How long is too long for cosmetic surgery?

While surgical advancements have made certain cosmetic procedures more efficient, many popular procedures like tummy tuck and breast reduction simply require several hours to complete. Additionally, patients often choose to have more than one procedure performed at once, thus lengthening the surgical time required in the operating room. 

If you are considering cosmetic surgery, it is key to understand how long you can safely be in surgery and how that affects your treatment plan. Below, St. Clair Shores cosmetic surgeon Dr. George T. Goffas explains what is a safe surgical duration, as well as the limits and the potential risks of prolonged surgery. 

Safe time frames for cosmetic surgical procedures

Most surgeons will not operate for longer than 6-7 hours—and even less for patients who are older or who have pre-existing conditions that may make them more susceptible to complications in the operating room (OR) and during recovery. 

Factors that influence the safe duration of a cosmetic surgical procedure 

Your overall health and medical history play pivotal roles in how long you can safely be in surgery. Conditions like heart disease, diabetes, or obesity can affect how well you tolerate anesthesia and how quickly you recover. Higher-risk patients may be limited by how long their desired procedure typically takes, and their surgeon may recommend alternative procedures or spacing the procedure out over several months.  

The expertise of your surgeon is also crucial. An experienced surgeon will know how to work efficiently so that you spend less time under anesthesia and experience optimal results. 

Preventing surgeon fatigue during lengthy procedures

One aspect you may not immediately consider is the well-being of the surgeon. Your surgeon must carefully balance your aesthetic goals and safety with their physical stamina and mental acuity when planning your surgery. 

They will take several measures to prevent fatigue and maintain focus during lengthy cosmetic procedures: one of the most important is to schedule regular breaks to stretch their muscles, rest their eyes, and reset their mental focus. Some may also adjust the lighting or switch positions or reduce physical strain.

Another strategy that can help keep your surgeon at peak performance is to work with a team of skilled medical professionals who can assist with less complex procedure tasks so they can concentrate on the critical tasks. Having a highly experienced medical team assisting your surgeon also ensures that multiple sets of eyes monitor your safety and progress throughout the procedure.

Most surgeons will not operate for longer than 6-7 hours—and even less for patients who are older or who have pre-existing conditions that may make them more susceptible to complications.

The role anesthesia plays

General anesthesia is a medically-induced state of unconsciousness to eliminate pain during surgery. It’s more complex than just a “deep sleep”—it’s a controlled, unresponsive state where you will not feel, remember, or respond to any stimuli or pain. And it is a determining factor when it comes to the length of surgery.

What happens to your body during general anesthesia

Here’s what typically happens to your body under general anesthesia:

• Induction. Your anesthesiologist administers medication through an IV or a mask that you breathe from. You’ll be safely unconscious in a matter of minutes.
• Relaxed muscles. The medication relaxes your muscles and helps keep the treatment area as still as possible. Keeping your muscles still helps your surgeon avoid disturbing nerves or other tissues that may impact your results and functionality. This is especially true for facelift surgeries.
• Reduced bodily functions. Your body’s normal automatic functions, like breathing, heart rate, and blood pressure, slow down. Your stress response also calms which helps minimize swelling and bleeding during surgery.
• Breathing assistance. A tube may be placed in your throat for breathing assistance (intubation) which is controlled by a ventilator to make sure you receive enough oxygen. 
• Constant monitoring. Your anesthesiologist closely monitors your vital signs and adjusts the anesthesia levels as needed so that you remain safe and comfortable throughout the process.
• Recovery. The anesthesia is stopped once your procedure is complete—you won’t remember any part of the surgery when you wake up. The medication leaves your system relatively quickly, but it may take hours or even days to feel like yourself again. 

How you tolerate anesthesia depends on the type of anesthesia used, your general health, and the type and length of surgery. You may experience some level of grogginess, nausea, dry mouth, sore throat, chills, or confusion when you wake up. These effects usually wear off as you get your bearings.

Risks of prolonged anesthesia 

Cosmetic procedures come in many shapes and sizes but typically have a predictable time frame for completion. Minor procedures like eyelid surgery can be performed in 1-2 hours, while a mommy makeover might take 4-5 hours.

But what happens when your surgery plan takes longer than a few hours? The longer you’re under anesthesia, the higher the risk of complications, such as:

• Postoperative nausea and vomiting. These side effects are common, but prolonged exposure increases the risk.
• Allergic reactions. Symptoms can range from skin rashes to difficulty breathing, and the risk can increase with prolonged exposure to the medication.
• Aspiration. This happens when stomach contents are inhaled into the lungs, which can cause a serious lung infection as the body’s natural reflexes that protect your airway are suppressed.
• Hypothermia. Your body’s temperature may drop during anesthesia, which may then lead to further complications such as wound infections or abnormal heartbeats.
• Blood clots. Prolonged immobility during surgery increases the risk of blood clots forming in the legs (deep vein thrombosis) or lungs (pulmonary embolism). These blood clots can be life-threatening if not treated in time.
• Postoperative cognitive dysfunction. Elderly patients or those with pre-existing cognitive issues may experience temporary or long-term cognitive dysfunction after prolonged anesthesia. They may experience memory problems, difficulty concentrating, or slowed mental processing.
• Respiratory complications. Anesthesia suppresses the body’s natural drive to breathe, which may lead to low oxygen levels or difficulty breathing. 
• Cardiovascular complications. Prolonged anesthesia can affect the heart and circulatory system, causing low blood pressure, irregular heart rhythms, or even heart attacks in susceptible individuals.

Vigilant monitoring helps minimize these risks. Your surgeon should also carefully review your medical history and any medications you are taking to help the anesthesiologist determine the appropriate type and amount of anesthesia to further limit any adverse reactions.

Trust a board-certified cosmetic surgeon 

Your choice of surgeon is the most important aspect of planning your cosmetic procedure. Detroit cosmetic surgeon Dr. George Goffas has over fifteen years of experience performing a range of surgical procedures in his private, on-site AAAHC-accredited surgery center at Cosmetic Surgeons of Michigan. Dr. Goffas is certified by the American Board of Cosmetic Surgery (ABCS) and specializes in personalized treatment plans that prioritize your safety while achieving the best possible results. Schedule your personal consultation with Dr. Goffas to learn more about your options by calling 586-745-3590 or contacting our practice online.