Can you have a full body lift, Brazilian butt lift, and fat transfer to contour body all in one surgery? (Photo)

Question

I'm about 300 pounds and am about to get the gastric sleeve surgery and with it will come a lot of loose skin. When that time comes, I want to get a full body lift, a Brazilian butt lift, and I want to contour my body so that I have a coca cola shape and I would like to have it all done in one surgery. Is it possible and what are the risks? Also I really like Dr. Cabral in the DR. Do you know a doctor in the states, who matches the kind of work that he does? Thank you

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding whether you can have a full body lift, Brazilian butt lift (BBL), and fat transfer for contouring all in one surgery. I appreciate your history, your wish pictures, and congratulations on your upcoming gastric sleeve surgery! This is a fantastic step toward weight loss and overall health.

After undergoing a gastric sleeve, most patients need to wait 10 to 12 months before considering reconstructive plastic surgery. If you are still losing weight beyond 12 months, it’s important to wait until your weight has stabilized for at least three months before proceeding with surgery. This ensures that your skin has settled and that your final contouring results will be long-lasting.

Most experienced, board-certified plastic surgeons specializing in reconstructive plastic surgery after massive weight loss recommend staging your procedures into multiple surgeries, rather than doing them all at once. This approach is safer, minimizes complications, and allows for better healing. Typically, the best approach is a two-stage process:

Stage 1 – 360 Circumferential Lower Body Lift
This procedure includes a tummy tuck (abdominoplasty), mons/pubic lift, rectus abdominis muscle repair, umbilical reconstruction (belly button reshaping), hip lift, and buttock lift.
The lower body lift is essential for removing excess skin and tightening the lower torso after massive weight loss.
Stage 2 – Brazilian Butt Lift (BBL) and Fat Transfer
Liposuction is performed in areas like the abdomen, flanks, and thighs to harvest fat.
This fat is then transferred to the buttocks for improved volume and contour.
If necessary, thigh contouring or a thigh lift can be included to improve overall proportions.
While combining all these surgeries in one procedure sounds appealing, it is not advisable due to the significant risks involved, including blood loss, prolonged anesthesia time, higher risk of infection, and more challenging recovery. The safest approach is staging these procedures to allow for proper healing and optimal aesthetic results.

If you are interested in finding a board-certified plastic surgeon in the United States who specializes in post-weight loss body contouring, I recommend researching surgeons with extensive experience in lower body lifts and BBLs. Look at their before-and-after photos, patient reviews, and credentials to ensure they have the expertise to help you achieve your goals safely and effectively.

I hope I’ve answered your question about body contouring after gastric sleeve surgery and why staging your procedures is the safest approach. Best of luck on your journey!

Sincerely,
Dr. Katzen, MD, MBA

Christopher K. Patronella, MD, FACS · Answer

Yes, I prefer tummy tuck and body lift surgery along with fat grafting of the buttocks (Brazilian Butt Lift) to be done simultaneously. This provides me with the greatest opportunity to contour the entire abdominal-hip-buttock aesthetic unit in the most attractive way. In addition, the fat that is to be removed during surgery can be converted to the fat that is placed in the buttocks to enhance the projection, roundness and fullness of the buttocks. If, on the other hand, the procedures are done at separate times, the fat that would have been used to enhance the buttocks will no longer be available. Ideally a patient is at a BMI (body mass index) of less than 30 to undergo this surgery, although in some patients, a BMI of 30 to 35 is acceptable. Ideally, for optimal wound healing, safety, and best results, the BMI is less than 30.

Jason E. Leedy, MD · Answer

After massive weight loss there is often excess skin.  The buttocks also tend to look deflated.  Buttock augmentation is nice to add to any body lift surgery for massive weight loss patients.  Without buttock augmentation the buttocks will be lifted and tighter but often flatter.  Since you haven't lost the weight yet the buttocks are probably full but after a significant weight loss there will probably be some deflation.  There are two ways to improve buttock shape after weight loss that I offer.  The main way is called autologous buttock augmentation.  In this procedure I take fat and skin from the upper buttocks that would normally be excised in order to lift and tighten the buttock skin, and then remove the skin portion and bury it underneath the lower buttock tissue.  (Think of tucking in your shirt at the small of your back.) The result is a rounder, smoother buttocks.  This is often necessary for weight loss patients.  The other way is fat grafting.  This can be added to further improve the shape but that is often done at a second procedure later on.  Best of luck.

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