BBL and tummy tuck - what are important things to research?

Question

Tell me what to research. After-care, pain Neds,etc. Does anyone advise getting a tummy tuck, and a bbl at the same time?

Kenneth Hughes, MD · Answer

In a healthy individual a combination of these two procedures can be performed by an expert plastic surgeon who can keep total operative time to less than 6 hours to minimize risk. After care, pain meds, and any additional concerns can be discussed during an in-person consultation with a board certified plastic surgeon.Kenneth B. Hughes, Board Certified Plastic SurgeonLos Angeles, CA

Tim Sayed, MD, MBA, FACS · Answer

Thanks for the question.As has been said here, combination procedures are common, but it is advisable to try to constrain the surgery to no more than 6 hours, especially when done on an outpatient basis in an accredited surgicenter. For many patients, I recommend doing the BBL first, where you can have the maximal amount of fat harvested including the part of the tummy that gets removed in the tummy tuck. You then heal from the buttock surgery and return for the skin removal and muscle tightening parts of the tummy tuck. This is the most conservative approach, although some patients don't like it because it requires two surgeries.Surgeons differ in opinion regarding whether "keeping off the butt" after BBL is important - some believe pressure may compromise the fat grafts, whereas others don't think it matters. That is part of the logic around staging the procedures in two operations. I have handled it both ways for patients - it depends on medical issues, patient preference, body weight/BMI, and other considerations. These are best assessed in person during a consultation, though video telemedicine consults and photos can also be preliminarily helpful in guiding a patient.We do have dedicated educational pages on our website to direct patients on frequently asked questions.Surgical simulation software (Crisalix) is available to help give patients an idea of what different techniques may be capable of accomplishing and to aid in decision making. Happy to help!

Johnson C. Lee, MD · Answer

Thank you for your photo. One of the main reasons some people to choose to separate their procedures is to optimize the healing from the BBL by not placing any direct prolonged pressure on fat grafted areas such as the buttocks and/or hips. This usually requires the patient to sleep on their stomach. Unfortunately, you will be unable to sleep directly onto your stomach if you also had a tummy tuck which makes it difficult avoiding pressure on their buttocks. It is possible to do both procedures in patients if you do not recieve any grafting in the hips in which case you can sleep on your sides. In terms of after-care, pain medications, etc, each surgeon will have their own plan according to the type of technique that they do and they should feel comfortable sharing it with you during your consultation.  Ultimately it is important that you discuss your concerns with  your plastic surgeon so that you can make an informed decision on what procedures will help achieve your goals in a safe and effective manner. Hope this helps!
Johnson C. Lee, MD Plastic Surgery

Sean Kelishadi, MD · Answer

Hello and thank you for your question!  I think that you could have both procedures performed as long as you are in good health and your surgery does not exceed 6 hours. With BBL, by performing liposuction of the abdomen, flanks, and back, your contour will be greatly improved and help to slim your waist. The fat that is suctioned can be transferred to your buttocks to add "cleavage" to your backside and give you more curves in the places that you want. I do think also that depending on your examination, it is possible that you could further benefit from a tummy tuck either at the same time as this procedure or later on to give your waistline the ultimate contour and tightness. I know you are concerned about recovery, but you will require AGGRESSIVE liposuction in order to harvest enough fat to get your buttocks closer to the shape you desire, and since you will be recovering from that, you might as well get the tummy tuck too and achieve your optimal silhouette. 
 With respect to recovery after these procedures, this will vary, but my own patients have claimed they were sore for 5-10 days. I also don't allow heavy lifting over 20 lbs for 8 weeks, and typically, bruising will resolve by 3 weeks. I like my patients to wear a pressure garment for 3 months. Some surgeons say you can't sit on your buttocks for 2 months, but I think there is no science to back up that recommendation, and I have my patients sitting within a few days and our fat grafts seem to do pretty well. Remember that each surgeon has their own protocol and please follow the instructions of your particular surgeon catered to your individual needs.  Many high end plastic surgery practices offer credit and finance options for their patients. The ones I am familiar with are Alphaeon credit and Care Credit and offer the following:
1) 0% interest plans for 6-12 months2) budget pay plans (like a gym membership) starting at $155/month: you pay this until it is paid off; you can pay more each month to pay off faster3) traditional type loan where you have an agreement over 2-3 years
It is important to get such an important surgery performed by a board certified plastic surgeon with expertise in advanced body contouring techniques.  You don't want to go to the "cheapest" surgeon, as in many cases, you get what you pay for. But it is important to get a good value for your money.  Make sure to check your surgeon's online reviews, see if they have a strong following on instagram/facebook/etc to see if they are credible, and ask their staff about how happy their patients are and if they have any that would be willing to talk to you.  I hope this helps and best of luck to you.
Sincerely,
Dr. Sean Kelishadi

Parviz Goshtasby, MD, FACS · Answer

Hello 'lclark101', thanks for your question.  It is always a good thing to research whatever procedures you may be interested in prior to your consultation.  An educated patient will be able to discuss their interests and goals in a more realistic and fundamental way than someone without any knowledge.  Common things to look into are the details of the procedure, before and after photos, preop preparation, postop recovery, risks, expectations, etc.  There are a lot of forums and information on the internet, and being on this website is a step in the right direction.  Once you do your research, nothing would take the place of an actual office history and physical examination with a board-certified plastic surgeon who will be able to go into more detail with all of the questions you may or may not have.  As for your second question, it is quite common to perform combined cosmetic procedures these days which is quite safe.  In fact, the tummy tuck and bilateral breast lift combo you mentioned is one of the most requested combos we perform, which is part of the growing 'Mommy Makeover' phenomenon.  If you would like to discuss further, please contact my office for a complimentary consultation.  Good luck!-Dr.Go

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