I want tummy tuck, lipo and BBL all at once.

Question

Full body transformation. Tummy tuck with lipo. Lipo of back, thighs and behind. And BBL. I see conflicting info about doing it all at once?? I see patients who have done it and look great and I see doctors comments saying no, have to do TT and BBL separate. I'm hoping this isn't the case, I don't want to be under anesthesia more than I have too (nor do I want to pay too). Plus taking 2 weeks off work is already a task. Is this true or can I have a one stop shop??

Ozge Ergun, MD · Answer

Thanks for the question. Yes, you can get a BBL, liposuction and tummy tuck at the same time. But first of all you need to lose some more kilos. After you lose kilos, you should meeting with a Board Certified Surgeon and planning the process. After planning, everything will be better. I wish you all the best.

Donovan Rosas, MD · Answer

There is a difference between procedures which "could" be performed simultaneously and those which "should" be performed simultaneously.
BBL and tummy tuck can be performed safely during the same procedure, however, some consideration should given to the nature of these procedures and the anticipated recovery period. In general, it is always best to minimize the pressure on the surgical site. The recommendations for these 2 procedures in particular contradict each other, with one necessitating prone (belly) sleeping and the other supine (back) sleeping.
There is no perfect solution in this scenario. For this reason, I do not regularly combine these procedures. Side sleeping is sometimes a reasonable compromise. Alternatively, patients can rotate position frequently (on the hour) or use a specialty pillow to offload the buttocks grafted area. However, for best results staging or staggering these procedures is best.
With regards to your specific question, stacking these procedures is safe, staggering them is relatively more practical/sensible (when one considers post op recovery). If one can make the necessary accommodations for recovery, the procedures should have no effect on each other. Undergoing BBL first will optimize fat harvest, however, will worsen skin laxity. Beginning with an abdominoplasty will avoid this issue but sacrifice fat yield from harvest secondarily
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

George Marosan, MD · Answer

Thank you for your question. If your BMI is 30 or less, than this is the way to go. I do this all the time in my practice, and there’s no increased fat loss from the BBL. I use VASER Hi Def liposuction to sculpt the torso, including the abdomen and do a full abdominoplasty via a small pubic incision. If your BMI is greater than 30, I might stage the procedure for best results. The body sculpting with the fat transfer is done first, followed by a TT 3-6 months later.I do these procedures under intravenous sedation only, not general or epidural anesthesia.You have to ask yourself, do you want a great long term result or since you are willing to take only two weeks off for recovery, you rather have an average procedure? Something to think about.See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Kenneth Hughes, MD · Answer

This is a common combination I perform several times each week for healthy patients who are good candidates for both.  Total operative time is usually 4 hours.Kenneth Hughes, MDLos Angeles, CA

Austin Hayes, MD · Answer

I would consider several consultations with board-certified plastic surgeons in your area. Most surgeons will combine procedures if they can be completed in less than six hours. I personally separate BBL and tummy tuck procedures, because I feel that the overall safety profile is better when separated. Also, recovery after a combination tummy tuck and BBL is challenging, because finding a comfortable position during the recovery is very difficult. After a tummy tuck you recover with your hips flexed, but a BBL requires that you take pressure off your buttocks. Speak with your surgeon about their specific recommendations.

Daniel Barrett, MD · Answer

Dear DazzlingSchnee,some plastic surgeons may want to split this into two operations depending on the time needed. Its best to see a board-certified plastic surgeon to determine your options and whether it would take too long, greater than 4 hours, to do both. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Tim Sayed, MD, MBA, FACS · Answer

The answer is in selected patients it is appropriate to do at the same time. This partly depends on:1. Your body mass index - if you are significantly overweight/obese you may have to lose weight and/or stage these procedures from a safety standpoint.2. How many areas of lipo are proposed for the fat transfer3. How long the surgeon thinks the combined surgery will take, as surgery over 5-6 hours may not be optimal from a safety standpoint as an outpatient procedure4. What your general health is like.The advantage of staging is shorter operative times and the opportunity to potentially recruit more fat for the BBL. For instance, you could undergo the BBL using all the fat in the abdomen and later remove the skin and tighten the muscle after you see how much retraction has occurred, possibly further optimizing the tummy tuck result. Alternatively, doing them together means one recovery, one downtime, but does take longer as you may require 3 positionings on the operating table in the operation (first on your back to harvest fat, flip you on your front to harvest from your back and inject your buttocks, then flip again to take skin and tighten muscle on the tummy tuck). For heavier patients it may not be appropriate to combine for safety. You should consult with a few plastic surgeons to decide what approach makes sense for you in the experience and judgment of each surgeon. This is at least as important as just deciding to go with whoever tells you it can be done at the same time as a blanket statement.While we commonly are concerned about the viability of fat grafts and therefore may recommend you stay off your buttocks while healing from BBL (which means you couldn't sit or lay on your back as you would when recovering from tummy tuck), it is not proven at this time that keeping off the buttocks actually improves graft take scientifically, and many plastic surgeons doubt that sitting/lying on the back on a mattress are enough to actually kill these grafted fat cells. We simply don't know for sure, so we often issue a precaution to keep off the buttocks which is why many plastic surgeons prefer not to combine these in one procedure.

Johnny Chung, MD, FACS · Answer

Thank you for your question. It is possible to have both tummy tuck and BBL at the same time. I recommend finding a board certified plastic surgeon near you who is also a member of the American Society of Aesthetic Plastic Surgeons. Make sure they have experience with BBL and tummy tucks. Also make sure your surgery is performed at an accredited hospital.

Curtis Wong, MD · Answer

but with a tummy tuck, your most preferred position will be on your back.  This will kill much of the fat grafted to the butt so that is why its not a great idea to do together.  My preference would be to do your liposuction and BBL first and heal, then do you tummy tuck later.  In my practice, when patients have liposuction, I will graft the fat as a courtesy with patients covering the additional 30 min of OR time and anesthesia time as well as the PureGraft prep system I use.

Jonathan Kaplan, MD, MPH · Answer

It is possible to get a BBL and tummy tuck at the same time. Patient's can sleep on their sides and can get some type of booty pillow to alleviate pressure on the bottom when sitting. The thing you do need to keep in mind is that for safety reasons there is a limit of fat that can be removed at one time. So, depending on your size and number of areas that you want to lipo, two procedures may be necessary to get the amount of fat/results you are looking for. Good luck with your transformation!

I want tummy tuck, lipo and BBL all at once.

Answers (15)

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