This response was dictated so I will apologize in advance for grammatical errors. Generally choosing the right procedure should be based on first, having a clear understanding of what the underlying problem or ideology is. In other words, the first step is to make an accurate diagnosis then prescribe an appropriate operation. Also, it is important to take the consideration what the individual is, hoping to achieve, especially in relationship with what they’re willing to go through guided. Decision-making for cosmetic surgery is often highly complex, bewildering and confusing. My most important variable is provider selection. In the hands of the right plastic surgeon, you’ll not only maximize the potential quality outcome, but will be guided through the decision-making process in the clear to understand manner. Finding the right plastic surgeon is not at all easy and most patients don’t do a very good job at vetting plastic surgeons or choosing the right provider. There are substantial differences among providers, despite having all the proper certifications, good reviews, and years of experience. in my opinion, the procedure that’s going to get you. The most benefit is the full tummy tuck. Second procedure that can potentially complement this and add the most benefit would be very well done Liposuction. I’m going to stop right here and talk a bit about Liposuction done in conjunction with a tummy tuck. I want to avoid making general statements, but I’ve seen this so many times that it seems like a general truth. When plastic surgeons have patience scheduled for liposuction of the flanks and waist with a tummy tuck, they pretty much view the operation as primarily at tummy tuck with some added liposuction. The patient may not be charged for just adding a little Liposuction, but that is how the procedure is usually done. There are a few reasons for this. The first one is that doing quality Liposuction of the love handles waste back, and under arms requires repositioning the patient either having patients laying on their abdomen or preferably, having them lay on their side. Repositioning patients under general anesthesia is time-consuming and cumbersome. It’s also somewhat risky and the anesthesiologist are not big fans of turning patients under general anesthesia. It typically takes six people to reposition a patient under general anesthesia and the entire process can take 20 or 30 minutes. Most plastic surgeons begin with the tummy tuck because it’s the primary procedure in their review. After the tummy tuck has been started, you can’t really turn the patient. The front of the abdomen is too tight to be fully stretched out. This leaves most of them to do liposuction on the backside with you laying on your back and the procedure becomes sort of a blind procedure done by feel. Liposuction results when done in conjunction with a full tummy tuck often look nothing like quality liposuction results done when someone goes in to have just Liposuction as a single procedure. reducing the love handles and waste correctly can in many ways almost eliminate the need for a BBL. Establishing proper, feminine S curve, a.k.a., coke bottle, a.k.a. hourglass figure it’s often better done with well done Liposuction then adding grafted fat. Of course, it depends on each person’s candidacy, and this varies from person to person. Those who have no fat on their bottom will definitely benefit from adding fat. There is an enormous difference among plastic surgeons in how they approach Liposuction. If there is one important message in this response, it is, the importance of vetting providers for Liposuction. Being board-certified in plastic surgery with years of experience does not mean a plastic surgeon has mastered any single procedure. They may be very good at doing tummy tucks, but they may have minimal skill in doing the BBL. They may be reasonably good at that transfer but not have good Liposuction skills. There are plastic surgeons who can do the combined procedure of a tummy tuck, liposuction, and BBL in conjunction with quality outcomes, but I would say the majority of plastic surgeons will fall short most likely in the liposuction, and or fat transfer outcome of the procedure whenever these are done in conjunction with a tummy tuck. if you can find the right provider who has a proven track record of doing these well as a combination, then you may be good to move forward. If not, it may be a much better idea to do these as separate procedures. My personal expertise is in Liposuction and fat transfer. For the last 10 years go to the only procedures I perform. For the first 15 years of practice, I did general plastic surgery with lots and lots of tummy tucks. None of my results were overall bad, but at the same time I never developed the opportunity to master a single procedure, until I began focusing exclusively on only one operation. At that point my liposuction and fat transfer results Became quantum leaps better than what they had in the past. I generally recommend patients have multiple in person, consultations before selecting a provider. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who had similar body characteristics to your own. An experience provider should have no difficulty showing you the before and after pictures of at least 50 previous patients for commonly performed procedure graded. If you’re having more than one procedure than ask specifically to see results of patients who had the same combination of procedures. At a minimum make sure you see enough before and after pictures at least of separate Patients who had individual procedures, but ideally what you’re looking for our patients who look like you who had the same combination. For fat trans results like the BBL recognized that early post operative results can look very impressive but do not in anyway represent final long-term results. Never assume that postoperative pictures are taken as long-term final outcomes. Always asked the provider when the after pictures were taken. After pictures need to be at least 3 to 6 months old in order to be representative. There’s no correct number of consultations needed to find the right provider. The more consultations you have the more likely are to find the better provider. Continue having consultations until you feel very comfortable. You’re with the right provider. In the hands of the right plastic surgeon everything will fall into place. my best guess is unless you confirm you may be disappointed with the Liposuction results if done in conjunction with a tummy tuck. Best, Mats Hagstrom, MD