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