When contemplating multiple surgeries at the same time, the length of the anesthetics is felt to be a rate limiting factor for safety. Generally, it is understood that if an anesthetic is longer than 5 hours that the complication rates escalate. Wound infections are more common, blood clots are more likely to form, and respiratory, fluid and electrolyte issues become a problem. At that point, the benefits of the surgery are outweighed by the potential risks. In order to make the surgery safer, we need to find ways to cut back the length of time spent in surgery. This can be done by limiting the number of things done with your procedure, speeding up the time each portion takes, or doing different parts of the surgery simultaneously (at the same time).
Most plastic surgeons would agree that addressing two major areas (such as the tummy tuck for the abdomen and augmentation, lift, or both for breasts) and one minor issue (like liposuction to hips, thighs, and/or back) at the same time can be done safely and in a reasonable time frame. It will be up to your surgeon to tell you what he/she can reasonably do in 5 hours. This may partly depend on how complex your particular case is, but also has to do with how efficiently the operating room runs and the speed of the surgeon.
At our facility, we have trained our scrub technicians to sew (up to our standards) and that cuts away a lot of time from the overall length of the case. Our practice also has multiple board-certified plastic surgeons, and in these types of cases, we work together on the same patient so we can do that tummy and breasts at the same time. Typically a mommy makeover with tummy tuck omaha, breast augmentation, and lift and liposuction takes us about 3 to 3.5 hours. That is well within the safe window for anesthetic length. This ability to work simultaneously is not available in all practices or cities. Be sure to ask your plastic surgeon what he/she is able to do to control the added risk associated with extended anesthetic for combination procedures. The goal is always to keep you, the patient, as safe as possible, but also let you enjoy the benefits these surgeries can provide.