Dear Rainboeone, Thanks for posting your pictures and congratulation on your massive weight loss on your own. Your BMI of 29 is sufficient for tummy tuck surgery and there is no need to lose additional 25 pounds before surgery, unless when you lie down on your back, your tummy is still protruding out. Based on your pictures, you do not need any " super extended tummy tuck" or "360 tummy tuck" but rather regular tummy tuck that includes muscles tightening and skin tightening with significant skin excision. That procedure will give you flat stomach, tight and youthful looking skin, nice belly button, improved body posture and most likely you will lose significant amount of weight due to the muscle tightening that will reduce the amount of food that you can eat and your sense of hunger. I do not recommend to combine tummy tuck with liposuction , because of the significant increase of severe complications, including death , when combining the procedures. In Florida, it is illegal to perform tummy tuck with liposuction over 1000 cc (small amount) after state investigation revealed that the combined procedures was the main reason for the large number of deaths and severe complications. In a recent article in the plastic surgery journal that was based on data from cosmetic surgery only insurance company, it was revealed that combining the 2 procedures in one surgery increases the severe complication rate X 10 , in comparison to tummy tuck alone... Cosmetic surgery is purely elective ( you do not need it but rather want it) and complication rate should be reduced to a minimum. An ounce of prevention is worth a pound of cure ! Liposuction of the abdomen, hips, waists and lower flanks can be done 2-3 months later, if needed. I have been in practice for over 30 years and performed tummy tuck surgery on well over 1000 patients. Only about 10% of my tummy tuck patients request liposuction. For the butt dimplings you can do butt lift, however that is a big procedure that requires long scars on the lower back. A much better option are the sub fascial butt implants that can be inserted through a single small incision, well hidden between the cheeks. The implants will smooth the dimples and give you a nice projection and round hips. BBL or fat injection to the butt is a total waste of your money and your time, because the fat disappears completely or almost completely within months or even sooner, as I have seen on many patient who came to my surgery center for butt implants surgery after the big disappointment from the BBL that was done by other surgeon. I never performed that procedure ! For the inner thighs, you will need liposuction and skin lift that requires incisions in the groins and the medial buttocks' crease. In summary, you will need 3 or 4 separate operations. Safety should be your main concern and , obviously, good outcome. Too long procedures means surgeons' fatigue and consequently compromised result. You have to realize that not all results are the same, because experience, technical skills and aesthetic eye are critical for good outcome. So, do your due diligence carefully and choose your surgeon wisely. Cost of surgery is important, but quality of surgeon is more so, because if you will require corrective surgery. it will double the total cost and recovery time. Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive. Best of luck, Dr Widder
