COMBINATION PROCEDURES in BEVERLY HILLS
Patients arrive to my Beverly Hills office consultation for combination procedures every week. Combination procedures, including augmentation, breast lifts, tummy tucks, and lipo-contouring of the body can be performed simultaneously as long as the patient is healthy and the operating room time is kept within, in my opinion, five hours of surgery under general anesthesia.
The next example is a patient who underwent augmentation mammoplasty and lipo-contouring of her inner and outer thighs and hips. The patient presented with having had three children, loss of upper pole fullness of her breasts and desired to have her breasts filled in again. Saline implants were then placed in the dual plane technique, under the muscle through a periareolar approach with high profile saline implants. We were able to regain her beautiful fullness, keep her narrow on the side and give her excellent cleavage. She had a gynoid appearance, the lower third of her body disproportionately larger than the upper and middle third upper body. Her liposuctioning was accomplished using a Klein needle infiltrator to infiltrate tumescent fluid per the tumescent technique and approximately 1 liter of fat was removed of pure aspirate. A small 3 mm triple lumen Mercedes tip cannula under direct one atmospheric vacuum suction pressure under general anesthesia. The localized deep fat deposits were removed from the anteromedial and the posterolateral thighs as well as the infragluteal folds. You can see a nice reshaping of the lower third of her body more to match the upper middle third. However, her natural curve was maintained. Suctioning was only performed in the localized deep fat deposit areas for two reasons: 1) to prevent contour deformity and surface irregularity of the skin; and 2) to allow her to maintain her natural contour shape. Postoperatively, her gynoid appearance is significantly reduced with more proportionality of the upper mid and lower third of her body.