Combining BBL and Tummy Tuck
It is not uncommon to combine BBL and abdominoplasty surgery. The order of procedures probably does not make that much difference.
However, if the abdominal fat is to be used for the BBL, then you would need to be turned twice during the procedure.
That would create a very awkward and potentially more dangerous situation.
For that reason, I always perform the abdominal liposuction first, then the tummy tuck, followed by a careful turning of the patient to the prone (face down) position to prevent disrupting the tummy tuck stitches.
This techniqued has worked well for many years now. Always remember that adding procedures together will increase the length of the surgery, which can increase the risks as well. Finally, a word about expectations. Several patients commenting on this website have failed to wait the requisite 6 month healing time to critically evaluate their results.
Virtually every procedure involving liposuction, that is tummy tuck, BBL etc will take a FULL 6 months before the final result is appreciated. This is because the scarring under the skin and skin contraction process sometimes takes that long.
This is a discussion that I undertake with EVERY patient in the preoperative consultation. Yet, patients continue to expect to see their final result immediately after the surgery. Listen carefully to what your surgeon is saying in the preoperative consultation. It makes sense and will save you some anxiety about your results during your postoperative healing process. (Kenneth R. Francis, MD, Manhattan Plastic Surgeon)
Tummy Tuck and Brazilian Butt Lift: Order of Surgical Procedure
A patient can undergo an abdominoplasty and Brazilian butt lift (BBL) in the same surgery if a good surgical candidate. If the goal is to transfer only fat from the back, for example the love handles, then I have the patient in the prone (on tummy, face down) after they get general anesthesia. The liposuction and fat transfer to buttocks is then done. The patient is then turned to supine position (face up) in order to perform the tummy tuck – this usually requires the patient to be put in the hips flexed position. If a lot of fat is needed or fat is needed from the abdomen, then the lower abdomen fat (from areas that will be removed when performing the tummy tuck) is removed when the patient is put in supine position first.
In our office a tummy tuck and BBL are often performed together. I perform the BBL first because I don”t want to disrupt any suturing done in the tummy tuck. Also after the tummy tuck I want the patient to be in the flexed postion. I don’t believe that lying on the buttocks for 2-3 hours doing the tummy tuck will have much effect on the BBL. (George Lefkovits, MD, New York Plastic Surgeon)
Then they are placed prone to finish any liposuction and do the BBL. Then turned back to supine to perform the abdominoplasty. It is better to have the surgery done right and sacrifice a relativley short period of time on the buttocks after BBL then to have the surgery compromised and doing the abdominoplasty first (as putting a patient prone after abdominoplasty can risk the surgery and by definition means that the abdominoplasty probably wasn’t as optimal in first place). Have this performed by only an experienced Board Certified Plastic Surgeon. (Ghada Afifi, MD, Orange County Plastic Surgeon)
In ordred to obtain the best results and have easier recovery time, I do recommend to perform tummy tuck first, liposuction and fat transfer to buttucks (Brazilian butt lift) to be done at least two months later. However if because of other reasons patient desire to have both surgeries done in the same setting, I would recommend to start up with tummy tuck first then proceed with lipotransfer to buttocks.
Positioning of the patient and turning into prone ( face down) requires special attention. Hips need to be kept in flexed position all the time. (Fereydoon S. Mahjouri, MD, San Jose Plastic Surgeon)
Tummy Tuck combined with Brazilian Butt Lift
Although there is no one or correct order in performing a Tummy Tuck, Liposuction, and Brazilian Butt Lift (free fat transfer to the buttuck), I prefer to perform the tummy tuck first, followed by the liposuction and finally perform the fat transfer to the buttuck.
I feel this order allows the surgeon to tailor the abdomen, hips and thighs immediately following the tummy tuck. It also decreases swelling and bruising by mininimizing the time between the liposuction and Brazilian Butt Lift and placement of the post op compression garment. (Vincent D. Lepore, MD, Dallas Plastic Surgeon)
It really depends on how much fat your surgeon plans to transfer. On occassion, I only am planning to trasfer 250-400 cc of fat to the buttock and sometimes patients have enough in the flanks for this amount and I would start prone (lying on your face) complete the butt lift and then turn you over to perform the tummy tuck.
If your surgeon is performing a larger volume butt fat transfer, then I would start supine (on your back liposuction the flanks and lower abdomen and then flip you prone to do the fat transfer, and then flip you again supine to complete the tummy tuck. Let me tell you this can be a long procedure and in my practice you would have to stay overnight. Make sure you are seeing a board certified plastic surgeon. (Vishnu Rumalla, MD, New York Plastic Surgeon)
While it is possible to do an abdominoplasty and autologous fat transfer to the buttocks in the same surgery, I don’t think it’s a good idea. There is always a compromise made in either surgery to make this possible. I believe this effects the final result in way of not adequate volume or placement of fat. It is a downside to do this in two separate times, but in my opinion better results are worth having a second surgery. In my practice, I perform liposuction and AFT first then after three months or longer LTA (tummy tuck) is performed. (Kevin Tehrani, MD, FACS, Washington DC Plastic Surgeon)
It is nice to be optimistic however you need to be also realistic. Cosmetic surgery is totally elective. You do not have to have the surgery (like appendix or gallblader etc. ), you elect to have the surgery. For that reason, complication should be reduced to a minimum. Combination of surgeries, particularly, those that take over 6 hours, increase the rate of complications. I am sure that you heard about celebrities that had a very bad outcome with lengthy combined surgery ! I have been a board certified plastic surgeon for 25 years. My recommendation to you is to split the surgery into 2 stages. Do the tummy tuck first followed by the second one at a later date. In regard to the buttock augmentation, give consideration to implants since fat injection is not very reliable and in many cases, does not last over a year. Implants do last and are very natural. Be sure to find an experienced plastic surgeon in that procedure. (Shlomo Widder, MD, New York Plastic Surgeon)
When I perform these two procedures together, I harvest the fat first then perform the tummy tuck and the final step is inject the fat into the buttock by turning the patient to the sides so as not to jeopardize the result of either procedure. (Dana Khuthaila, MD, FACS)