Hello, and thank you for your question about whether it’s better to get a lower body lift versus an extended tummy tuck, butt lift, and BBL after a 100-pound weight loss. Thank you for your history. Pictures and the physical examination are important for accurate diagnosis and for developing a further treatment plan. However, in general, after a 100-pound weight loss, if you want your abdomen, hips, and buttocks addressed, most plastic surgeons would certainly suggest a 360 circumferential lower body lift. If your breasts bother you, you can also undergo a breast lift. If you have excess skin and fat above your belly button, you may need the vertical abdominoplasty component of the 360 body lift. Some people called this a Fleur-de-Lis. You could combine the 360 circumferential lower body lift with the mastopexy or breast lift. Most plastic surgeons would not suggest undergoing an extended tummy tuck with a breast lift and then, later, undergo a posterior butt lift. The “tissue issue” occurs over the lateral hip or the lateral extent of the extended tummy tuck. With significant weight loss, most patients need an abdominoplasty, hip lift, hip reduction, and butt lift. With the extended tummy tuck, the abdominoplasty or tummy portion of the lower body lift incision is carried from the mons or pubic region over the hip. When you return for the posterior body lift, the incision would extend from the top of the buttock cleft forward over the hip region. Usually, what happens is that the hip region is lifted and reduced twice. During the abdominoplasty, the hip region is tapered or feathered to avoid a dog-ear. That means over the hip, not as much tissue is removed to avoid a significant dog-ear. During the posterior body lift, the hips can be lifted and reduced more. However, to minimize the dog-ear from the posterior body lift, the incision is tapered into the abdominoplasty scar. Usually, during a posterior body lift after an extended tummy tuck, the incision is carried down to the iliac spine. The posterior body lift usually winds up as not a 360° circumferential lower body lift but a 270° or a 300° circumferential lower body lift. That means there is a segment over the hip that ranges by about 8 to 10 inches, which is lifted and reduced twice. Revising this area twice is just extra time under anesthesia, extra surgery, extra expense, and a higher risk of wound complications. If planned accordingly, it would not need to be done twice. A 360 circumferential lower body lift would avoid this and only address the hips once. Therefore, most experienced board-certified plastic surgeons who specialize in reconstructive plastic surgery after massive weight loss would suggest undergoing a 360 circumferential lower body lift and mastopexy. Most plastic surgeons would not suggest a two-stage procedure, including an extended tummy tuck and mastopexy to be followed by a posterior buttock lift. Good luck. If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please get in touch with an experienced plastic surgeon. Since the body lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, lower-body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen, MD, MBA. (President of the American Society of Bariatric Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)