Tummy tuck 360 lower body lift before before full leg lipo (Photo)

Question

I had a consult and quote for tummy tuck 360 , lipo360, bbl. I recently found out insurance will cover full leg lipo suction to treat some early stage lipedema but not until end of 2025 for front leg then backs 4 to 6 months later. If i move forward with the 360tt with fat grafting to the butt would the future leg liposuction ruin my lower body lift results and make every all saggy again and if so would a future thigh lift fix that or would i have to repeat lowr body lift?

J. Timothy Katzen, MD, FACS · Answer

Hello honest680923, 
Thank you for your question regarding whether you should have a tummy tuck or 360 lower body lift before or after full leg lipo; specifically, whether you should a lower body lift and then undergo insurance coverage full leg liposuction for lipedema or wait.
A 360 circumferential lower body lift includes an abdominoplasty (tummy tuck), hip lift, hip reduction, buttock lift and buttock reduction. During the hip lift, the lateral thigh (outer thigh) is lifted and reduced. The hip lift helps to augment and accentuate your outer leg shape. ALso, the hip lift during the lower body lift, smoothes away any loose, lateral thigh skin.  A tummy tuck does not effect the outer thighs or hips.
During leg liposuction, thigh fat is removed from the groin to the knees. Most plastic surgeons would suggest aggressive liposuction to remove the lipedema leg fat.   However, the thigh lipo may cause some loose skin, especially on the outer thighs.   
Therefore, most plastic surgeons would suggest you undergo leg liposuction for lymphedema first. Also, most plastic surgeons would suggest you wait until all your leg liposuction is completed and then, undergo the 360 circumferential lower body lift. You will achieve a much better lateral or outer leg lift if the staging is done. 
In addition, it is conceivable that so much fat is removed during the leg liposuction, that you may need a longitudinal, medial vertical thigh lift with an incision from the groin to the knee. It truly depends on how much excess thigh fat is removed during your insurance approved leg lymphedema liposuction surgery. If you do need a longitudinal vertical medial thigh lift often this can be combined with the lower body lift.
Therefore, in conclusion, I would suggest you have your insurance approved,  leg liposuction fro lipedema, first. Then, once your leg liposuction is complete, consider a lower body lift. I hope this helps to answer your questions regarding a tummy tuck or 360 lower body lift before before full leg lipo.  Good luck. When seeking complex surgeries, always find an experienced board-certified plastic surgeon who specializes in lower body lift and thigh lifts.  
Sincerely, Dr. Katzen

Emre Guvercin, MD, FEBOPRAS · Answer

Hi there,You’re asking a very smart and important question &mdash; especially when balancing aesthetic surgery with medically necessary procedures like lipedema liposuction. It’s great that you’re thinking long-term, and you're not alone in navigating this challenge.
Here’s how I’d break it down:1. Will future leg liposuction affect lower body lift results?Possibly &mdash; but not necessarily in a negative way.
If you move forward with a 360 tummy tuck + BBL (including posterior lift components) now, and then undergo liposuction to the legs later, the key risks would be:
Skin laxity returning in areas of aggressive leg liposuction (particularly inner thighs or lateral thigh roll)Tissue deflation that could alter smooth transitions from your lifted areas into the newly treated zonesPotential imbalance between treated and untreated zones if lipedema liposuction is staged months apartHowever, if your lower body lift doesn’t include inner thigh tightening or vertical thigh lift components, the risk of disrupting the original lift is lower &mdash; especially if the liposuction is focused more on the legs rather than the lateral hip/glute junction.
2. Would you need to repeat the lower body lift later?In most cases, no. If the lower body lift is done well, with stable suspension and a conservative fat grafting plan, it's unlikely you'll need to fully repeat it after lipedema liposuction.
What you may need later on is:
A thigh lift to address skin looseness from leg liposuctionMinor touch-up liposuction or fat redistribution for symmetryPossibly fat grafting adjustments to the buttocks if shape shifts over time
3. How to best sequence your procedures?Since lipedema liposuction is delayed by a full year, and your tummy tuck/BBL is elective, it’s reasonable to:
Proceed with the 360 TT + BBL now, knowing you may need a future thigh lift after the lipedema lipoOR delay the BBL if you're worried about contour distortion later, and just do the tummy tuck nowOR consider light/moderate BBL now, understanding it may shift subtly after the legs are debulked
Your lower body lift results won't be "ruined" by lipedema liposuction, but the treated leg areas may loosen or need contour revision later on.

Camille Cash, MD · Answer

Begin by getting the liposuction for lipedema approved and then have that procedure completed since it is medically necessary.  Then you can continue with the lower body lift as a separate stage.  If there is too much fat removed for the legs you may get some improvement with a lower body lift but it would not be the same as having a leg lift.  You'll know better what is recommended after the liposuction.

Daniel Barrett, MD · Answer

Dear Honest680923,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Mark Eberbach, MD · Answer

Your pictures help a great deal. I believe the operation you need is a lower body lift which includes liposuction of the thighs, combined with buttock lift in abdominal plasty.

My perception may be covered for lipedema. It is not for cosmetic fat reduction. Paragraph you do not have lipedema from what I can see so do not expect Insurance to cover it.

Good luck.

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