I’m having surgery, can I add on something cosmetic?

This question is very common in our practice.  We get calls everyday from patients who are having surgery of different sorts (hernia repair, hysterectomy, breast lumpectomy, etc). They are interested in also having that cosmetic procedure they have been pondering for years.  It seems like a great idea right?  You are already going to be in the operating room, why not?  In many cases, it’s a great option, but sometimes not so much.  Here are some general guidelines and information about combined medical/cosmetic surgery cases.  


The time under anesthesia is a very important consideration when planning surgery.  It has been well documented that surgeries over eight hours in length lead to more complications, in particular the life threatening ones.  Most surgeons try to keep elective procedures six hours in length or under to keep complications at a minimum.  If your cosmetic procedure (performed by a board certified plastic surgeon!) can be performed simultaneously, your combo surgery may be a great option.  If the procedures need to happen one after another due to positioning or both surgeons needing to be in the same place, it might not be a great idea.


Your cosmetic procedure may be less expensive if you combine it with a medically necessary procedure that is covered by insurance.  Although your surgeon’s fee will be the same, you may need to pay less for operating room time and the anesthesiologist if both surgeries can be performed simultaneously.  Surgeries are billed by the operating room and anesthesiologist based on time.  This can be a bit misleading. 

If your medically indicated surgery needs to be done at a hospital, the fees there are often much higher than at an outpatient surgery center (where most cosmetic procedures are done).  Even with less hours billed for the cosmetic procedure, you still may owe the same, or even more!  If your procedures can be performed at an outpatient surgery center and be done simultaneously, your surgery will likely be a bit less expensive than if both procedures are done alone. 

Patients often ask if their insurance pays more than the “cosmetic” fees for OR and anesthesia if that money can be applied to their cosmetic portion.  The answer is a hard NO.  This is insurance fraud and this will not be done by any ethical surgeon, operating room, or anesthesiologist.  


If your recovery from the two procedures will be similar with similar activity restrictions, a combined surgery may be a great idea.  If the activity restrictions are in conflict, this can be problematic.  Proper recovery from any surgery means that the patient starts using their body at the optimal time.  If your cosmetic procedure keeps you from moving longer, this is not a great idea. 

Medications are also an important consideration.  If your typical recovery requires use of a medication not allowed by the other surgery, this can be problematic as well.  The surgeries that work the best together have similar post-op care and recovery.


Many plastic surgery operations utilize implants of different types.  Implant infections are a devastating complication that is both emotionally and financially difficult.  Plastic surgeons will not be willing to do operations which utilize implants in combination with procedures with higher infection risk.

Adjunctive Therapy

I often do cosmetic procedures in patients that are undergoing cancer treatment.  It is very important to not add a procedure that has a significant potential of problems that can delay additional needed therapy, such as chemotherapy or radiation.  

Pregnant Patients

One of the most common requests I see is pregnant women wanting to undergo an abdominoplasty (tummy tuck) at the time of c-section.  This sounds like a dream, but it’s actually a horrible idea.  Beautiful long term results mean patients are at their goal weight at the time of surgery, this is never the case at the time of a c-section. 

The uterus is often very prominent making the diastasis repair and abdominal muscular tightening suboptimal.  Finally, recovery is much harder compared to c-section alone which can be very problematic for a new mom managing a newborn.   

The best time for a Mommy Makeover is also when your littles are independent enough they don’t need constant care and supervision. Recovering from major surgery with a newborn in tow is difficult/impossible.

It is always reasonable to ask and acquire information if you are interested in doing this.  Most surgeons will have a favorite board certified plastic surgeon they will refer you to and I encourage everyone to get some info if you have that cosmetic procedure you have been dreaming of!

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