5'11, 230lbs, will lipo 360 & BBL get my stomach or will I need a TT? (Photos)

I would suggest starting with liposuction first to remove the excess fat in your abdomen and flank areas. Once healed, then access your skin to see if a tummy tuck, full or even a mini is needed. You may find that your skin tightened well enough to avoid the tuck. With a tummy tuck, liposuction is not down on the mid upper or lower abdomen for safety reasons to the skin. Even with a tuck, you will still have excess fat in those areas.

Hello and thank you for your question. From the pictures you have provided, it is difficult to determine the extent of striae (stretchmarks) present- I see some to your lower/mid abdomen in the first picture, but otherwise cannot tell. There is a moderate/severe amount of excess skin and subcutaneous fat present diffusely throughout your trunk- from your abdomen into your flanks and extending into your back. This is asymmetric in distribution. There are skin folds across your lower abdomen extending to at least your flanks, but again, evaluations is limited by your underwear. You also have multiple skin folds present to at least your right mid back (and likely the left as well). Based on all this, you would benefit from an abdominoplasty (tummy tuck- includes muscle repair) and 360 liposuction and fat grafting to your buttocks (BBL) to best help improve your abdominal/trunk contour.
The reason I said abdominoplasty instead of circumferential belt lipectomy ("circular tummy tuck") is because the excess skin in your back is located more in your mid/upper back, not as much in your lower back.
Liposuction would definitely provide benefit for you, particularly to the contour of your flanks and back, and is necessary for the buttock fat grafting (BBL) portion of the procedure. The reason you would require an abdominoplasty to address your trunk contouring is because you have such significant excess skin to your abdomen and flanks, which would not be addressed by the liposuction or BBL procedures, and which would become more noticeable and even appear deflated after liposuction.
For a similar reason, because of the significant skin present on your mid/upper back which is not addressed with the 360 liposuction, BBL, or abdominoplasty procedures, you would likely need another procedure to address your excess mid/upper back skin at some point in the future in order to further improve your overall trunk contour. This would most likely consist of a staged upper back lift- the incision can be hidden in your bra line. A benefit of staging these procedures, is you can do further revision liposuction at that time, to correct any asymmetries or to provide further improved contour overall.
With all that said, it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from any photos and descriptions provided. I recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Thank you for your inquiry about whether to undergo 360 lipo and BBL (Brazilian Butt Lift) or to consider a tummy tuck as well. Evaluating the need for such procedures usually requires a comprehensive physical examination, including skin elasticity and the amount of excess skin present. However, based on your description, here's some general advice:

When considering liposuction (whether it's traditional or 360 lipo), it's essential to understand that while it removes fat, it doesn't necessarily address skin laxity. If you already have loose skin and stretch marks, these are often indications that your skin's elasticity is compromised. Post-liposuction, this can lead to the skin not contracting back as one might hope, potentially leaving behind sagging or uneven skin.

In such scenarios, a tummy tuck (abdominoplasty) is beneficial because it not only removes excess skin but also tightens the abdominal muscles, providing a firmer and smoother abdominal contour.

Combining procedures depends on multiple factors, including your overall health, the extent of the surgeries, and the surgeon's experience and preference. There are two main approaches:

Combined Procedures: A tummy tuck, lipo, and BBL can be performed in one surgical session. This method has the advantage of a single recovery period. However, it can be a lengthier surgery, and there are considerations regarding positioning during recovery to ensure the best outcomes for both the tummy tuck and BBL.

Staged Procedures: Liposuction and BBL are done initially, and after a recovery period, the tummy tuck is performed. This allows for separate recovery phases, which some people find easier, and it can optimize results since the surgeon can assess and plan the tummy tuck based on the outcomes of the initial lipo and BBL.

Your decision should be made after a detailed consultation with a board-certified plastic surgeon who can assess your individual needs and provide recommendations tailored to your goals and anatomy.

I hope this provides clarity on the matter. Whichever route you choose, ensure you're informed, prepared, and in good hands. Best of luck with your journey!

Sincerely,
Dr. Katzen