Can I have a TT w MR full back and front lipo. (photo)

Abdominoplasty treats the skin excess and muscle weakness of the abdomen, as well as any fat that is between the belly button and the pubic hairline. Liposuction treats only fat. It can be used to thin out the abdomen, but the skin must be in good condition with no excess, and there should not be muscle weakness. I do not like to combine abdominoplasty with liposuction because of the added risks of fluid collection under the skin, VTE and wound healing problems.





Aggressive liposuction with tummy tuck is dangerous.  A full tummy tuck with liposuction at the same time will certainly put you at a high risk for fluid under the tummy tuck skin (seroma). A full tummy tuck with aggressive liposuction at the same time will also certainly put you at an unacceptably high risk for a potentially fatal pulmonary embolism (PE), venous thromboembolic event (VTE). The literature is complete with this information. The science is the science. This is a risky combination.





The incidence of seroma formation is about 16.0 percent in the abdominoplasty-alone group and 31.2 percent in the abdominoplasty with liposuction group.





The combination of abdominoplasty and liposuction procedures can still overwhelm the body's ability to resist these shear forces by the fact that more surface area is available to “shear” and thus produce seroma fluid. Not so much as an additive effect but synergistically, such that the seroma fluid from the flanks flows into the adjacent abdominal space and resists the ability of the upper abdominal flap to close over the abdominal wall. Patients must be counseled about their risk for seroma formation and treatments aimed at resolving them including frequent postoperative visits for needle drainage and the rare case requiring operative drainage in the face of a persistent seroma.

I do not recommend doing both procedures at once because after BBL, you must sleep on your stomach to avoid pressure on the grafted fat in your butt. A painful and difficult thing to do right after a Tummytuck ! I usually do the BBL first to obtain as much fat as possible from the stomach and back regions, and 4-6 weeks later, perform the Tummytuck. Be sure to consult with a board certified plastic surgeon. Good luck!

Hello and thank you for your question. Based on your
photograph, you are a great candidate for a tummy tuck with liposuction. 
This can be done through a low and short incision, all completely below the
bikini line.  Your muscles can also be
plicated resulting in a flat abdomen.  BBL can be performed at the same time.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.  The
most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

I do not perform these together, especially with your medical history- you are increased risk for blood clots and post op positioning is very difficult if both are done at the same time. We have an internist in our practice to medically clear all of our pre and post op patients as well.Rather, these should be staged- Vaser ultrasound liposuction to flanks, back, abdomen with fat grafting. Then, several weeks later when up to it, tummy tuck. The order can be reversed depending upon how much fat is needed for grafting.An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations. 

Thanks for reaching out. You are absolutely a candidate.  I would however continue in you diet and exercise program and continue to loose weight first.  Your results will be far superior.  It is always best to operate once you are at a stable weight for a little while.  Any weight gain or weight loss after surgery can alter the outcome.I hope this helps :)