Why won't some doctors do a tummy tuck and a BBL at the same time?

This is a common question. I typically do not perform the procedures at the same time. There are several reasons why:In my hands this would be an extraordinarily long operation.While performing one procedure you would jeopardize the results of the other procedure. Example, want the tummy tuck is done I like to leave my patient slightly flexed. If I did a BBL and a tummy tuck at the same time the patient will need to be flat on their tummy while placing the fat into the buttocks. This could compromise the tummy tuck. On the flipside, if the BBL is performed first then the patient will be on their fat grafts with pressure for our hours while I was performing the tummy tuck.Recovery will be difficult. Could not rest on your backside because that could compromise the fat grafts. You could not rest on your abdomen because that could compromise your tummy tuck.I choose to perform these procedures separately.  Performing BBL first followed six months by performing the  tummy tuck. 

Combination procedures are safe and very effective in the right hands. The surgeon HAS to be an expert in EACH procedure and must have a lot of experience in performing combination procedures and can minimize the operative time.  Combination procedures can give powerful results but SAFETY is KEY. You definitely have to choose your surgeon correctly and make sure that he/she has the training and experience to meet your goals with absolute safety. Don’t settle for less than a Board Certified Plastic Surgeon with specialized expertise in this procedure.

While in theory  the combination might not be totally desirable ,in my practice the combination of both has not created any disadvantages .On the contrary ,the tummy tuck results  to be complete often benefit from liposuction of the flanks which are also  the safest source of fat for BBL.In addition, liposuction of the tummy fat  during the tuck can provide needed additional grafting material especially in thin individuals.I do  recommend for my patient to line up a recliner with eggcrate mattress  to avoid  undue pressure on the grafted areas and also  provide them with a protective dressing.

Thank you for your question.  Similar to some of the answers below, I don't do a TT and a BBL at the same time.  There are several reasons for this.1.  When I do a BBL, I do an aggressive lipo of the abdomen, waist and lower back.  When you do that and a tummy tuck at the same time, you increase the chance of having wound healing complications.2.  When I do a BBL, you cannot sleep flat on your back for 3 weeks.  When you do a tummy tuck, you are not going to want to sleep on your stomach because it will be sore and you will have drains coming out.

I am not a proponent of doing a buttock fat transfer at the same time as abdominoplasty. The tummy tuck usually requires the inability to fully straighten up in order to facilitate the best result. Whereas fat transfer to the buttock area usually requires staying off of this area directly for several weeks postoperatively. All unnecessary pressure on the buttock area following fat transfer could reduce the overall final result by preventing the transferred fat from creating the best possible result.. For more info- you can read my blog here:

These two procedures in particular are not done at the same time because the recovery of one would affect the recovery of the other.  This is mainly due to positioning during recovery (tummy tuck patients are typically sitting in a reclined position on their back, while BBL patients are laying on their stomachs).  Fat transfer is more successful when one is able to not compress the transferred fat significantly for extended periods of time.  This is especially true for the buttocks, where a large amount of fat is typically moved.  This allows for the transferred fat to develop its own blood supply by which it can be noursished and survive indefinitely.  If this does not occur, those transferred fat cells will not survive, and will be lost, thereby minimizing the effect of the procedure.During a tummy tuck the discomfort associated with moving around much in the early days of recovery means people sit quite a lot.  This would have a negative effect on the fat transfer from the BBL.  Hope this makes sense to you.  Seek a plastic surgeon certified by the American Board of Plastic Surgery for your procedures and education as you find an appropriate surgeon.

Thank you very much for sharing your concerns with us.In my practice I usually perform those procedures you want in the same surgical time. For safety reasons, to be a good candidate for those procedures you want at the same time your labs and cardiovascular preoperative evaluation must be optimal.Therefore, you must be a healthy person, within an appropriate BMI and no history of diseases that increase the surgical / anesthetic risk degree.Finally, I recommend you a skilled certified plastic surgeon in body contouring surgery and experienced in cases like yours where the planned operating time is less than five hours.Respectfully, Dr. Emmanuel Mallol.-

Hello dear, thanks for your post. Each doctor has their own politics, but those procedures can be done at the same time if you are in good health. I recommend to go to a board certified plastic surgeon for a person evaluation and to talk about your goals. Good luck :)

GREAT QUESTION! You need to understand in the State of FL there are guidelines/rues from the FL Board of Medicine that restricts the amount of liposuction to be done with a combination of a TT. It is ONLY 1 liter of fat, which might NOT be enough to fill your buttock. So I always requests 2 operations: #1 BBL with 4 liters of lip. #2 full TT with 1 liter lipo.

We ever faced with opposite opinions and not knowing all the facts, ask yourself who stands to profit more me or him/her(in this case the Plastic surgeon)? Obviously the more operations a surgeon can do on you, the more money he makes. So if a surgeon turns down the opportunity of increasing his income and working against his economic interest shouldn't you pay attention and listen??There are 2 major reasons not to do these operations together: long duration of the operations and a painful recovery which may bring about blood clots and loss of the fat grafts. Let's address the duration. A high quality operation requires attention to detail. Plastic surgery should never be one a NASCAR pit tire change. Quality products be they suits or cars require attention to detail and such quality is list when one speeds through an operation and shortcuts are taken. All Plastic surgeons decide early in their career which surgeon they will be and speed in many cases, not all, suggests less attention to detail and even a poor closure. Recovery. How sore do you want to be and in how many opposite areas? If your front, buttocks, sides back and sometimes arms are really sore, how are you going to get out of bed? Go to the bathroom? Dress yourself? Drive? if as a result, you put pressure on the grafted fat, more of it will die leaving you with asymmetry and a worse result. If you do not walk you will end up with potential deadly blood clots. Is such a recovery really worth the savigs？While I'm not accusing my colleagues who like to do huge combination operations of being purely focused on maximizing their income, there is an element of that involved here especially by those who claim to be able to do everything in 3 hours. Unless they operate on a different race of super-humans who feel no pain and recover without any problems, I remain skeptical and Luke my colleagues prefer to make LESS money but protect our patients and get nice results with quicker recovery. Good LuckPeter Aldea MD