Thanks for your question. I always prefer to
perform these procedures separately. The
recovery from each procedure on its own is significant. Usually, it is
suggested to sleep on your stomach after the butt lift, and that is almost
impossible to do if you have the tummy tuck at the same time. Of course the
exact opposite is true with the tummy tuck — you have to sleep on your back and
butt after a tummy tuck. The bottom line (no pun intended) is that if your
surgeon has had a good experience performing both together, then you should
follow his lead. Good luck with your decision.
There are many procedures that I will perform together, sometimes three procedures in a given anesthetic. In general, if the procedures can be performed in under 5 hours, I feel that it is safe to proceed. Most commonly, I perform breast and tummy procedures together.
However, the risk of complications increases when surgery lasts longer than 5 hours and when multiple procedures are performed together. These risks include infection, wound problems, and most notably deep vein thrombosis (blood clots). The risk of blood clots when tummy tuck only is performed is about .3%. When you combine a tummy tuck with additional procedures, the risk goes up to around 1%. This is still a low number, and still is considered safe, but it is three times the risk doing the combined procedure.
I generally prefer to stage a tummy tuck and Brazilian butt lift, for example, in order to reduce this risk, and I make every effort to ensure that cost is not a barrier to safely staging complex procedures.
If you have carefully chosen your surgeon and entrustd you care to her/him - then I would suggest that you follow your surgeon's advice including a discussion of risks.
Thank you for the picture. Personally in my hands I don't do those procedures together. If you have chosen surgeon that has a reputation and evidence that he/she has good results by combining the procedures then you should feel confident in going that direction.
These procedures can be done together, but the important question is what you are trying to get out of the surgeries. The Brazillian butt lift can encompass several different procedures. If you are having skin resected from your back, butt, and thighs to elevate and tighten the buttocks and lateral thighs, then doing both may comprise the results of each. Doing both together will end up in less tightening the separating the surgeries. If your BBL procedure involves the injection of fat only, then it would seem more reasonable to do them together. However, the tummy tuck can not be too aggressive when performing liposuction for the BBL as ther may be healing problems. Your plastic surgeon can discuss all these issues, and depending on your anatomy and desires doing both together may be fine.
Eric Weiss MD
I personally prefer to perform the BBL first and then stage the tummy tuck so that I can be aggressive with the fat harvest in the abdominal regions during the first stage. Plus, I like to perform a wide undermining for the tummy tuck and doing it together may risk skin flap loss.
In my experience, the two procedures simultaneously can lead to a lesser result in each. I am opposed at this time to doing them together. There is validity to gather as much fat as possible and transfer it to the buttock area first. To obtain maximum augmentation of the buttock area after fat transfer requires a period of no pressure on the buttock region. The Tummy Tuck (Abdominoplasty) requires flexion of the abdominal waist area after excision of the skin. These two post operative requirements are- in my opinion opposing to each other. I usually recommend abdominoplasty first as it gives the most dramatic improvement that will last.
Tummy tuck and BBL are procedures that I don't do together. The recovery is the major issue. After a tummy tuck one is bent at the waist to some degree for about a week for a fully tightened result. After a BBL I don't allow patients to sit or lay flat for a full week with limited sitting for 3-6 weeks. BBL patients are expected to sleep on their belly which is impossible after a tummy tuck. There is simply not a comfortable position.
In my patients, I recommend that if they can afford to do them separately, to do the Brazilian Butt lift first and then do the tummy tuck 2 months later. The reason for that is that after the BBL, I recommend they sleep on their stomach for 2 months to maximize the chance that the fat grafts won't shift. If you do the tummy tuck, you will have to sleep face-up so you will be putting weight on your buttocks. That would cause the fat grafts to shift or die. With a tummy tuck, most patients cannot sleep comfortably on their stomachs for 6-8 weeks.
In good candidates who are healthy, the combination can be performed effectively and safely. Appropriate postoperative protocols are necessary to ensure proper healing and fat survival.
Kenneth Hughes, MD
Los Angeles, CA