When doing liposuction in conjunction with a tummy tuck, it’s very important to be thorough when it comes to vetting plastic surgeons, and carefully reviewing before and after pictures. To do Liposuction well on the backside of the body, the patient needs to be turned on their side or face down. turning patience during surgery is time consuming and requires a significant number of people to assist. Generally takes six people to properly train a patient during surgery. Some plastic surgeons will cut corners and do liposuction even abdomen 360 with patients laying on their back. Some Liposuction will be done this way it’s not possible to get a quality outcome. It’s really important to have a clear understanding of if the surgeon is planning to turn your during surgery and to have seen previous examples of patients who have this combination of surgery and make sure their results look acceptable to you. Delivering consistent quality liposuction results is more difficult than most people realize. The number of plastic surgeons who truly mastered Liposuction are in the minority. This procedure has more variation and outcome, depending on who you choose as your provider than any other plastic surgery operation. anyone can do liposuction, but to do it well it is another story. During each consultation, ask each provider to open up their entire portfolio and show you their entire collection of before, and after pictures of previous patients, who had similar body characteristics to your own. In your case, that means patients who had thick layers of subcutaneous fat on their lower back, and then their love handles. You have significant cellulite on your buttocks and this can be made worse with a BBL. I don’t think a BBL is needed as much as well done Liposuction. The emphasis here is on well done. An experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. considering how much variation there is in Liposuction skill I recommend patients of multiple in person consultations before choosing a provider. Provider selection is the only variable patients have control over in regards to having consistent quality outcomes. In the end, only patient candidacy, and provider selection really matter. There isn’t much patience can do regarding the road candidacy for the procedure, but they do have control over provider selection, and the difference between those to spend the rest of their life. Having regrets versus those who say I should’ve done it earlier is generally those who spent the effort properly, bedding, plastic surgeons, and spending enough time, having multiple consultations to make sure they were the hands of the right provider. Everything you describe, seems appropriate. I questioned the need for a BBL and I also personally generally prefer doing body contouring with Liposuction as a separate procedure from the tummy tuck. I generally prefer the tummy tuck to be done first, and then do liposuction as a second procedure. it’s not uncommon to do this as a combined procedure but from what I experience the liposuction too often takes a backseat to the tummy tuck and liposuction results can sometimes be a little sub par because the surgeon is focusing on the main procedure, which is generally the tummy tuck. When, having combined procedures, we need to vet the provider for each of the procedures you’re having. This means seeing enough before and after pictures of each procedure ideally combinations of each procedure to know what kind of results you go to obtain. There should ideally be no questions about what your results will look like. Sufficiently experienced surgeon should have enough before and after pictures generally hundreds or thousands to choose from to be able to show you what previous patients look like in the hands of each provider. Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like or how many of these procedures anyone the surgeon has actually performed. My last thought is that you do have a bulging abdomen, and this is generally Caused by muscle separation in patients seeking a tummy tuck. There are two variables that can cause bulging of the abdomen. What is muscle separation and the other is excess of visceral fat. It’s important to differentiate between the two because of visceral fat is causing a significant problem the outcome of the time attack, and will be inherently limited. Excess visceral fat takes up intra-abdominal space. The intra-abdominal volume is reduced with muscle type thing during a tummy tuck. This can cause increased intra-abdominal pressure, which will eventually go somewhere. Individuals who have excess visceral fat should consider weight loss before having a tummy tuck in order to get a flat abdomen after the procedure. You can differentiate muscle separation from visceral fat by seeing if your abdomen goes completely flat when you lay on your back. If it does, the problem is more likely related to muscle separation. If it’s still bulges while you’re laying on your back, then visceral fat may be a significan component in weight loss may be indicated before surgery. We can also differentiate between muscle, separation and excess visceral fat by simply pressing on the upward Amanda. You can do this yourself with your nondominant hand. If it’s relatively easy to press, your abdomen completely flat with your nondominant hand in Masullo seperation is probably the primary problem. If it takes a great amount of force to press your abdomen flat then visceral fat may be a significant problem and muscle tightening may still cause your abdomen to bulge after. In the end, there are four tissue variables to determine what the abdomen looks like. These are skin, laxity, excessive subcutaneous fat, muscle separation and excess visceral fat. Overall, it looks like you’re a good candidate for both Liposuction and a full tummy tuck. In the hands of the right provider, you should have a stellar outcome. Judge Tommy tuck results based on who gets the most natural looking belly button with a very low set scar that follows anatomic contours, naturally and evenly, leaving the torso, looking attractive appropriate And balanced from all angles, including from behind. The single, biggest mistake patients make before having cosmetic surgery is not properly vetting, plastic surgeons, and having to few consultations. The time to be critical of plastic surgeons is before if you schedule a permanent irreversible body contouring procedure. Best, Mats Hagstrom, MD