Is it safe to do a tummy tuck and BBL together?

Question

I am very confused as to why some doctors do a tummy tuck and BBL together and some do not. Is it medically not safe? I would really prefer to do it together as I save time off work and go through the pain once. I'm planning on travelling to Miami and I am still under the process of researching doctors. Your insight would be greatly appreciated.

Sheila S. Nazarian, MD · Answer

Their are two main concerns with doing the together. One is your recovery. With a BBL, I ask patients to sleep on their stomachs. Which you can't do with a tummy tuck. And with a tummy tuck, I want patients sleeping on their back for at least the first 2 weeks. The second issue is safety. Furthermore, in your case, you are planning on doing outside of your area which is concerning in terms of traveling post op and in terms of your post op care. Make sure that your surgeon has reciprocal privileges with a doctor in your area as tummy tuck in particular requires a lot of post op care. Best, Dr. Nazarian

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. For safety reasons, to be a good candidate for the procedures you want at the same time, your labs and cardiovascular preoperative evaluation must be optimal.Respectfully,Dr. Emmanuel Mallol Cotes.-

Leila Kasrai, MD, FRCSC · Answer

The main reason why I don’t suggest having the procedures done at the same time is because of how difficult the recovery period can be. You’ll need to avoid resting on your front and back, leaving only your side. However, if your side is also treated, you won’t be able to rest on that part of your body either. This makes for a very uncomfortable recovery. While it can be done if your surgeon deems it safe for you, I don’t recommend it.In addition, you may want to reconsider having your surgery performed in Miami (unless you stay there for a long time after your surgery). This is because you’ll want to be near your surgeon if a complication arises. In addition, sometimes a BBL requires touch ups and if you’re not close to your surgeon, this can be problematic.

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

You can certainly do a tummy tuck (abdominoplasty) and in fact harvest fat from the tummy including the extra part that would be discarded and use if for the Brazilian Butt Lift (BBL). 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.You heal simultaneously from both. Pain is very manageable especially with Exparel injections which numbs the surgical area for 3-4 days and is injected at the time of surgery. Our patients usually do great with this combination.

Pedro M. Soler, Jr., MD · Answer

Thank you for the question. It is possible to do a tummy tuck and BBL  together. However, typically after a BBL the patient is asked to sleep on their belly for 4 weeks and to sit with a pillow beneath the thighs for 8 weeks to avoid the buttocks from resting on the sitting surface. Sleeping on your belly will be somewhat difficult to do if a tummy tuck is done at the same time. I usually recommend to have the BBL first followed by the tummy tuck. I hope this helps.

R. Stephen Mulholland, MD (retired) · Answer

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

George Lefkovits, MD - Account Suspended · Answer

Plastic surgeons are divided about doing simultaneous TT and BBL. The concern is that addtional pressure on the buttocks may affect the take of the fat transfer. In my center we often perform the TT and BBL together and have not found a deleterious effect on the buttocks. We do suggest certain precautions. Patients often request these procedures to be done together so as to avoid 2 operations and 2 recuperations.,

Is it safe to do a tummy tuck and BBL together?

Answers (7)

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