How am I supposed to sleep after having a tummy tuck and a BBL done at the same time?

Question

I'm having tummy tuck and bbl done but I'm trying to figure out how I'm supposed to sleep or relax if I can't lay on my back nor my stomach?

Young R. Cho, MD, PhD · Answer

Thank your for your question.  A tummy tuck can address the skin and muscle laxity of the abdominal region as well as reducing the excess fatty tissue.  A brazilian butt lift helps to shape the buttock by borrowing fat from one part (or several) and transferring this fat to another.  They are both extremely rewarding procedures.  The best approach for a patient who wants to have both procedures is to stage them and possibly start with the BBL.  Here is why:1) A brazilian butt lift is transferring fat from one area to the buttock.  One common donor area is the tummy.  Once the fat is transferred, you need to keep pressure off the buttock as this allows new blood supply to develop to the newly grafted fat cells.  Any stress such as pressure can reduce the efficacy of this process and hence you may lose some fat.  Hence, no sitting or laying on your bottom for ~2 weeks.2)  A tummy tuck is removing excess skin and tightening the muscle as well as remove extra fat.  To make the skin removal efficient and protect the incision, you surgeon will often remove skin while your hips are flexed.  You will need to maintain this position after surgery for about a week.  This will required you to sleep in a recliner position for a good week. In addition, l often combine liposuction of the abdomen and flanks as part of this procedure and once this fat is removed, it cannot be stored for the brazilian buttock lift in the future.Since the recovery process for these two popular procedures compete, I would recommend staging them.  If your surgeon is needing as much donor areas to recruit as much fat as possible, then I would start with the brazilian buttock lift so you can use the abdominal and flank regions as donor areas.

Mariam Awada, MD, FACS · Answer

While these two procedures can be completed at the same time, We usually recommend doing the BBL first in order to harvest the maximum amount of fat to transfer and allow the abdominal skin to retract and let the surgeon determine how much excess abdominal skin will need to be removed for the abdominoplasty procedure. This will also allow for the procedure to be completed in a reasonable amount of time while allowing for you to heal properly. If you are choosing to have these procedures completed as some do, due to the added benefit of lower cost in combining procedures, it is important to understand that there may be added recovery that will also be limiting on your rest. You will need to rest only on your right or left side and will need assistance the first week or more as your body heals and deals with swelling, bruising, post-surgery pain etc. while your movements are limited. This could be challenging for you to relax or find a comfortable position for the first couple of weeks.

Emmanuel De La Cruz, MD · Answer

Hello Dominican_luvly, 
  
I appreciate your questions! I would recommend you having a Vaser Liposuction with fat transfer to the buttocks (Brazilian Butt Lift (BBL) done first, and an abdominoplasty (tummy tuck), 6 months after you’ve completely recovered from the initial procedure. Based on my experience, after performing BBL surgery you must avoid sitting or sleeping on your back for 8 weeks or else the desired outcome will be negatively affected. Putting pressure on your bottom by sitting down or laying on it during the recovery period can stiffen, deform and even cause the resorption of the newly transplanted fat cells. On the other hand, if you get an abdominoplasty done at the same time, you’ll be required to sleep on your back and keep your upper body elevated or else you would hurt the results. Hence, it wouldn’t be suitable to get all the procedures performed at once. Consult with your plastic surgeon about your specific needs and concerns. Best wishes! Dr. De La Cruz.

Donovan Rosas, MD · Answer

The benefit of staging is ease of recovery. The benefit of stacking is the convenience of a single procedure which may represent a time or cost savings.
There is a difference between procedures which "could" be performed simultaneously and those which "should" be performed simultaneously.
While they can be performed safely during the same procedure (assuming a 6 hour max OR time), 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 are in conflict with each other (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 can be 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. The mattress may be of help, however, it is up to the patient to decide of these accommodations can be made.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Kamran Azad, MD · Answer

Unfortunately the only way to sleep would be on your side as you don't want to pressure on your buttocks or on your stomach. You may need to use pillows to prop yourself into a position to ensure you don't turn onto your back or stomach. This problem is the main reason I recommend my patients to stage these two surgeries, doing the BBL first and then having a tummy tuck 3-6 months later. Good luck!Kamran Azad MD, Board Certified Plastic Surgeon

Constantino G. Mendieta, MD · Answer

Your surgeon should have a protocol for sleeping when going thru multiple procedures like this. Some patients choose to split these procedures up - but that is your discretion following a consultation with a board certified plastic surgeon. Good luck-

Jerome Edelstein, MD · Answer

If your sides were not treated, then you would have to lie on your side to get comfortable and sleep.

Larry S. Nichter, MD, MS, FACS · Answer

Typically after a tummy tuck/BBL combination we have our patients sleep in a reclining chair for most of the first week. If you don't have one you can borrow or rent one rather than a surgical bed. Discuss this with your plastic surgeon.

Janet Woodyard, MD · Answer

After tummy tuck, the best sleeping position is slightly sitting up with a pillow under the knees so you are comfortably flexed at the waist. This will take off the strain off of the muscle repair and you will feel most comfortable, particularly when getting out of bed. Unfortunately, this puts pressure on the buttocks and is a problem after a BBL. You can usually sleep on your side in a fetal position or better yet, do the procedures at two seperate times. Your recoveries will be easier and neither procedure nor post-op positioning will negatively impact the other.

Kenneth Hughes, MD · Answer

This recovery is difficult. You have a couple of options. You can sleep on your sides or place pillows underneath your thighs and lower back. Ask your plastic surgeon what he or she recommends. Find a plastic surgeon with ELITE credentials who performs hundreds of Brazilian buttlifts and tummy tucks each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

How am I supposed to sleep after having a tummy tuck and a BBL done at the same time?

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