As the world of plastic surgery continues to expand and patients become increasingly aware of the need to combine procedures for superior results, the procedure of stacking body treatments is certainly having a moment.
Staying stacked
What does stacking treatments mean?
True to its name, body stacking treatments refer to the concept of performing more than one body treatment in the same procedure or surgery. “Stacking treatments can be an effective way to ensure patients get the most value from their experience,” explains Tucson, AZ plastic surgeon Raman Mahabir, MD. “One of the best examples of stacking treatments is the ‘Mommy Makeover’, which is a combination of procedures performed simultaneously to restore the shape and appearance of a woman’s body after childbirth. This may mean that you will have breast augmentation and abdominoplasty or breast lift and abdominoplasty with liposuction in the same surgery.’
“The concept of stacking non-surgical treatments for body and facial applications usually refers to using different types of energy treatments to create improvement in a specific area,” explains Newton Center, MA plastic surgeon, Joseph Russo, MD. “This is achieved by using different devices, which create a greater overall improvement.”
For example, explains Dr. Russo, you could combine a superficial treatment like microneedling with an intermediate-level treatment like high-focus ultrasound, along with a deeper-level treatment like laser. “All of these treatments are done in the same space and are literally stacked on top of each other,” he says. “Treating the surface, intermediate and deeper layers in a specific area will result in greater overall improvement, along with faster recovery and less downtime. The concept of stacking can also be used with a single device such as laser hair removal. For example, instead of pulsing each area once, you can double—or in some cases, even triple—pulse an area to increase damage to the hair follicle, resulting in less hair regrowth and more effective result”.
Chicago plastic surgeon Michael A. Horn, MD, combined liposuction and a tummy tuck to define this 50-year-old patient’s tummy.
The distribution of benefits
When, where and why patients should consider stacking treatments
There are many pros and cons to body stacking treatments, but according to Dr. Mahabir, one undeniable benefit is recovery time. “While stacking procedures can make recovery a bit more tedious, you still benefit from only having one recovery period for multiple procedures. To use the Mommy Makeover example again, the recovery time for a tummy tuck for someone with a physical job or even someone who just likes to work out is six weeks, and for people with very physical jobs like nurses or competitive athletes it can be longer. close to eight weeks. Now, if they come back a few months later for a breast lift or an arm lift, that recovery time starts all over again. But by combining something like a breast lift and implants with a tummy tuck and liposuction, the total recovery time is just six weeks. The benefit is obvious.”
Houston plastic surgeon Henry Mentz, MD, emphasizes the advantages of stacking treatments in terms of downtime. “Mothers who are ready to reverse the changes of childbirth often combine a breast lift, breast augmentation, body contouring, liposuction and tummy tuck,” she explains. “If a patient had done all of these individually, they may require separate weeks of recovery, but by stacking or combining these cases, the recovery time could be as little as 10 days in total.”
Another benefit of stacking treatments comes in the form of finances. “There is also a financial benefit to stacking treatments, as you save money on anesthesia and surgery time,” explains Dr. Mahabir, “Many clinics also offer a multi-procedure discount, meaning patients get a discount on each procedure after first if they are executed at the same time”.
Moms who are ready to reverse the changes of childbirth often combine a breast lift, breast augmentation, body contouring, liposuction, and tummy tuck.
Dr. Medz
Regarding the procedures recommended by stacking professionals, Dr. Mahabir starts again with the classic Mommy Makeover. “Mommy Makeover consists of breast and tummy tucks, in any combination. Stacking different treatments in a variety of ways that can allow us to tailor the combination of treatments to achieve each patient’s desired outcomes is an effective way to provide the best care, value and overall experience. Some examples of treatments I recommend stacking include breast augmentation and abdominoplasty, breast lift and fat grafting with abdominoplasty and liposuction, or brachioplasty (arm lift) and breast lift with implants.”
Stacking method
Chest + Chest
As for how stacking works in different areas of the body, Dr. Mahabir recommends a “less well-known, but possibly even more essential” stacking treatment, which is lateral chest wall liposuction with breast procedures. “When it comes to breast reduction, the reduction makes the breasts smaller and perkier, but leaves the ‘fat roll’ bra line. Adding liposuction can dramatically improve the outcome, so much so that we include it in every breast reduction and lift.”
Rochester, NY plastic surgeon Calvin Young, MD combined a breast augmentation and breast lift to address volume loss and sagging after childbirth.
Stomach + Waist
“As previously emphasized, by combining surgeries you can actually improve the results of the individual procedures,” says Dr. Mentz. “For example, when you combine liposuction of the waist with a tummy tuck, it allows for more skin growth in the tummy tuck and, in turn, tighter skin and a more beautiful contour in the abdomen and waist.” Combined body contouring procedures, especially those of sensitive areas like the stomach and waist, can be uncomfortable, which is why Dr. Mentz turns to the innovative pain-relieving drug Exparel for many body contouring procedures. “Body contouring combinations can be more painful, so I use a drug called Exparel, which is a long-lasting, local anesthetic that can significantly reduce pain. There is also a special technique where we use Exparel with a small pump and a larger needle at the end of the operation to inject local anesthetic over the entire surgical surface, so that, for example, if you’re doing abdominoplasty and liposuction, you can inject local anesthetic to the entire area, allowing patients to be relatively numb for three days afterward.
Houston plastic surgeon German Newall, MD stacked a breast augmentation with a tummy tuck and liposuction of the hips, flanks and back.
To keep in mind
Risks
As with any plastic surgery procedure, stacking body treatments has its own risks. “As surgeons, we pride ourselves on safety and will do everything we can to optimize your results while minimizing risk,” assures Dr. Mahabir, “This includes pre-operative medications to minimize the risk of infection and postoperative nausea. as intraoperative techniques aimed at minimizing discomfort in the first four days, and even post-operative devices to reduce the risk of blood clots, such as calf massagers or SCD sequential compression devices. But even with all these precautions, there are risks. Stacking procedures increase the length of surgery, which, in turn, slightly increases the risk of infection, blood clots and other complications, so it’s important to discuss this with your surgeon as part of your surgical plan.”
While Eugene, OR plastic surgeon Mark Jewell, MD says it’s common to combine liposuction and abdominoplasty, as well as liposuction and breast augmentation (which may use fat grafting), he offers a word of caution: “Patients must be careful. the field of stacking technologies when it comes to radiofrequency helium plasma and laser liposuction,” he says. “All of these technologies are being promoted for skin tightening after liposuction, but none are FDA-approved for use in combination with liposuction, so they are still considered off-label use at this time.”
