Timothy M. Bradley, MD

Yes, a lower bodylift lift is exactly THE procedure you require. A lower body lift will address the redundant hanging skin circumferentially around the waist and address the sagging skin of the abdomen, waist, thighs, buttocks all in one procedure with a scar which is completely hidden by a bathing suit or underwear. It is a BIG surgery (7+ hours), requires the patient to be nutritionally & metabolically sound , but the results can be astonishing.

Hello,
Congratulations on the weight loss after child birth. 50lbs weight loss is commendable!
Your skin looks remarkably good for three pregnancies. I can not any see any stretch marks and the overall tone is very good.
What you see when bending over is the classic positive “swimmer’s view” which plastic surgeons frequently test when evaluating patients who complain of a “pooch” of the lower abdomen after having children. I would ask you to “suck in your belly” as you are bent over to see if what troubles you is improved. If so, then a muscle tightening procedure would help correct this “pooch”. Your complaint is due to laxity of the underlying muscle and not a skin issue per se. An endoscopic Abdominoplasty can achieve this through a two inch incision in the pubic region well below your panty line. No skin excision scar is required. A “mini abdominoplasty” corrects the muscle laxity, and removes excess skin of the lower abdomen withOUT violating the patient’s belly button through an incision which is well hidden below the panty line and is half the length of a regular abdominoplasty.
Either procedure would correct your pooch while bending over, but the mini abdominoplasty would provide a more definitive correction. Which type you choose depends on the correction you want, and can be determined by your plastic surgeon during an in person consult with a physical exam. One word of caution , however. I would advise against either procedure if you are not done having children. Best wishes.

Your skin elasticity appears to be good, and there should not be an issue with having loose skin following a liposuction procedure. Not only is good skin quality extremely important to a good out come when treating the inner thigh area, but conservative and proper fat removal is also paramount to a good outcome. Aggressive fat removal of the inner thigh area as is frequently performed when treating the abdomen or flank area can result in what is known as a “shark bite” deformity of the inner thigh. Be sure you choose a surgeon who has extensive experience with liposuction. A shark bite deformity is not only exceedingly unsightly, but also impossible to fully correct

A faja is a compression garment, but to specifically answer your question: a compression garment that includes the hips, buttocks and thighs is required after BBL surgery. A proper fitting compression garment post operably will not do the damage to your freshly fat grafted areas as does pressure from sitting, and shear stressors.
Is very important to provide proper compression to all areas which have undergone liposuction in order to have the best possible outcome. Specifically, a abdominal binder will create misshapen hip areas due to confined swelling below the binder. Also, a binder is vastly inferior to the uniform compression Provided by a proper fitting compression garment. Also, there are many different qualities of Compression Garments. Some of them are very cheap and can do quite a bit of damage to your skin, including skin death, because they do not move in all directions. Cheaper Compression Garments fabric is very stiff and very dangerous. Be sure you do not skimp on a proper fitting postoperative compression garment, because they can become rather pricey. but a good compression garment is well worth the investment. Lastly, the fat grafted areas do well with mild postoperative compression. A properly fitted and specific post op BBL compression garment will have less compression over the central buttocks so that there is less chance of adverse skin damage to freshly fat grafted areas

Hello, the procedure which will help you achieve an hourglass figure is what is commonly referred to in Miami as “360 Lipo with BBL” . The 360 refers to the areas treated with liposuction: the entire abdomen, waist, flanks, bra strap area of the lower back and the sacral area. The bump you mentioned at the sacrum area (“bump right before your butt”) is most likely a fat deposit which in my experience is very common finding in African American women who present to me for BBL procedure. This is removed with liposuction to help shape the upper buttocks and produce a more aesthetic shape to this area. Your reported weight and height places your BMI at slightly above 26 which tells me you will have enough fat harvested from the liposuction procedure to allow for a full BBL which will give your hips a feminine curve and fullness and more projection to the central buttocks. The change in shape in the hips from fat grafting and the deep waist curve produced from the liposuction will result in an hour glass figure. I hope this helps

Hello Lyn,
yes, I have performed BBL procedures on several transwomen with nice results which were pleasing to both patient and myself. (I tend to be my harshest critic!)
From what I can discern from your photos, I think you would be a a suitable candidate for liposculpting of your abdomen, waist, and flank regions and fat grafting of the buttocks and hip areas. The liposuction procedure not only harvests fat for the fat grafting procedure, but will markedly deepen the waist and help define the upper buttock area. Properly performed fat grafting to the lateral hip area will provide a significant improvement in the development of a feminine curve. Fat grafting the lateral hip area in conjunction with developing a deep waist curve is the most important aspect of achieving a feminine outline. Fat grafting of the central buttock area is of secondary importance and you must be realistic in your goals. Your calculated BMI is around 26, which should provide adequate fat to make a significant improvement in your figure.

Hello, Using a silicone implant inside your bra, or bags of rice for that matter, has absolutely ZERO correlation as to what size breast implant (in cc’s) will fill out your bra in the same way post operatively. Think about this for a moment: an implant will go UNDER your pre-existing breast tissue and even you pectoralis muscle. There are different profiles to implants so that a 285cc high profile silicone implant will act on an individual’s overlying breast tissue and muscle very differently than a similar volume low profile breast implant. A patient who has never had a pregnancy, who has very dense, glandular breast tissue, and a tight skin envelope will respond very differently to an implant of the same size and profile as a woman who has breast fed a couple of children, whose breast tissue has atrophied, and their breasts are very soft, with lax and “stretchable” skin. If you place a bag of rice , or a silicone implant over either one of these breasts, the change in perceived breast size within the patient’s bra will be quite similar. You place the same volume implant with similar profiles in each of these theoretical patients, and the post operative outcome
Will be vastly different. Using the aforementioned pre operative “sizing” techniques is a way if making a patient feel like they are more involved in the pre operative decision making, when in reality, the patient’s surgeon should be taking the time pre operatively to thoroughly examine the patient’s breasts, and taking into consideration the many variables which affect post operative outcome and also very much impacts the volume , profile, and even the shape of the breast implant chosen for each particular patient and her desires. I tell my patients that when done correctly (meaning the pre operative examination and taking into account the myriad of variables each patient presents) that the patient’s breast selects the implant, not the patient or surgeon. Performing a breast augmentation surgery is not at all a difficult procedure in the grand scheme of things within a board certified plastic surgeon’s armamentarium, knowing how to properly determine the best breast implant to meet each patient’s particular outcome desires is another story.

Sleeping on your side is not going to hurt your implants, but there may be a relationship between breast implant rupture and implant folds. Theoretically, implant manufactures have postulated that the folds which inevitably occur to breast implants over time MAY lead to implant wall material fatigue, much like what happens if you repeatedly fold a soda can back and forth in itself. The aluminum will eventually fatigue along the fold and this will lead to a tear. This is what is thought to occur to a breast implant wall. It is thought that silicone gel lubricates the wall some what better than saline, thereby lasting longer than saline implants. This is all theory of course, but it does sound reasonable. I have always recommended to my breast surgery patients that they wear some type if light support garment to bed as a matter of routine following surgery. Something as simple as a shelf bra in a camisole will do. Try it yourself and see how much less the breasts are affected by gravity with the garment vs without This will support the breast when they lay on their sides to sleep and will help delay soft tissue stretch . Soft tissue will happen over time, but a light support garment will help in this regard.
Regarding a breast implant fold, I doubt there is anything that can be done to eliminate the wear and tear every breast implant endures during its lifetime. Like everything else, a breast implant will wear out and need to replaced at some point. I would not give it much room in the attic as they say.

A “Donut” mastopexy, or Periareolar mastopexy can be performed , but internal breast tissue modification will be required to shape the inferior pole of the breast (the skin & tissue below the areola) and to provide shape to the breast. If a skin only Periareolar mastopexy is performed for your breast, without an implant, or without your own breast tissue to provide projection , you may experience flattening of the breast post operatively. I would not recommend fat grafting to your breasts for your particular needs. Best wishes

Generally speaking, a curve to the waist with tummy tuck can be easily obtained if the necessary procedure(s) is performed in conjunction with removal of the excess abdominal skin. A thorough liposuction procedure of the waist, and hip area concurrent with abdominoplasty will achieve the feminine silhouette to which you refer. All individuals are built differently. Some women have a longer waist, defined by the distance from the top of the hip bone to ribs. A longer waisted individual has more “room” Ethernet the hip bone and the ribs to allow the surgeon to sculpt a deeper and more pronounced curve to the waist than a short waisted individual, however, in my experience I have been able to achieve notable improvement and shape to the waist regardless of long or short waist if the patient is willing to undergo liposuction in addition to the skin removal procedure. In high BMI patients, sometimes it is necessary to extend the abdominoplasty incision further around the hip region so that the surgeon has better control of the final shape of the waist area. This is known as an “extended” abdominoplasty. A patient who desires the maximum improvement in her waist when undergoing a tummy tuck will have to accept the addition surgery (liposuction) and perhaps a longer tummy tuck scar of an extended abdominoplasty if needed.