del Rey and Palos Verdes, Calif.

Stevens and two colleagues analyzed records from patients who underwent tummy tucks alone or in combination with breast augmentation/reduction, facial surgery, or both breast and facial surgery.

It's commonly assumed that the longer a patient spends on the operating table, the higher the risk of complications. But Stevens and colleagues found no such risk in the patients Stevens treated.

"This study adds evidence that combined cosmetic procedures may not be associated with increased morbidity and may yield higher patient satisfaction," Stevens and colleagues write in the July/August issue of Aesthetic Surgery Journal. "As long as we scrutinize our care and strictly adhere to the principle of 'do no harm,' plastic surgery techniques will continue to evolve with the goal of improving both safety and patient satisfaction."

One Stop Chopping

Why have multiple plastic surgeries at the same time? The main advantage is that there is only one recovery period. It's also less expensive than multiple surgeries and patients see a bigger difference after an extreme makeover than after a single cosmetic surgery.

Historically, the downside has been increased risk of something bad happening. Patients spend much more time in anesthesia. Studies from previous years show high rates of adverse events when tummy tucks are combined with other procedures.

Stevens says modern surgical techniques today offer patients a far better picture than that painted by these older studies.

However, an editorial by Charles E. Hughes III, MD, an Indianapolis-based plastic surgeon, questions whether most plastic surgeons could match Stevens' success rate. Few surgeons, he says, could do the same number of surgeries that Stevens accomplishes in only five hours of operating time. And the longer a patient remains on the operating table, Hughes argues, the higher the risk of problems.

"One surgeon's excellent experience with a selected group of patients can provide a useful contribution to this discussion," Hughes writes. "However, in my view this experience is not in itself sufficient to justify the drawing of more wide-ranging conclusions with respect to the safety of multiple operations performed under one session of anesthesia."