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On occasion, patients have inquired about combining other surgical procedures with their chest reconstruction. Inquiries have been made regarding adding hysterectomy and oopherectomy (removal of ovaries), liposuction, and/or other cosmetic procedures to their chest procedure. Hysterectomy requires the expertise of a gynecologic surgeon. When combined with chest surgery, the hysterectomy is performed immediately before or after the chest procedure. This combined procedure is preferably done on an inpatient basis for reasons of safety and recovery. Gynecologic surgeons may perform the hysterectomy either abdominally, or vaginally with or without laparoscopic assistance, or by total laparoscopic hysterectomy. These options must be discussed with the gynecologic surgeon in detail. My experience is that most patients prefer the endoscopically assisted procedure if possible. For more detailed and specific information regarding hysterectomy, please refer to Dr. Kate O'Hanlan in Redwood City California, or to Dr. Leslie S. Kardos in San Francisco, California, at (415) 923-3123. When a patient undergoes both procedures at the same operation, recovery may be somewhat more difficult and prolonged. The advantage lies in the fact that there is one anesthetic induction and one recovery period. Liposuction may be performed in addition to chest reconstruction, sometimes as an adjunct to the primary procedure to facilitate removal of fatty tissue along the sides of the breast or up toward the arm pit. It may also be performed to remove unwanted fat depositions over the abdominal wall, or in the "love handle" area, the hips, and/or the thighs. Unless there is considerable fat to be removed by liposuction, the addition of the procedure does not unduly prolong the total procedure time or the recovery period. Again, a thorough discussion with the operating surgeon is necessary to learn of the limitations, inherent risks, and possible complications of the liposuction operation. Various cosmetic surgical procedures can be combined with chest surgery. These may include facial enhancement operations such as eyelid plasty or nasal surgery. Whether or not additional procedures can safely be added to the primary surgery of chest reconstruction will depend upon the patient's general health, the extent of the secondary procedure, the ability of the patient to adhere to the recovery time and limitations, and the costs. All of these matters need to be discussed preoperatively with the surgeons involved. It is important to understand that additonal procedures add to operating time and increase the costs due the surgery centers, anesthesiologist, and hospitals if inpatient care is required. I am pleased to discuss any of these options with any of my patients. |