Dear mtd831, Thank you for your clinical post and this is a common question. Certified plastic surgeons are divided as to performing tummy tuck with adjunctive and additional procedures. One school of thought is that abdominoplasty with muscle plication, umbilicoplasty (belly button repositioning and restructuring) and skin excision has a relatively risk of deep venous thrombosis and pulmonary embolism (blood clot) that may or may not travel to your lung. By combining this with multiple zone liposuction the relative risk of pulmonary embolist increases. However, with modern techniques such as blood thinning techniques keeping people over night in a certified surgical facility, intravenous fluid rehydration, sequential compression garments and early mobility the relative risk of a DVT or pulmonary embolist are extremely low. The other factor that surgeons and patients to keep in mind is that the post-op instructions after Brazilian butt lift or fat grafting to the buttocks calls for sleeping on one’s tummy or side. Often tummy or side sleeping is more difficult following an abdominoplasty, which may result in more pressure on the fat graft donor site by sleeping on the buttock. If patients are able to sleep on their side; however, following an abdominoplasty and fat grafting to the buttocks, combined with multiple site liposuction which is required to harvest the fat cells to perform the Brazilian butt lift then this combination procedure can be quite safe. I for one believe that with the aforementioned safety precautions and an overnight stay, careful fluid rehydration through intravenous means, blood thinning techniques, sequential compression garments and early mobility that abdominoplasty combined with multiple zone liposuction, harvesting the fat cells and fat grafting to the buttocks or a Brazilian butt lift can be performed safely. I’ve been combining this technique for years using my provincially certified facility and monitoring patients closely have not had any untoward complications. However, one does assume more risk when doing more procedures and both patient and physician need to take all precautions and preventing these risks and accept that it is the nature of surgery. I would seek out consultations with certified physicians with many years of experience in performing these techniques and I think you should end up with an excellent result. I hope this information is of some assistance and best of luck. To find out more, please visit the link below and then pay particular attention to the sections on fat grafting to the buttock. R. Stephen Mulholland, M.D. Certified Plastic Surgeon Yorkville, Toronto