Would I be considered as a candidate for a BBL or should I lose weight first? Would a tummy tuck be necessary? (photos)

Question

I am 45 years old, my height is 5"6" and I weigh 187 lbs with a BMI of 31. I have had 3 children and 1 c-section. I am looking for a heart shaped butt, hourglass figure with a small waist and flat tummy. I currently have 800cc mentor silicone implants which I am looking into having a potential explant/exchange and breast lift. Please help!! Thank you so much for your time and feedback!

Finny George, MD · Answer

Hi, thank you for sharing your question. Based on your photos and information, you are a good candidate for 360 Lipo, BBL, TT and breast lift with implant exchange. These procedures should be staged so that you can minimize your risk of complications.

Semih Yildiz, MD, FEPOBRAS · Answer

At 5 ft 6 in and 187 lb, your BMI is about 30, so BBL candidacy depends on your overall health, exam, and your surgeon’s safety limits. In the photos, there appears to be abdominal and waist/back fullness that could provide donor fat, but the images are limited and cannot show skin quality, muscle separation, or the safest amount of liposuction.

If your main goal is a small waist and heart-shaped buttock, liposuction with fat transfer may help with contour. If your goal is also a flat tummy after three pregnancies and a C-section, a tummy tuck may be needed if there is loose lower abdominal skin or diastasis; liposuction alone will not tighten that. Losing some weight first can lower risk and may make the result more predictable, but you should avoid major weight loss after a BBL because it can shrink the transferred fat. Breast explant/exchange with lift and body contouring may be best staged rather than all done in one long operation, depending on your exam and surgical plan.

Brian E. Rosett, MD · Answer

At your age and after having 3 kids you will most likely need a tummy tuck with the BBL for the best result. That being said you should pick a couple surgeons in your area and get some consultations and compare what everyone says and thinks after an exam. I would only go to a board certified plastic surgeon and RealSelf is great with telling you what type of doctor you are looking at by telling you what they are board certified in if you have any uncertainty.

Alan Gonzalez, MD, FACS · Answer

Hello @LiveLifeHappy4u, thank you for your question. Every practice has different requirements for performing a BBL or a surgical procedure. The BMI is one of them; not everything depends on it but it helps determine how risky and optimal the surgery will be. An optimal BMI is 30 for surgery. If you continue to keep lowering your weight and eating healthy so you can maintain your figure after the procedure and have excellent results in the long run. About a tummy tuck I consider it will be necessary to have the two procedures done, because a tummy tuck will remove excess skin and fat from the middle and lower abdomen and strengthen the abdominal muscles. If you are considering surgery, consultation with a board certified plastic surgeon who is experienced in the procedures is essential to ensure optimal results. I link a video talking about explant to share more light! Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. After analyzed your pictures I recommend you Tummy tuck as a first option to obtain better results, removing the skin excess and with the liposuction give you better body contour also take the fat we get and transfer to the buttocks and hips, to mold them and get better volume, contour and butt projection, is that we know as "Brazilian Butt Lift" (BBL).

Kind regards,
Dr. Emmanuel Mallol Cotes.-

Kind regards,
Dr. Emmanuel Mallol Cotes.-

Daniel Barrett, MD · Answer

Dear LiveLifeHappy4u,
based on your photos, you look like a good candidate for a TT and BBL. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Liposuction of your abdomen, back and flanks should give you more curves and hourglass shape and fat transfer to buttocks should give you more projection. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Cagil Meric Erenoglu, MD · Answer

Hi, LiveLifeHappy4u! Thank you for your question and photos.
The current form of your body does not necessitate weight loss for a BBL. A 360 Lipo including sacral region will be necessary for fat harvest and curvy shaping. Your abdominal skin shows some laxity, indicating a tummy tuck including rectus muscle repair (As there is abdominal wall laxity due to previous pregnancies). So my recommendation will be a 360 Lipo + Ultrasonic Safe BBL + Tummy Tuck with Rectus muscle repair.

Darryl J. Blinski, MD · Answer

Thanks for posting photos. You would need a few surgery rounds. Start with lipo 360/BBL under ultrasound guided fat injections, fee from $6,000. After 3-6months then stage 2 would be if needed a full TT with muscle plication plus explant or downside implant or leave same size and do lift with any added lipo/BBL if needed. A stage 3 might be decide later on. Best to virtual consult with...

Adolfo Sesto, MD · Answer

Hello. In my 29 year experience with an BMI of 31 you may undergo a Tummy Tuck plus Liposcultpture and BBL (if your hemoglobin level is 12 grans or up). You are a good candidate for this procedure since your abdominal muscles are separated (diastasis recti) and you have excessive skin and fat in the area. I will also make a lipo in your upper and lower back, and flanks, and transfer it to your buttocks.

For not raising your risks durign surgery the breast will need to be taken care on a second surgery.
See some of my cases in the video below.

For not raising your risks durign surgery the breast will need to be taken care on a second surgery.
See some of my cases in the video below.

Mats Hagstrom, MD (license on probation) · Answer

Gluteal fat transfer primarily adds volume. The combination of grafting fat and appropriate liposuction is what creates hyper feminine curves.
Fat can be harvested from any area and does not necessarily include or exclude treatment of the abdomen.
There are four variables determine what the abdomen looks like. These are a skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies and lastly access visceral or intra-abdominal fat.
Based on your pictures you probably have some of all four of these but pregnancy related changes i.e. skin laxity and muscle separation are contributing significantly.
Liposuction alone will reduce your subcutaneous fat layer but will not give you a tight flat abdomen. For that you will need weight loss and a full tummy tuck.
Some plastic surgeons will do a tummy tuck and BBL as a combined procedure others recommend doing them as separate procedures.
Personally my preference is to do them as separate procedures and patients who are closer to their ideal weight doing the tummy tuck first.
To get a quality assessment and better understanding of treatment options I suggest all patients considering cosmetic surgery have multiple in person consultations with local board-certified plastic surgeons.
I encourage patience to avoid virtual consultations whenever possible.
During each consultation I asked each provider to open up their portfolio and show you their entire collection of before and after pictures. Some surgeons may be reluctant to do this but you should still ask them to show you as many pictures as they are willing to.
You should specifically ask to see as many pictures as possible of patients who have similar body characteristics to your own.
For tummy tuck results look carefully at what surgeon gets the most natural looking belly button with a very low set scar that follows the anatomic contours naturally with a torso that looks balanced proportionate and attractive from all angles including from behind.
For Liposuction results look carefully at all areas treated to make sure there are no skin contour irregularities anywhere on any treated area.
Ask the surgeon to review the pictures with you pointing out what areas were treated and what areas were not treated looking carefully at transition zones between treated and untreated areas.
An experienced surgeon should have no difficulty showing you at least 50 sets before and after pictures. Highly experienced surgeons will have much more than that.
Asked to see as many examples as possible of patients with similar body characteristics to your own. You should also ask to see examples of patients who had excellent outcomes, average outcomes and less than outcomes. we all have a variety of different outcomes and it’s fair for patients to ask to see a variety of outcomes from each provider.
Being shown a handful of preselected pictures which most likely represents the best results of their career is insufficient to get a clear understanding of what average results look like in the hands of each provider.
For Liposuction discuss in detail what will be included and what will not be included. This includes where the transition zone is on the BBL and exactly at what point your body will start coming in and at what point the bottom will start expanding.
The goal should be to develop a smooth harmonious feminine S-curve that goes from the armpit to the knees.
Make sure you discuss exactly what areas will be included with Liposuction. Personally I view the torso as a single anatomic unit and prefer to treat the entire torso when doing liposuction.
A full torso includes upper abdomen, lower abdomen, love handles, waist, entire back and under arm areas all the way to the side of the breast.
By treating the entire torso as a single anatomic units patients are left with an even natural thing a fat distribution without transition zones between treated and untreated areas.
The transition zone is what differentiates a quality BBL. this means bringing in the love handles in the waist and knowing exactly at one point they should begin transitioning out towards augmentation. 
Continue having consultations until you found the most skilled and talented a provider in your community who meets your needs. When in doubt slow down and schedule more consultations.
Expect to get different opinions from different providers regarding the appropriateness, combinations or what procedures to do first.
There’s not necessarily a right or wrong way to do this but different providers will have different opinions based on their own background, education and personal experience.
Best,
Mats Hagstrom MD

Would I be considered as a candidate for a BBL or should I lose weight first? Would a tummy tuck be necessary? (photos)

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