I want a BBL, but some PS say I need a TT as well. Do I need both for good results? What about sagging skin? (photo)

I am 36yrs old, 3 deliveries. I am 5f tall and 127lbs. I do not like the fat around my waist, love handles, and there is also a fatty pad above my tail bone that could maybe look better. Plus, I have a flat butt. I hate my butt and wear padded panties everyday for the past 3 yrs. I spoke to a PS that wanted to do BBL & TT at the same time and another recommending I separate the two, doing the BBL first and then possibly the TT. My fear is sagging skin after BBl. What do you think?

Doctor Answers 13

Brazilian Butt Lift with Tummy Tuck gives the Best Results for Loose Abdominal Skin

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Thank you for your question.

The Brazilian Butt Lift (BBL) is a Liposuction plus Fat Transfer procedure that relies on two powerful effects to reshape the body and booty:
  1. Reducing and shaping the FRAME around the hips and waistline and back (and buttocks as needed), and 
  2. Fat Grafting to the outter and upper buttocks as well as the body of the butt in an individualized manner to create the most desirable shape.
Very commonly liposuction of the whole trunk from the back and flanks to the waistline and abdomen is a great option for the BBL. This is one of my favorite body contouring procedures and I basically refer to this as Circumferential Liposuction of the Trunk with Fat Transfer (grafting) to the Buttocks.

From your photos, it appears that you would get a much better result in the abdomen with a Tummy Tuck being added to the Circumferential Liposuction of the Trunk, and this is what I'd most likely recommend for you.

Hope this helps.

Nick Slenkovich, MD FACS
Denver Plastic Surgeon

I want a BBL, but some PS say I need a TT as well. Do I need both for good results? What about sagging skin? (photo)

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Thank you for your question . 

You look like a great candidate for both procedures. It is always recommended to have a liposuction with transfer to your buttocks first as this guarantees more fat to be transferred than when it is combined with another procedure . As a surgeon is only allowed to take only about 1000cc of fat in a combo procedure instead of 4000cc in a single procedure, 6 months after will be a perfect time to have a tummy tuck. This will give you the best results for your money . 

Choose a board certified plastic surgeon who has done a ton of Brazilian Butt Lifts and has privileges to do this surgery at a local university hospital. This says his credentials have been checked out by fellow Drs. All surgeries carry risk, talk to your plastic surgeon and choose one wisely.

Liposuction and BBL firstand tummy tuck later

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Thank you for your question and photograph.  Many feel that combining tummy tuck and BBLcan result in difficult recovery because resting in bed laying on your back can cause problems.  In addition your tummy tuck results will be much better after fat has been removed from the abdomen and flanks by your liposuction.  Please consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced in these procedures, and who has an excellent reputation in your community.

TT and/or bbl

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The degree of flaccid skin you have on your abdomen makes you a perfect candidate for a Tummy Tuck in order to get rid of that saggy skin which will only be saggier after just liposuction. Lipo, laser, vaser or exercise will not make your skin tighter. 
Liposuction can be done on your back and transfer the treated fat, into your butt. 
I personally would not recommend to do lipo to abdomen and TT later, because the blood circulation of the flap may be damaged during lipo and also because fibrosis or unevenness are more noticeable once the skin is pulled down. 
Be encouraged. 
You will be loving your results!!!
dr. Cardenas

Combining a tummy tuck with a fat transfer to the buttock

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Based on your photos, I would recommend a combined tummy tuck with a fat transfer to the buttock. The liposuction would be performed to the lower abdomen, love handles, back and inner thighs. If you do not do a tummy tuck and just do the fat transfer, you will likely have loose abdominal skin and have to wait about one year before having the tummy tuck done. Patients who are in good overall health can tolerate this combination of procedures, which usually takes about 4 and one half hours to complete. You may consider consulting with a few more plastic surgeons and asking more about the risks and benefits of these procedures.

Best wishes,


William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 410 reviews

Abdominoplasty, Liposuction and BBL -- 1 procedure

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Great question. Based on your photos, the best option for your case would be an abdominoplasty (tummy tuck) with liposuction of the hips, flanks and back and fat grafting to the buttocks. These can be performed in one procedure; there is no reason to separate into two surgeries. If you are trying to avoid having a tummy tuck, the second option would be liposuction of the abdomen, hips, flanks and back with fat grafting to the buttocks. 

German Newall, MD
Houston Plastic Surgeon
4.4 out of 5 stars 57 reviews

I want a BBL, but some PS say I need a TT as well. Do I need both for good results? What about sagging skin?

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I think that you can get a dramatic result with the right plastic surgeon.  I would find the surgeon who you feel gives the best results and then trust the judgment of that surgeon.

Try to research this to find the surgeon who consistently produces the results you would expect. Look at reviews on this site and see who gets the surgery right every time.

Find a board certified plastic surgeon who performs hundreds of Brazilian buttlifts each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD

Los Angeles, CA


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If you are not bothered about fatty abdomen then you can go ahead with BBL only,it is not a must to combine TT.It is your choice however TT will help you look better.

Tummy tuck and buttock augmentation

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It looks as if you are going to get the best result with both a tummy tuck and liposuction with fat grafting to the buttocks.  You are likely going to be dissatisfied with loose skin in the abdominal area with just liposuction of the abdomen.  If you are getting conflicting opinions get some more and go with the surgeon with which you are most comfortable.

Lipo and TT

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Thank you for the pictures.
I believe that you make a great candidate for a tummy tuck in combination with liposuction of the waist, upper and lower back and fat grafting to the buttocks area.

The cost can be very affordable.

Dr. Campos

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 257 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.