BBL or Tummy Tuck which procedure should I do first? (photos)

Question

I booked my surgery in July in Miami. I wanted to do tummy tuck and bbl at the same time. But after my friend told me that someone died in the Philippines of organ failure for doing multiple surgery at the same time, Breast Augmentation, Bbl and liposuction. Now after hearing this it scared me and I just wanted to do one procedure at the time just to be safe. My question is should I do BBL first or Tummy tuck and how many months after I do the first procedure, can I do the second one.

Kenneth Hughes, MD · Answer

If you are healthy, the combination can be performed by a surgeon who is an expert at both procedures and can limit surgical time to 4 hours.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question.  After having analyzed your Information and photos provided to us, I see that you'll need a Tummy Tuck with muscle repair plus abdomen, waist and back Liposuction with BBL.Kind regards

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  In my practice in healthy patients, I frequently combine tummy tuck and BBL into one surgery.  If you would prefer to separate them, then definitely do the BBL first and the tummy tuck second, usually with a three month separation.  Based on your photograph, you are a
great candidate for a tummy tuck with liposuction.  This can be done
through a low and short incision, all completely below the bikini line.  The belly button can be designed to look
natural and have no scars on the exterior.  
Your muscles can also be plicated resulting in a flat
abdomen.  A BBL can be performed for improved
buttock and waist contour.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.
 The most important aspect is to find a surgeon you are comfortable with.
I recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Alexander Q. Ereso, MD, FACS · Answer

Thanks for your question. There are several ways to answer this 
question. In choosing between two procedures, the safety of performing 
the procedures should always be considered. These two operations are 
relatively large in extent and can take a long time and so would 
probably be much safer to stage. Furthermore, the recovery from just 
performing a tummy tuck by itself is already difficult so adding 
liposuction to multiple areas along with a BBL on your back side will 
really impair your mobility, increase your pain, and be difficult to use
 other areas of your body to compensate for areas that are sore and 
recovering. For example, prolonged sitting is discouraged after a BBL 
which means constant rolling which is difficult after a tummy tuck.

In choosing which operation to perform first, it depends. Many times, I advise choosing the area of your body which bothers you the most. You never know what will happen in life afterwards and you may never get around to doing the second operation. However, in the case of these two operations, performing the BBL first is recommended as by doing the tummy tuck first, a major source of where fat can be obtained will be removed. I don't recommend storing fat either as this fat does not survive as well after being outside the body for so long. While certainly anyone can perform an operation together at the same time, in my experience, the difficulty in recovery and the increased risk from the length of surgery does not justify the money saved or feasibility of combining the two procedures. In terms of the amount of time to space the procedures, everyone recovers differently depending on many things but I think 3 months is reasonable. Regardless, talk to your plastic surgeon and see what they have to say. Good luck!

Austin Hayes, MD · Answer

Very good question. In my office, I start with the Brazilian butt lift. I want to have as much fat available as possible to transfer to the buttocks. After three months, a tummy tuck is performed if needed/wanted. I agree that separating these two procedures increases the safety and it's my preference to separate. However, there are surgeons who do combine there procedures. It's not wrong to combine them, but make sure that you fully understand the pros and cons.

Donovan Rosas, MD · Answer

Staging procedures is never a bad idea (longer/stacked procedures have an elevated risk profile). BBL and abdominoplasty, while often performed in concert, are not well suited to this approach for a number of reasons:-Limited donor harvest (you cannot suction the abdominal flap without potentially compromising vascularity and abdominoplasty healing).-Recovery caan be challenging as you cannot sit without compromising your BBL grafts. The abdominoplasty requires that you not lay on your stomach.When considering staged BBL and tummy tuck, one should carefully consider the requirements of each. Ultimately, BBL is donor fat dependent. If you do not have the donor fat reserves you are unlikely to be satisfied with your result. If you are planning to harvest fat from the abdomen, the BBL should precede the abdominoplasty as this will optimize your fat harvest volumes. However, you need to be aware that in areas of skin excess such as the abdomen, pre-operative liposuction will likely worsen the appearance of the skin that will ultimately need excision. For all of these reasons: BBL first, Abdominoplasty second.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

George Marosan, MD · Answer

Thank you for your question and photos. Based on your photos, I would recommend doing the BBL and liposuction 360 degree for fat harvesting. Your whole abdomen, back, waist, hips and possibly right lateral thigh needs to be liposuctioned and sculpted. This will allow for maximum fat collection and contouring of the buttocks. It will also allow for significant skin tightening of the abdominal skin which will result in a shorter abdominoplasty incision. The tummy tuck can be done 4-6 months after the BBL. Good luck.

Sam Jejurikar, MD · Answer

Given that you are committed to having both procedures performed, it seems most appropriate to have the BBL first. That way, you're not wasting any fat that could be used down the road for buttock augmentation. I'd wait at least 3 months between procedures so that your swelling has completely resolved prior to proceeding with tummy tuck.Hope this helps! Sam Jejurikar, MD

Mel T. Ortega, MD · Answer

It is always recommended to have a liposuction with transfer to your buttocks first as this guarantees more fat to be transferred than when it is combined with another procedure . As a surgeon is only allowed to take only about 1000cc of fat in a combo procedure instead of 4000cc in a single procedure, 6 months after will be a perfect time to have a tummy tuck.A Brazilian butt lift is a safe and effective procedure that combines liposuction of the abdomen hips waist and back and then fat grafting to the gluteal region. This is a safe and effective way to contour the lower body. After a successful Brazilian Butt lift, the fat that remains will stay there for the rest of your life. Like the rest of the tissue in your body this fat will grow and age with you.Choose a board certified plastic surgeon who has done a ton of Brazilian Butt Lifts and has privileges to do this surgery at a local university hospital. This says his credentials have been checked out by fellow Drs. All surgeries carry risk, talk to your plastic surgeon and choose one wisely.Many surgeons, including myself, offer online virtual consultations where you send us your photos and we can estimate the cost. I, like many surgeons, also offer free consultations so that you can be examined and given the most accurate quote.

Shain A. Cuber, MD · Answer

You will benefit from a tummy tuck with a fat transfer into the buttocks. Body contouring in this area should make a tremendous improvement. If you are planning on having children in the near future, I would recommend waiting on these procedures so you will not have to get them done twice. Seek out a Board Certified Plastic Surgeon in your area to discuss options.

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