Which should come first, TT or BBL?

Hi.I would definitely recommend a tummy tuck in the future. If the BBLis done first, the fat from the abdomen can be harvested and not discarded as it would with a tummy tuck.I do not perfom both at the same time and would caution you if someone suggests it. Following the BBL you should not place any weight on the buttock region becacause the newly transferred fat cells will be die.If you have a tummy tuck done at the same time, how are you going to avoid lying on your back, face up when the TT prevents you from lying face down? I recommend that the BBL be done first . After a minimum of three months, the patient is brought back and the tummy tuck performed. I am certified but the American Board of Plastic Surgery and have practiced in the Miami area for the past 30 years. As you we'll know, the South Florida area has become a hot bed for Brazilian Butt Lifts. Unfortunately, cosmetic surgery down here as also given rise to a number of mom and pop clinics who perform surgeries at unimaginable low prices. Buyer beware. The key is............ does the surgeon have a keen sense of aesthetics? Can he/she create a shapely, attractive buttock or are they just technicians that wind up with large unshapely behinds? The same holds true for the liposuction portion of the procedure. Understand that liposuction whether SAL, PAL or UAL ( not including LAL because the fat obtained through this technique will not be useful) is not that technically challenging. However, the keen aesthetic eye will determine the eventual work of art.We are creators and have the ability to turn out beautiful works of art. Simply put................not all artists create quality work.Always seek out the opinion of a surgeon certified by the American Board of Plastic Surgery with years of experience in liposuction and fat transfers . Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits? How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations.How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications.In our office we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. We can accommodate patients from as far away as California. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up.Give yourself the highest percentage of a sucssesful operation. Good luck, Dr. PG

Certainly not at the same time.Abdominoplasty treats the skin excess and muscle weakness of the abdomen, as well as any fat that is between the belly button and the pubic hairline. Liposuction treats only fat. It can be used to thin out the abdomen, but the skin must be in good condition with no excess, and there should not be muscle weakness. I do not like to combine abdominoplasty with liposuction because of the added risks of fluid collection under the skin, VTE and wound healing problems.





Aggressive liposuction with tummy tuck is dangerous.  A full tummy tuck with liposuction at the same time will certainly put you at a high risk for fluid under the tummy tuck skin (seroma). A full tummy tuck with aggressive liposuction at the same time will also certainly put you at an unacceptably high risk for a potentially fatal pulmonary embolism (PE), venous thromboembolic event (VTE). The literature is complete with this information. The science is the science. This is a risky combination.





The incidence of seroma formation is about 16.0 percent in the abdominoplasty-alone group and 31.2 percent in the abdominoplasty with liposuction group.





The combination of abdominoplasty and liposuction procedures can still overwhelm the body's ability to resist these shear forces by the fact that more surface area is available to “shear” and thus produce seroma fluid. Not so much as an additive effect but synergistically, such that the seroma fluid from the flanks flows into the adjacent abdominal space and resists the ability of the upper abdominal flap to close over the abdominal wall. Patients must be counseled about their risk for seroma formation and treatments aimed at resolving them including frequent postoperative visits for needle drainage and the rare case requiring operative drainage in the face of a persistent seroma.

I appreciate your question.





I would recommend that you stage these procedures for optimal results.  Start with BBL then do the Tummy Tuck.



The best way to assess and give true advice would be an in-person exam.



Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.





Best of luck!





Dr. Schwartz



Board Certified Plastic Surgeon



#RealSelf100Surgeon



#RealSelfCORESurgeon

Thank you very much for sharing your concerns with us.

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 Cotes.- 

Additional procedures that may enhance the result are Liposuction, Breast Procedures, or Thigh Lift. Mommy makeovers usually include multiple operations.  Brazilian “butt enhancement” can be done at the same time to provide best body contours. Arm reduction or brachiaplasty is also common. The best way to determine your combination for proper final results is in consultation with a local board certified plastic surgeon. You will be able to plan out the procedure in the most ideal manner, especially considering that combined procedures help save surgery time and cost as well as recovery time. Good luck!

to have them both performed at the same time. Better to get the BBL performed first bc if you have the TT performed first, then a portion of your fat will be harvested and will not be able to be used for your fat transfer. 

I am not a proponent of having BBL and an Abdominoplasty performed at the same time- you can read my blog attached with more info re/it. Best to seek in person exam to know exactly what your options are.

In healthy patients, the two procedures can be performed at the same time by a surgeon who is an expert at both procedures.

Thank you for your question. I do not think it is a good idea to have a tummy tuck and BBL at the same time. I believe you will have better results if you stage the procedures. First, do liposuction to harvest fat from the hips, flanks, thighs, and abdomen. This fat can be used for the BBL. Once you have recovered from Stage 1, a tummy tuck can be performed. Please see a board certified plastic surgeon who commonly performs these procedures. Ask to see a lot of before and after pictures of their work. Hope this helps and good luck. 

I concur with my colleagues that the Brazilian Butt Lift (BBL) should occur prior to a Tummy Tuck (TT), and should not occur during the same surgery. Seek in-person consultations only with plastic surgeons certified by the American Board of Plastic Surgery. Best wishes.Karen Singer, M.D., P.A.Harvard GraduateBoard Certified Plastic Surgeon