44 yr old needing a tummy tuck, BBL and breast reduction w/o implants. (Photos)

44 yr old mother of twins. 5'6, 260 lbs. Have lost 40 lbs and want to lose 40 more prior to surgery. Highest weight 354 lbs and lost 130 lbs with gastric bypass in 1999. This left me with lots of loose skin all over. I have no other health concerns and take no medications. Do you think it is safe for me to have a TT, BR w/o implants, and BBL? Looking to have surgery June 2017. Would like to get an arm and thigh lift later.

Doctor Answers 10

Needing a tummy tuck, BBL and breast reduction w/o implants.

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Hello Dear, thank you so much for your questions, pictures and concerns.

Congratulations on your weight loss!! 

According with your pictures you would be an excellent candidate for a Tummy Tuck, This procedure consists in the removal of excess skin and abdominal fat and muscle flaccidity correction. This situation of excess skin and relaxation of the abdominal wall is often in patients who have had weight gain and subsequent loss or in womenwho have had multiple pregnancies. Tummyu Tuck (Abdominiplasty)  get a flatter, firmer abdomenand a narrower waist. Also i would recommend a Breast reduction in the same round.

Multiple procedures are very common in my office and within the more common this realization of Tummy Tuck, Lipo and breast reduction, this will depend on your state of health generally. This which is why the recommended would be an assessment in person with your doctor and starting from there decide the procedures that would be made.

Hope to hear from you soon, best wishes!!

Dominican Republic Plastic Surgeon

Breast reduction without implants

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Congratulations on your weight loss. Continue with your efforts to minimize risks and complications associated with obesity and prolonged time under general anesthesia. You are off to a good start! I have attached a short video of what can now be accomplished with breast lifting/reduction technology. Breast implants and the vertical component of the traditional lifts/reductions is now obsolete. You are welcome to visit my gallery to see more examples. 

Best wishes and kind regards,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Combining body contouring procedures

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First of all, congratulations on taking control of your health and losing the excess weight. Once you are at a maintainable goal weight, you will be ready for your body contouring procedures. Personally, I don't combine these three procedures. I typically don't think it's safe and the recovery of a BBL and TT combined is gruesome. I would advise you to combine the breast reduction & tummy tuck, but have the BBL on its own. You can have the BBL first. It depends on which areas bother you most. But wait at least 6 months between procedures to give your body time to fully heal. Hope this helps.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 38 reviews

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44 yr old needing a tummy tuck, BBL and breast reduction w/o implants. (Photos)

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At my Practice i don't perform those two procedure at the same time.  Remember when you do a BBL you cant lay on your back for 2 weeks and when you do a tummy tuck with breast reduction you cant lay on your front.

   The patient should know that when procedures are combined especially when it includes liposuction the complication rate goes up tremendously.

    The recommended BMI is less than 30. This is the recommendation of the American society of plastic surgery. The reason simply, is increased chance of complications. These include but limited to, pulmonary embolus, deep venous thrombosis, delayed wound healing and increase infection rate.

     there are different types of tummy tucks which one is right for me and how are they different from the other? There is a mini tummy tuck, Full tummy tuck and a vertical abdominoplasty. The appropriate procedure depends the amount and location of the excess skin. That's what your plastic surgeon will have to determine after the actual physical exam.

     What are the basic tips to know if I need a breast augmentation or breast lift? It all depends on the position of the nipple on the breast. The further down the nipple is in relation to the fold the more the chances are the patient needs a lift.

Choose a board certified plastic surgeon who has done a ton of Tummy Tuck and has privileges to do this surgery at a local university hospital. This says his credentials have been checked out by fellow Drs. All surgeries carry risk, talk to your plastic surgeon and choose one wisely.

Many surgeons, including myself, offer online virtual consultations
where you send us your photos and we can estimate the cost. I, like many
surgeons, also offer free consultations so that you can be examined and
given the most accurate quote possible. Please be mindful that the in
person physical exam is the most important and could potentially alter
your treatment plan.


Multiple procedures

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Be cautious of doing too much at same time- consider tummy tuck with or without breast reduction. Personally, I do not perform fat grafting with tummy tuck as it poses increased risks and problematic post op positioning.

If you are planning to lose more weight, you may want to defer any procedures.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations. 

TT, BBL and Breast Reduction

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It is best to review your options at a consultation.  Sometimes it is best to do several procedures together and other times it is best to stage the procedures.  At the consultation your specific case can be reviewed and options discussed.  Considerations are the extent and complexity of surgery required, health of the patient and recovery time.

Good Luck

Weight loss and surgery

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I think that it is a good idea for you to get to your goal weight first before having surgery.  Best to stage some of these procedures. I work with weight loss patients all the time. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Mommy makeover

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Thank you for the question and photos. Congratulations on losing the weight and keep it up!

After you lose the weight you would be a good candidate for multiple procedures however they would have to be done in stages to minimize the risks and complications. 

A thorough and detailed discussion is needed with a board certified plastic surgeon to plan your surgeries. 

Best of luck!

Dr. Khuthaila  

Dana Khuthaila, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 77 reviews

Surgery & BMI

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Thank you for your question and photographs.

Firstly, i recommend that my patients have a BMI of 30 or less to have the best and safest results and minimize your risk of running into any complications during surgery or post-operatively. Your BMI is 42 which is considered obese so I would continue to lose the weight until you are in a healthy BMI range and therefore, can achieve optimal results. Based on your photos and cosmetic goals though, I think you would benefit from a Brazilian lipoabdominoplasty. Breast reduction and Brazilian butt lift once you have reached your goal weight. A Brazilian lipoabdominoplasty is the combination of liposuction and a traditional tummy tuck. During a tummy tuck I tighten the diastasis rectus muscle which brings in the waist then I cut out the excess skin to achieve overall, a smaller waist with a nice flat abdomen and a thin scar hidden below the bikini line. Then the use of liposuction will help remove any excess fat deposits along with creating a nice, smooth silhouette. I generally stage these procedures simply because you will have to refrain from sitting/applying pressure on your buttocks for at least 3 weeks after a BBL which means you would need to sleep on your stomach, which may not be optimal when just having a tummy tuck and breast reduction. This reduces complications and provides for a more comfortable post-operative recovery. It would be best for you to schedule a consultation with a board certified plastic surgeon so they can perform a physical examination and determine whether you are a good candidate for these procedures. 
Best of luck!

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 86 reviews

Not in one sitting

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Even with a team of people working, that would amount to too great a fluid shift following surgery.  You would need to be hospitalized, possibly for more than one night. 

Ethan Philpott, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.