摘要

Objectives: Recently, mommy makeover and other combined procedures have become more popular among patients who desire maximum impact and fewer procedures, lower cost, and minimal psychological stress and convalescence. This has raised questions about the definition of combined procedures regarding anatomic area, type of operation, and operation time. Introduction: Concerns were also raised about complication rate, pain relief, recovery time, and rate of late correction. Because of the number of deaths that have occurred after aesthetic plastic surgery in the past few years after combined and extensive high-risk and non-combined procedures, it is crucial to define certain standards and regulations: safety management routines for patient selection, preoperative assessment, performance of the procedures, operation time, extent of surgery, and postoperative recovery. Materials / method: We retrospectively examined our medical records of combined procedures performed at our clinic for 10 years. Relevant parameters were extracted: operation time, preoperative medication, perioperative sedation, postoperative pain relief, convalescence, complication rate, and correction rate. Comparison was made to determine whether the combination of 2 procedures improved/shortened the duration of the operation and lessened the amount of anesthesia used. A total of 178 (6.2%) patients were culled from 2867 procedures. During the past 2 years, the number of combined procedures increased by 11%. Results: The number of breast combinations was highest in 85 patients, followed by combination liposuction (n=84), combination facial procedures (n=77), combination fat grafting (n=68), and combination abdominal (n=41) procedures. The lowest number was seen in combination genital procedures (n=19). The longest operating time with combination breast-abdomen was 260 min; Complications occurred in 7 patients (4%): swelling (n=1), infection (n=4), fistula (n=1), and nausea (n=1). Correction rate was 2 times higher. Pain control consisted of paracetamol, paracetamol/codeine, opioids, and dexamethasone. Conclusion: The number of combined procedures performed doubled in the past 2 years. The rate of correction rate was higher for combined procedures. Larger dissection areas, longer operation time, and loss of a large amount of liquids/blood should be avoided. By rigid selection of patients, limiting operation time to less than 4 hours, use of TIVA sedation and lipotumescent infiltration, adequate pain control, and early mobilization, the combined procedures could be advantageous for both the patients and clinics regarding cost, psychiatric rehabilitation, and environmental aspects.