The 6-Hour Rule
Industry consensus: 6 hours is the maximum safe operative time for elective cosmetic procedures. Many surgeons prefer to stay under 4-5 hours. Longer surgery dramatically increases complication risk—including DVT, infection, and anesthesia complications.
Combining procedures makes sense for many patients. One trip to Medellín, one anesthesia, one recovery period. But safety must come first. Here's how to think about combining procedures intelligently.
What This Guide Covers
Why Longer Surgery Increases Risk
Every additional hour under anesthesia adds cumulative risk. Here's what happens:
DVT Risk Increases
Blood clot risk rises with prolonged immobility. Your body also releases more clotting factors during extended surgery.
More Healing Sites = More Stress
Your body can only heal so much at once. Multiple surgical sites compete for resources and increase infection risk.
Longer Anesthesia Exposure
Extended general anesthesia carries its own risks, especially for patients with underlying health conditions.
Complex Recovery
Different procedures may require conflicting recovery positions (face-down for BBL vs. elevated for facelift).
Surgeon Fatigue
Even skilled surgeons experience fatigue. Precision declines after many hours. Quality surgeons recognize this.
Common Safe Combinations
These combinations typically stay within safe time limits and work well together:
| Combination | Typical Time | Notes |
|---|---|---|
| Mommy Makeover (TT + breast + lipo) |
4-6 hours | Most popular combination. Synergistic results. Same recovery position. |
| Facelift + Neck Lift | 4-5 hours | Same incision sites. Natural pairing for comprehensive facial rejuvenation. |
| Breast Lift + Augmentation | 2-3 hours | Commonly combined. One recovery. Better results than staged. |
| BBL + Lipo 360 | 3-5 hours | BBL requires lipo for fat harvest. These are inherently combined. |
| Tummy Tuck + Liposuction | 3-4 hours | Synergistic results. Flanks and back lipo common addition. |
| Upper + Lower Blepharoplasty | 1-2 hours | All four eyelids in one session. Short procedure, easy combination. |
Colombian Approach
Many Medellín surgeons work in teams of two to reduce total operative time. One surgeon handles the body work while another handles the breast work simultaneously. This is a major safety advantage when combining procedures.
Dangerous Combinations to Avoid
Red Flag Combinations
Arm lift + thigh lift + other procedures
Multiple extremity procedures carry higher infection and healing complications.
Facial surgery + extensive body surgery
Different recovery positions conflict. Face requires elevation; BBL requires avoiding back.
Any combination exceeding 6-8 hours
Complication risk rises exponentially with time. Stage instead.
Procedures with conflicting recovery positions
If you can't follow both recovery protocols, results and safety suffer.
Full body lift + other major procedures
Circumferential body lift is already at the upper limit of safe operative time.
When Staging Makes Sense
Sometimes the smart choice is two separate surgeries. Here's when to consider staging:
Stage If:
- ✓ Total operative time would exceed 6 hours
- ✓ Recovery positions conflict
- ✓ You're having extensive body contouring after major weight loss
- ✓ Your BMI is higher (increases complication risk)
- ✓ You have underlying health conditions
- ✓ Your surgeon recommends it
Staging Recommendations
- • If total time exceeds 6 hours: stage 3-6 months apart
- • Post-weight loss body contouring: often 6-12 months apart
- • Minimum wait between major procedures: 3 months
- • Some patients plan two trips to Medellín 6 months apart
Cost Consideration
Two staged procedures mean two sets of anesthesia and facility fees—but often the same surgeon fee applies. Some surgeons offer discounted rates for planned second procedures. Ask about staging packages if you're considering multiple trips.
The Bottom Line
Combining procedures is cost-effective and convenient—but safety limits apply. Trust a surgeon who tells you "let's stage this" over one who promises to do everything at once. The 6-hour rule exists for good reason. A quality surgeon will design a surgical plan that maximizes your results while keeping you safe.