Should I get a Lipo 360 with a BBL before doing a tummy tuck?

If you are in good health, you could be a good candidate for Brazilian buttlift (BBL), and tummy tuck. Fat can be taken from many different areas of the body including abdomen, sides, bra rolls, arms, underarms, flanks, lower back, upper back, posterior neck, submental areas, jowls, thighs, calves, ankles, and inner knees. You have to consider not only which areas will have perhaps the best fat, but also you have to consider which donor sites will have the fewest problems afterward with the liposuction. In general, the abdomen and thighs are preferred, but, if those sites are not available, other areas can be used.
I perform the tummy tuck and liposuction/BBL combination frequently because many of my patients only want to go through surgery and recovery one time. Recovery can be challenging and uncomfortable. However, there are creative ways to manage the recovery position. Pillows can be placed under the lower back and the posterior thighs and patients can sleep on the back. A cushion with a hole cut out can perform a similar function. There is also a mattress with a hole into which you can place your buttocks and sleep on your back.
You could stage the procedures and have the TT done first; then the liposuction and BBL. However, the result will not be as tight as liposuction and BBL first and then TT. Both can be performed at the same time, but the upper abdomen cannot be aggressively liposuctioned at the time of the TT due to blood supply issues. The reason for this is simple. More skin can be removed when less fat is present.

You need a formal evaluation by an expert in body shaping and contouring to determine what is best. The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heats the skin with radiofrequency devices such as Renuvion (J-Plasma), InMode BodyTite, and ThermiRF to heat the undersurface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HI-DEF VASER Liposuction and can only be done by a well-trained body contouring specialist. At the same time, fat should be harvested and purified, with PRP and stem cells added, and then injected into muscles, indentations and cellulite to get body shaping and contouring. For a Brazilian butt lift (BBL), we inject the fat into the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face. Cellulite should also be treated with a combination of QWO or Cellfina, subcision, and/or fillers such as Bellafill, Renuva synthetic fat, or Sculptra. If skin is very loose before surgery, then it will need to be removed: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin.

Overall, you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting. See an expert. Best, Dr. Emer.

I always recommend doing the tummy tuck first. The whole purpose of combining your multiples procedures is to change your shape. Abdominoplasty with mesh creates a more dramatic reduction of your abdominal wall projection. You may get by with less fat transfers for the BBL which would be safer and easier to do.

Best Wishes,

Gary Horndeski, M.D.

​Thank you for your question. It is hard to provided with a valid medical opinion without photos. I would suggest to be treated by board certificated plastic surgeon with experience in this procedure, to get the best desired results.

Kind Regards,
Dr. Emmanuel Mallol Cotes.-

Dear elishay,
if you want to get BBL and tummy tuck, then it is probably better to do liposuction and fat transfer prior to tummy tuck. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

A BBL is primarily a gluteal augmentation procedure. Despite the fact that Liposuction is often done of the abdomen in conjunction BBL by itself is a gluteal augmentation operation.

To assess someone for a BBL means assessing the person both in terms of fat transfer and in regards to Liposuction.

When using procedures the decision should be based on what the primary underlying ideology or diagnosis is.


For example when making an assessment on the front of the Abdomen there are four variables that contribute to shape and contour. In other words if someone doesn’t like the way their belly looks it is always because of one or more of these four reasons

The variables that affect the appearance of the abdomen are skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies and lastly excess visceral or intra-abdominal fat.

Skin laxity and muscle separation are best treated with a tummy tuck. These basically present changes that are related to previous pregnancies.

Liposuction only reduces subcutaneous fat. This can also be achieved through weight loss.

Visceral fat cannot be reduced with Liposuction and can only be lost through weight loss.

For patients contemplating having both a BBL and a tummy tuck the procedures can either be done simultaneously or a separate procedures.

Personally I think it’s a better decision to do these as separate procedures but there are pros and cons for both sides of this coin.

When doing a BBL and tummy tuck as split procedures they were also pros and cons for doing the tummy tuck first or the BBL first.

Personally I think patients should do the procedure that will give the greatest impact first and as a general statement that tends to be the tummy tuck.

I also don’t like doing a tummy tuck on patients who have had previous abdominal Liposuction because Liposuction creates scar tissue that makes the fat and skin layer less pliable for the tummy tuck.

There are however arguments why the BBL should be done first and some plastic surgeons will recommend this route.

In the end by far the most important decision and variable is finding the most talented and experienced provider.

This really trumps all other decisions and is more important than all the other choices.

In the hands of the most talented and experienced provider outcomes and decisions will be as they should and patients are more likely to have overall high patient satisfaction.

Find the right plastic surgeon and everything falsive the place.

Do this by scheduling multiple in person consultations with experienced local board-certified plastic surgeon in your community.

During each consultation ask each provider to show their entire collection of before and after pictures for the procedure you’re interested in.

This should include less than ideal outcomes and especially include patients who have similar body characteristics to your own.

For common procedures like a tummy tuck or BBL and experienced plastic surgeon should be able to easily demonstrate a minimum of 50 quality before and after pictures.

In reality highly experience providers will have hundreds or potentially thousands of before and after pictures for just these two procedures.

The second thing to look for is other patients experiences with these providers by reading all the reviews and all the various physician review websites.

My recommendation is to pay particular close attention to justify negative reviews. The absence of justified negative reviews is far more important and more telling than an abundance of positive reviews.

This is because justified negative reviews are always organic but positive reviews may or may not be.

The combination of having know or very few justified negative reviews and a stack of before and after pictures that reads like a telephone book is usually the two variables that set the truly great apart from the rest.

Best,

Mats Hagstrom MD