Controversy over twilight sedation/multiple surgeries - your thoughts?

[Bluesea71 698]

Hi ladies - I was on the Realself website last night (my latest obsession) and was reading through questions people had posted and surgeon responses. There were a few that I came across that I wanted to get your thoughts on. I wish I could have saved the links so you could refer to them for reference.

Someone (in the states) had asked a question about getting multiple procedures done and twilight sedation used vs. traditional anastesea (spelling? My iPhone can't spell it either!) Specifically she wanted to know if she could have a Tummy Tuck and butt grafting (I think that was the procedure name - when they inject fat into your back side) at the same time.

The Mexican surgeons who replied said it was perfectly safe to combine the two procedures and raved about how their patients woke up refreshed, etc after using twilight sedation. They actually called it something different, but I assume its what people on these boards refer to as that.

The American surgeons who responded (and there were plenty) said while this sedation wasn't used in the US much or at all, it would never be used during a tummy tuck because it doesn't sedate your stomach muscles and during surgery you need your abdominal region to be as inactive as possible during the surgery. They were appalled any surgeon would do it any other way and pointed to that as an example why Medical Tourism is never a good idea. They also mentioned what while several surgeries CAN be combined, a tummy tuck and butt grafting would never be combined as your working on opposite sides of the body. A tummy tuck requires you to lay on your back post-surgery. A butt grafting frequently leaves you sore and you want to avoid laying on your backside so pressure won't build. Having the two combined they said would likely lead to serious complications.

I'm curious what you all think? I'm a researcher by nature, so I will find any and all information I can. I immediately discredit any review by any US doctor who says statements like, "we've been told for years not to drink the Water in Mexico, so why would you have surgery there?" I travel to Mexico and abroad frequently, so I'm not afraid of other cultures or experiences. I value and appreciate hearing from other "real life" experiences. Please share.....

[AvaFern 3,516]

I tend to feel that reputable Mexican surgeons are just as competent as American ones and you save a ton of money by going there. That being said, I have heard good things about twilight surgery, but I haven't had any awful experiences with traditional anesthesia and I used an American surgeon who uses traditional anesthesia.

Now...you can have procedures done on both your front and your back at the same time. A full body lift which is an abdominoplasty and a posterior body lift with the possibility of buttock augmentation can be done at the same time- they just flip you over mid surgery. I was flipped for two of my surgeries...one I had an abdominoplasty with Lipo to my back, so there was a flip involved, and one I had a posterior body lift which was all my back, but a revision of my thigh lift which is all on the front. They just lift you up and toss you onto the other side like a slab of beef.

So...yes you can have your back and front done in the same surgery and yes I agree that arbitrarily disregarding plastic surgery in Mexico is uneducated. As for twilight surgery, I don't have enough research to really give an educated opinion.

[Bluesea71 698]

I tend to feel that reputable Mexican surgeons are just as competent as American ones and you save a ton of money by going there. That being said, I have heard good things about twilight surgery, but I haven't had any awful experiences with traditional anesthesia and I used an American surgeon who uses traditional anesthesia.

Now...you can have procedures done on both your front and your back at the same time. A full body lift which is an abdominoplasty and a posterior body lift with the possibility of buttock augmentation can be done at the same time- they just flip you over mid surgery. I was flipped for two of my surgeries...one I had an abdominoplasty with Lipo to my back, so there was a flip involved, and one I had a posterior body lift which was all my back, but a revision of my thigh lift which is all on the front. They just lift you up and toss you onto the other side like a slab of beef.

So...yes you can have your back and front done in the same surgery and yes I agree that arbitrarily disregarding plastic surgery in Mexico is uneducated. As for twilight surgery, I don't have enough research to really give an educated opinion.

That's a good point you bring up... A full body lift WOULD require surgery to both your front/back, so what are these surgeons talking about?!? Well, okay, there's still the point that with a lift there's not the issue of putting pressure on your bum like the other procedure would.

Edited May 31, 2015 by Bluesea71

[CanyonBaby 1,852]

You're smart to collect all the info you can on the two, information is power. That being said, how willing are you to find out the "hard way" about twilight sedation, considering the forewarnings given by American surgeons? It's my feeling that just as there are reasons for speed limits, there are also guidelines for surgery and sedation in this country. No, the two are not necessarily the best comparisons, but if you go around that curve faster than the sign said to, you're likely to have an "issue". Same with sedation. Why risk complications, when there are apparent risks (given the fact that American surgeons are uncomfortable, or downright against it for reasons maybe unknown to us)?

Is there a particular reason you wouldn't want to go with the typical anesthesia? I've had it for all of my 22 surgeries, and the only issue I've had to date is some memory loss. And I'm not 100 percent sure it is from the anesthesia!

I have had the TT and lipo/butt lift, separately, and I'm glad I did it that way; the pain from the Lipo on my back was some of the worst I have ever gone through. The TT was bad enough, but combining the two would just blow me out of the Water. There would be no way for me to be comfortable while recovering.

Let us know what you find out, I'm sure there are many on here who would love to hear what you have to say!

[BethinPA 305]

I originally wanted to have a lower body lift and a breast lift at the same time, but my American surgeon said that was no longer done, because it would require too much time under anesthesia. It took 6 hours to do the lower body lift. And part of the reason it takes so long is because they have to be so careful when turning you over, it can take something like 45 minutes to do so. As it is, even though I tried to be a careful and compliant patient, I was too active, and my incision open up in a deep way in the back, required stitches and took weeks to close up. Now I have scar tissue there that sticks up, which I'm not happy with, but will have to learn to live with.

[CowgirlJane 14,259]

I had the classic Mexican surgeons multiple

[CowgirlJane 14,259]

My kindle does NOT get along with this forum....sorry.

Anyway I had multiple procedures under twilight sedation in Mexico in Oct 2013..i remain thrilled with my results. It was absolutely the right decision for me. During my plastics journey I learned there are trade offs...

For you to decide... spend many many months going to consults, looking at before and after photos (of people of your age, and comparative "befores". Talk to people on the phone if you can. Really think hard about this. Is Dr Almanza clinic really good at reconstructive plastics after massive weight loss?

[CowgirlJane 14,259]

i am sorry, the Almanza part was for a different post. I was very frustrated with my Kindle last night!

[MichiganChic 3,262]

I used a very reputable American surgeon, and I had abdominoplasty and butt lift with auto fat flap, and brachioplasty in one surgery. They flipped me part way through. It was six hours, which was the longest time she is willing to do surgery (due to anesthesia risks). I had general anesthesia, and I'm certain I needed it.

My second procedure was breast lift/augmentation and thigh lift, and it lasted 6 hours, but I had a lighter anesthesia.

So, while I didn't go to Mexico, my experience does describe what I think is typical with American physicians, as a point of reference.

[jess9395 5,449]

My American physician puts an 8 hour limit on his surgeries and works with general anesthesia. I will have a Tummy Tuck, breast lift with augmentation and brachioplasty done at the same time. He said that he felt confident doing those three together for me because I need no liposuction at all, just skin removal and likely muscle/fascia tightening for the tummy tuck.

[snacky 6]

Could someone tell me how he does his pain management down there? I know that they aren't allowed to prescribe narcotics, so what do they end up giving you? I am afraid of being in a whole bunch of pain!

Right now I am torn between Dr. Peter Fisher or Dr. Sauceda. I like the idea of staying in a recovery house for 12 days.

[CowgirlJane 14,259]

Dr Sauceda keeps you in his clinic for about 3 days which is the way they are allowed to provide "narcotic pain management". I had multiple procedures done at once and I did NOT anything stronger than over the counter meds (probably didn't need them either really) once I got to the hotel for recovery. It is not a recovery house - if you go to obesity help and read Dr Sauceda forum there you will get the low down.

The only pain I experienced was from some of the drain removal. Some were painless, but some had adhesions that smarted. Pain pills don't help with that kind of very short lived sharp pain anyway.

[Bluesea71 698]

Thanks all - your responses are very helpful. I'm finding that just venturing out of my area is providing cheaper options as I live in a very expensive part of the country for plastics. I have contacted Dr. Fisher for a consult and will be curious to see what he says. At this point I don't have any ball park figure so it's hard to say how much I would be saving by going out of the city, state, country, etc! Regardless, I need to save money... so that's what I'm doing as I collect my research! ????

[snacky 6]

Thanks all - your responses are very helpful. I'm finding that just venturing out of my area is providing cheaper options as I live in a very expensive part of the country for plastics. I have contacted Dr. Fisher for a consult and will be curious to see what he says. At this point I don't have any ball park figure so it's hard to say how much I would be saving by going out of the city, state, country, etc! Regardless, I need to save money... so that's what I'm doing as I collect my research!

I'm right there with you! I live in Alaska and its no joke up here. I talked to Dr. Fisher last night and I'm waiting on my quote today. I would prefer to stay in the country, but reading Dr. Sauceda's reviews makes me lean towards him also!