What are the pros and cons of liposuction 6 months before an extended tummy tuck? (Photos)

Question

What are the pros and cons of doing Lipo first and then the extended tummy tuck 6-months after? I have done a few consults, for the most part drs agree on what should be done:Extended tummy tuck, breast lift, lipo on the tummy, back, bra till, arms and fat transfer to hip dips and deflated flat bottom. But when and what order there are a variety of suggested approaches. A few went to break it up into 3 surgeries (6-months apart), some 1 or 2 surgeries. Thanks!

Robert M. Tornambe, MD · Answer

Most board-certified plastic surgeons prefer to stage that many procedures. It is safer and better for your recovery. BBL and Tummytuck operations each carry a higher incidence of blood clot formation and possible harm or blockage of the lungs. Performing them simultaneously statistically increases the chances of this occurring. Also, recovery from BBL requires no pressure on your buttocks for two weeks after surgery to preserve fat take. You also cannot lie on your stomach after tummy tuck, so this limits the positions that you can recover.  Also, the maximum OR time for an ambulatory operation should be no more than 6 hours, BBL and MM certainly takes longer.  It is best to perform the BBL first, to allow your surgeon to harvest as much fat as possible for transfer. 4 to 6 months later, mommy makeover surgery can then be performed. Be certain to consult with a board-certified plastic surgeon  to increase chances for the safest and best possible results. Best of luck.

Keith Hodge, MD · Answer

The advantage of breaking this into two surgeries is that if you perform 360 liposuction first, you can use all of that fat to shape your hip and buttocks. It also makes the procedure safer by decreasing your anesthesia time per session, and you will be more comfortable during your first recovery period. During the second session, you could have your breast lift and tummy tuck without having to flip to treat your back side. It would also allow for any additional liposuction to be performed on your abdomen to improve contouring. Good luck!

Kenneth Hughes, MD · Answer

Lipo is not a weight reduction procedure and it will not eliminate extra skin, stretch marks, and issues stemming from loose abdominal muscles. In women with less visceral fat and great skin elasticity, a TT may not be needed after lipo.  Loose skin or lax muscles can only be corrected with a TT.
You could have the TT and breast lift done first, then the lipo and BBL.  However, the result will not be as tight as lipo and BBL first and then TT and breast lift six months later.  Both can be performed at the same time, but the upper abdomen cannot be aggressively liposuctioned at the time of the TT due to blood supply issues.
BBL/Lipo/TT is a very common combination but recovery is uncomfortable. I allow patients to sleep on their sides. Lying on your stomach or on your back will create pressure on your butt or stomach.  Patients can also rest in other positions as long as the other areas do not receive pressure.  There are creative ways to manage this. For example, my patient coordinator recommends a plastic inflatable with a hole in it (called a lilo), where instead of your tummy, you place your butt, so you can sleep on your back with pillows propping up your neck and head.

Gary M. Horndeski, MD · Answer

I would begin with your breasts first.  The technique I recommend is a lift using The Bellesoma Method.  This will reshape your breast tissue creating  upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  At the same time, a brachioplasty can be performed to correct the excess hanging skin of the arms.  After these have been completed, a tummy tuck can be performed.  If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement.  The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.  After this is completed, you can consider liposuction and fat transfers to the buttocks or breasts if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I routinely perform mommy makeovers in one stage. It definitely requires having an assistant surgeon and an ability for an overnight stay. I have built my office around doing these types of procedures. In your case, it would be difficult to fit all of the surgeries in one stage safely.and agree with staging. It would be best to do all of the liposuction, tummy tuck, and BBL in one stage then come back a few months later to perform the the breast lift and any residual body touch ups.It is important to review your prospective surgeon's gallery critically to make sure that they have the results and detail that you are looking for. It is a big investment and want to make sure it is done correctly.  Best wishes to you.

Daniel Barrett, MD · Answer

Dear FactoryReset,
generally speaking, it is possible to combine tummy tuck and flanks liposuction. I understand your concern. It is best however that you consult with a board certified plastic surgeon to determine whether you can have several aesthetic surgeries in one session, as this would depend on various factors including but not limited to your general health condition, the type of anesthesia that will be used, and the type of surgeries that will be performed among others.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  I agree that a staged approach will improve your surgical results and maintain greater safety margins.  I would perform your liposuction and fat transfer in a single stage and the remainder of the procedures in a second.  Hope this helps.

James Knoetgen, III, MD · Answer

Liposuction and an extended tummy tuck are often performed together or in sequence to achieve comprehensive body contouring results. Here are some potential pros and cons of having liposuction approximately 6 months before undergoing an extended tummy tuck:Pros:1. Improved Contouring: Liposuction can help remove excess fat from specific areas, improving the overall contour of the body. This can be beneficial when combined with a tummy tuck to achieve a more sculpted appearance.2. Enhanced Tummy Tuck Results: Removing excess fat with liposuction before a tummy tuck allows the surgeon to focus on addressing loose skin and muscle tightening during the tummy tuck procedure. This can lead to more refined and targeted results.3. Reduced Surgical Trauma: Performing liposuction separately from the tummy tuck may reduce the overall surgical trauma to the body. This can potentially lead to a smoother recovery process.Cons:1. Additional Recovery Time: While separating liposuction from the tummy tuck may reduce overall surgical trauma, it also means an additional recovery period for the liposuction procedure. This could extend the total time needed for recovery.2. Multiple Anesthesia Exposures: Undergoing separate procedures means multiple instances of anesthesia exposure. While modern anesthesia is generally safe, repeated exposure may have some associated risks.3. Cost: Having liposuction and an extended tummy tuck as separate procedures may have financial implications, as you will incur costs for each surgery, including facility fees, anesthesia fees, and surgeon fees.4. Potential for Overcorrection or Undercorrection: If liposuction is performed too close to the tummy tuck, there may be challenges in accurately assessing the amount of excess skin to be removed. This could lead to overcorrection (too much tissue removal) or undercorrection (insufficient tissue removal).It's essential to discuss your specific case, goals, and concerns with a board-certified plastic surgeon during a thorough consultation. Your surgeon can provide recommendations based on your anatomy and desired outcomes. They will help you understand the potential benefits and risks associated with the timing and combination of these procedures, helping you make an informed decision about the best approach for your needs.

Camille Cash, MD · Answer

Combining procedures is common and considered safe but there is a limit.  With the procedures you are considering, having the liposuction with fat transfer as the first stage and the breast and tummy tuck as the second will help with several things.  The first is safety.  Second, positioning during recovery will be more comfortable.  With a BBL you can't lay on your back and with a tummy tuck and breast work you can't lay on your tummy.  Separating the procedures will allow for comfort in positioning.  Third will be results.  Staging the procedures will allow your surgeon the opportunity to optimize your results.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and photos and staging the procedures is certainly a good idea with liposuction and fat transfer first followed by breast lift and abdominoplastyDr Corbin

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