Combination cosmetic surgery: an individual surgeon's experience in non post-massive weight loss patients.

Combination cosmetic surgery is a term used to describe the performance of more than one procedure to achieve unrelated aesthetic outcomes during the same operation. Patients request combined cosmetic procedures due to time constraints hence the wish for one recovery period, immediate gratification and financial considerations. Although combined cosmetic surgery dates from the late 70’s the literature regarding its safety has been conflicting. Early concerns regarding combining cosmetic procedures included an increased need for blood transfusions and prolonged hospital stays, but this is not supported by recent reportswhich attribute complications to patient factors such as obesity rather than procedural complexity. Current reports in the non-PMWL population include abdominoplasty in combination with other cosmetic surgeries, but the overall patterns of combinations are not well documented. Post-massive-weight-loss (PMWL) body contouring surgery has popularized combination cosmetic procedures and literature reports show that increasing the number of simultaneous procedures correlates with increased rates of seroma, wound dehiscence, wound infection and hospital stay. The consensus amongst anaesthetic colleagues has been that prolonged surgeries or those with multiple combined procedures increase the risk of perioperative complications. Our aim was to evaluate the procedural patterns and complication rates of combined cosmetic procedures in non-PMWL patients and compare these with the PMWL data published in the literature. We undertook a retrospective review of a single surgeon’s (CMM) experience of combined cosmetic procedures 2000e2012 with regard to their patterns and morbidity. We