After multiple pregnancies or undergoing a massive weight loss program, many women can be left with overly large and sagging breasts with an unaesthetic, saggy pouch on the abdominal area. Overly large breasts can be corrected with a breast reduction surgery, and a tummy tuck can sort a sagging abdomen, but can the patient have both procedures performed at once?When is a breast reduction recommended?Breast reduction is the recommended surgical solution when the patient is confronted with breast hypertrophy, which is the excessive development of the mammary gland. The procedure is different from breast lift surgery; this intervention is performed when there is just an excess of skin.To be eligible for a breast reduction surgery, the patient needs to have not only skin sagginess but also a significant quantity of mammary gland that creates a disproportion between the breasts and the rest of the patient’s body. When the patient has overly large breasts, issues such as skin sagginess, dermatological conditions, and back, neck and shoulder pain are usually associated with it.The procedure targets women of all ages, and it is a complex intervention that can require 24-48 hours of hospitalization once it is performed. During a breast reduction, the breasts will be lifted and the asymmetries will be fixed. For a good aesthetic result, the plastic surgeon needs to perform precise measurements to harmoniously remodel the breasts and bring them to the same volume. The procedure is performed on the lower part of the breasts, under the level of the mammary areolas not to leave too visible scars, to lift the mammary gland and to create a nice cleavage.When is the tummy tuck recommended?The tummy tuck procedure aims to provide a flat and firm abdomen to patients who are confronted with skin sagginess on the inferior part of the abdomen. During the procedure, the plastic surgeon will perform an incision (usually from hip to hip on the suprapubic area) to strengthen the abdominal muscles, correct a potential umbilical hernia, and remove the excess skin and fat tissue. The incision is then sutured.The intervention is recommended for women who underwent multiple pregnancies or a major weight loss program, but also for men and women with a poor skin tonus on the abdomen that would make liposuction fail to provide good results. However, liposuction can be associated with the tummy tuck to reduce the thickness of the fat layer on the tummy.Can the two procedures be performed at once?There are plastic surgeons who won’t recommend this, while there are others who do it on a weekly or monthly basis. However, the answer depends from patient to patient. There are several aspects to be taken into consideration to see if they can be performed in the same sitting:1. The complexity of the proceduresWe have different types of tummy tucks and different types of breast reduction surgery. There is a mini tummy tuck, the standard tummy tuck, and the extended tummy tuck. For breast reduction, the complexity varies depending on the amount of mammary gland to be excised. If the patient would need an extended tummy tuck and also to have more than 500 grams extracted from the breasts, then the procedures should not be performed at the same time. If one of the procedure is complex and the other less complex, then there should be no problems performing them in the same sitting.2. Operative hoursDepending on the complexity of the procedures, the operative times vary too. General anesthesia needs to be performed and the shorter the period the patient is under anesthesia, the better. This is why operative times shouldn’t be longer than 6 hours. In complex cases, it can be just the breast reduction that will take 3 to 4 hours, and this means combination of both procedures need to be determined as well.3. The health condition of the patientTo undergo combined procedures with a long operative time, the patient needs to be in perfect health and emotional condition; otherwise, severe complications might occur and delay the recovery process. If the patient has chronic conditions, we usually recommend for the procedures to be performed separately.4. Comfort during the recovery periodBreast reduction and tummy tuck both require long incisions. This translates into long surgical wounds that will need to heal. Arm movement will be restricted after breast reduction and the indications after the tummy tuck is for the patient to maintain a slightly bent forward position. The recovery after these combined procedures might be more difficult and stressful for the patient, especially if the patient doesn’t have someone available to help her at home with chores around the house or if she needs to return to work after a week from the procedures. However, the benefit of undergoing combined procedures is that the recovery period happens once and not twice, so this is something the patient needs to consider, especially if she can’t take time off work multiple times.ConclusionThe breast reduction surgery and the tummy tuck can provide a significant improvement in the patient’s body, re-contouring the front side. Even if the aesthetic result is superior when combined procedures are performed, it is not always possible to have a tummy tuck and a breast reduction at the same time. This depends on the health and emotional condition of the patient before the procedure, the complexity of the interventions to be performed, and the operative time. The comfort during the recovery period must be considered when making the decision to undergo both procedures at the same time. The complexity of the procedures depends on the quantity of mammary gland (for the breast reduction) and skin and fat tissue (for the tummy tuck) to be removed.