Tummy Tuck, Brazilian Butt Lift, and Breast Augmentation Advice?

Question

I want to get a Tummy Tuck, Brazilian Butt Lift, and Breast Augmentation. The doctor I'm considering said it is possible to get all three at once, and also suggested I can have the Brazilian Butt Lift and Tummy Tuck, then Breast Augmentation 3 months later. What are your recommendations? Has anyone done this and can give me some advice?

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

In my practice it is common for me to perform all of the procedures you mentioned at the same time. However, I use an assistant to save total operative time with the goal less than 6 hours of surgery (often far less than that) to minimize potential complications and for a speedier recovery. Sometimes there are even less scarring as for straight augmentations, I place the implants using the TT incision without the need for breast scars. My patients following a TT with or without a BBL stay in a reclining chair the first week. A flat tempurpedic pillow beneath your back and upper thighs will offload pressure on your buttocks. The benefit is only one surgery, only one recovery (you heal from all procedures simultaneously) and that you can use the fat that would normally be discarded from the tummy tuck. Pros and cons of this decision should be part of your in depth consultation with your plastic surgeon including the increased risk of complications with long surgeries and how to prevent them. Your plastic surgeon will guide you into making the best decision in your individual case. The most important decision is picking the best plastic surgeon experienced in this technique. See link regarding finding the best surgeon for combined surgeries.#BB,TT,BAatSameTime

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your thoughtful question regarding whether you should combine a tummy tuck, Brazilian Butt Lift (BBL), and breast augmentation into one surgery or split them into two stages. Technically, yes, it is possible to combine all three surgeries in one session, and some plastic surgeons do offer it. However, many experienced, board-certified plastic surgeons, myself included, often recommend staging these procedures for a few important reasons.

First, the total surgical time when combining a tummy tuck, BBL, and breast augmentation can easily stretch to 8 to 10 hours or more. Longer surgeries are associated with a higher risk of complications, including blood clots, wound healing problems, and infections. Secondly, there are significant postoperative positioning challenges. After a tummy tuck, patients need to stay flexed, meaning slightly bent at the waist, to protect the abdominal closure. After a BBL, patients must avoid putting pressure on their buttocks to protect the newly transferred fat. Combining the two surgeries makes it extremely difficult to protect both surgical areas properly during recovery, and this can compromise results. Third, combining all three surgeries places a tremendous healing burden on the body. Your body heals best when it can focus its resources on fewer areas at once. Stretching your healing capacity across your breasts, abdomen, and buttocks simultaneously can lead to increased swelling, prolonged recovery, and higher risk of setbacks.

For these reasons, many surgeons, and it sounds like your surgeon as well, recommend staging the procedures. Typically, the first stage involves performing the tummy tuck and the Brazilian Butt Lift together. After about three to six months, once the body has had time to heal and swelling has subsided, the second stage would be the breast augmentation. Staging your surgeries makes recovery safer, more manageable, and often produces better aesthetic results because each area gets the attention it needs during healing.

In short, if you are very young, healthy, and low risk, it may be possible to combine all three surgeries, but it will make your recovery extremely difficult and uncomfortable. For most patients, separating the surgeries is the safer and smarter choice. It is wonderful that you are thinking ahead and asking these questions — it shows you are serious about making the right decision for your body and your long-term results.

Wishing you the best as you move forward with your journey.

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FASMBS, FICS
(Certified by the American Board of Plastic Surgery and President of the American Society of Bariatric Plastic Surgeons; Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery; Member of the American Society of Plastic Surgeons, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame)

Before moving forward, be sure to review your surgeon’s qualifications carefully, look at detailed before-and-after photos, and ensure your surgical plan prioritizes your safety and long-term satisfaction.

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. To provide a valid medical opinion I will need to see pictures of you body from different angles. I would suggest to be treated by board certified plastic surgeon with experience in this procedure, to get the best desired results.
Respectfully,Dr. Emmanuel Mallol Cotes.-

Jed H. Horowitz, MD, FACS · Answer

#Combined operations are often performed with our #Gynecology colleagues. Tubal ligation is a common post pregnancy procedure which is done at the time of many of the surgeries included with a #MommyMakeover. If you require a gynecologic operation or study (laparoscopy) and are considering a plastic surgery procedure, discuss these issues with your physician and board-certified plastic surgeon. Also, combining these #procedures may decrease anesthetics, costs, and recovery time.

Many procedures can be combined. Cosmetic procedures such as Brazilian Butt Lift (#BBL), Thigh Lift (#TL) and Mommy Makeover (#MMO), which usually concentrates on the breast and abdomen areas, may be combined together. However, I look at the risk factors such as surgery time greater than 6 hours, or #anesthesia time, increased risks of DVT, prolonged  #healing, #positioning after surgery to name a few, which are a lot to consider. These factors are relative to performing any variety of combinations.  Your procedures should be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

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 you are 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. In addition, I would combine the tummy tuck and breast augmentation together as the recovery position of the tummy tuck and breast augmentation are complementary.

Armando Soto, MD, FACS · Answer

Hi there-
This is a question that comes up often.
I personally would not recommend undergoing Brazilian Butt Lift, Abdominoplasty, and Breast Enhancement at the same time for several reasons:

The length of the operation- the longer an operation is, the greater the risk for you.
After a Tummy Tuck, you will need to be a bit bent at the waist for comfort, and lying on your abdomen will be uncomfortable.
After breast enhancement, I would not want you lying on your abdomen, or on your sides for a few weeks.
After a Brazilian Butt Lift, I would ONLY want you lying on your sides or abdomen, and NOT AT ALL on your back.

The whole point of pursuing these procedures, I assume, is to achieve the very best possible outcome, right?
I also assume you want to avoid problems after surgery as much as possible.
If these two assumptions are valid for most women, then combining these procedures would not be how I would recommend you proceed.
Here's the bottom line- most Board Certified Anesthesiologists would agree that if you are a healthy person, the risks of going to sleep twice (say 6-8 weeks apart) are MUCH LOWER than the risks to you of staying asleep for 5-8 hours and having a very limiting recovery period.
I agree with my colleague from Memphis- there are many things in plastic surgery that are "possible", but it turns out that some of these are not in the best interests of the patient.

Otto Joseph Placik, MD · Answer

Tummy tucks and brazilian butt lifts are frequrntly performed together as can be seen in the attached video below.The length of time under general anesthesia will vary with the amount of fat to be injected as well as the extensiveness of the tummy tuck. While mentation is certainly possible, it really depends on how complex the tummy tuck isaddition of breast aug

Farbod Esmailian, MD · Answer

I would not do all that at one time.  It is way too much surgery and way too much risk and way too long of anesthesia time.  I would breast them up.  Do the tummy tuck and brazilian butt lift at one sitting and the breast surgery at the other.
The brazilian butt lift surgery takes time and can not and should not be rushed to achieve optimal results.  The fat needs to be injected in small increments to achieve a nice result, so it just takes time.
Good luck.

Steven Wallach, MD · Answer

It is certainly possible to offer multiple procedures to be done in the same setting, as long as you are healthy and the surgery can be done within a reasonable amount of time.

Pat Pazmino, MD, FACS · Answer

Tummy tucks are a very popular and effective technique to contour the abdomen. The effects of a tummy tuck may be complimented with a breast augmentation and a Brazilian Butt lift. Although a breast augmentation can safely be done at the same time as either a tummy tuck or a Brazilian Butt lift, it is not recommended to perform a tummy tuck with a Brazilian Butt lift. When patients are considering these procedures they need to keep in mind the individual recovery requirements for each surgery. The recovery process for a tummy tuck is the opposite of the recovery process for a Brazilian Butt lift. After a tummy tuck, patients must rest on their butt and often in a seated or flexed position. After a Brazilian Butt lift, patients cannot rest on their Butt and must lie face down. Because of these different recovery requirements, we recommend that patients who are interested in both procedures receive them separately. They may receive a breast augmentation with either procedure.

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