At “5’8” and 236 pounds” your BMI is 36 (mid OBESE range) making you heavier than many Plastic surgeons would consider performing body contouring procedures on.
The closer you can come to 150 pounds or so SAFELY and stay there, the better will be the results of ANY Body Contouring surgery done on you.
C-sections do NOT result in weight gain. If not done well, the scars may be indented, too high or too low but the procedure does not cause obesity.
Obesity is caused by a large caloric intake which is not offset by a corresponding burning of the extra calories by an increase in exercise. With a proper diet and exercise you should be able to shed most of this weight.
I ASSUME you are NOT planning on having any more children. Doing so will destroy the results of any body contouring procedures done on you. Such procedures are best done when EVERYTHING is stable – weight and no future pregnancies. I have YET to see a “butt-less” individual. I have seen hundreds of women’s rear ends claiming to have this serious affliction but have been repeatedly disappointed (just like presumed sightings of the Loch Ness monster and “Big Foot”).
If you critically look at your behind you will see that there is NO clear border between the lower back and the origins / upper borders of the spherically shaped buttocks. In other words, you have and excess of low back fat which covers up the upper buttock margins, the V-zone in the divergence of the buttocks extending to the hips. Once you lose your weight this MAY improve but odds are you could get a GREAT result at that time with a Tummy Tuck with Back Scoop Liposuction. The Tummy Tuck would flatten the abdomen and narrow the waist while the Back Scoop liposuction would unveil the full buttocks you ALREADY have and define the buttocks nicely.
In my opinion you do NOT appear to need a Brazilian Butt Lift as your rear cheeks appear full enough. (Peter A. Aldea, MD, Memphis Plastic Surgeon)
Weight loss would be the best first course of action
Before you consider any cosmetic surgery, it would be in your best interest to lose a signficant amount of weight, probably at least 50 pounds or more. By doing so, you will be able to obtain a much more desirable and contoured outcome (in addition to reducing some of your surgical risks).
Once you get down to a more ideal, reasonable weight, go see a board certified plastic surgeon who can provide you with appropriate recommendations for cosmetic procedures. (Steven Turkeltaub, MD, Scottsdale Plastic Surgeon)
As the other doctors have correctly stated. Lose 40 lb. and then do the tummy tuck. It will really give you more of a body change and then do the butt last. By then your weight should be stable and you can then see exactly where your backside ends up after all the weight loss! (John J. Corey, MD, Phoenix Plastic Surgeon)
Abdominoplasty after pregnancy
As others have mentioned before, you could benefit from loosing weight before considering any type of plastic surgery in order to have the best results possible. Loosing weight alone could improve your tummy. Another option is to have a TT with mesh to help you loose weight. In order to have this procedure you need to have finished bearing children. (Gary M. Horndeski, MD, Texas Plastic Surgeon)
Simple Abdominal Panniculectomy For Belly Concerns
While it would be more ideal to lose some significant before having any form of a tummy tuck, you can proceed with a simple abdominal panniculectomy at your current weight.
This is essentially an amputation of the overhanging abdominal skin and fat and would provide an immediate solution to your belly concerns.
Whether you have done at the same time fat injections to the buttock is a matter of personal choice. Buttock enlargement and an abdominal panniculectomy are only related by the surgical opportunity that one presents if the other is being done. (Barry L. Eppley, MD, DMD, Indianapolis Plastic Surgeon)
Brazilian butt lift or tummy tuck?
I think you have to sort out a couple of issues – the 2 procedures you are considering have very different goals. If you want to tighten your abdomen and get rid of loose, stretched skin, you should contemplate abdominoplasty. If you want more projection in the buttock area, a buttock lift or fat injections are an option.
However, like everyone has mentioned so far, it is unlikely that a qualified plastic surgeon will consider you to be a good candidate for any type of body contouring until you reach a healthier weight. It will be worth it in the end – your results will be better, you will feel better, and your healthy body will be able to bounce back and heal more easily! (Michelle Spring, MD, Los Angeles Plastic Surgeon)
I would want to see your weight at 180# or less before considering surgery. Also it would be best if you finish having your family before any precedures or they may have to be repeated. I frequently hear patients say the C-Section did this, but it is only a scar. It did not create any excess tissue. (Ronald V. DeMars, MD, Portland Plastic Surgeon)
You need to lose weight first and foremost then have an abdominoplasty. After pregnancy if there is a significant weight gain it needs to be reduced. (Jay M. Pensler, MD, Chicago Plastic Surgeon)
You are a high risk for surgery. Your BMI is 35.9, puts you at a high risk for healing and blood clots. Loose the weight if you can first. Then a tummy tuck can be done with dermis fat graft to the buttock and fat transfer as well (Samir Shureih, MD, Baltimore Plastic Surgeon) In order to get the best result you will have to lose the baby fat before you consider cosmetic surgery. Anything less and you are certain to be unhappy. (Peter E. Johnson, MD)