Combination procedures in plastic surgery are commonly highly sought services. One of those highly sought services is a gluteal or buttock augmentation at the same time as an abdominoplasty or tummy tuck. I am not a proponent of doing a buttock fat transfer at the same time as abdominoplasty. My reasoning is very clear. With respect to body contouring in general if the abdomen merits surgical intervention in order to achieve a much flatter and appealing condition then this should be in my opinion the top priority. The greatest value will be obtained by 1st addressing the excess skin and fat on the lower mid and upper abdomen. In conjunction oftentimes with liposuction of the hips and flanks an improved midsection can be achieved giving the patient a highly desirable and much more attractive anatomic result..
In addition to the abdominal appearance and contour it is often desirable to have a full lower more attractive gluteal or buttock region. Each of these procedures has its own postoperative requirements. The tummy tuck usually requires the inability to fully straighten up in order to facilitate the best result. Whereas fat transfer to the buttock area usually requires staying off of this area directly for several weeks postoperatively. All unnecessary pressure on the buttock area following fat transfer could reduce the overall final result by preventing the transferred fat from creating the best possible result..
Furthermore it is my opinion in order to achieve the optimal most long-lasting gluteal or buttock augmentation gluteal implants will be required. To gluteal implants can provide a much sought after reliable and long-lasting result as opposed to the fat transfer to the buttock. Even when cultural norms and desires are taken into account I still prefer the gluteal implants as a much more reliable dependable result. All operations have inherent risks and they are reviewing detail prior to proceeding with any cosmetic surgical procedure.
In summary the abdominoplasty or tummy tuck is in my opinion the gold standard for body contouring. In Florida we are allowed to harvest 1000 mL of fact with that procedure. I prefer to discard this fat as most of it can not be relied upon to survive during a fat transfer to the buttocks and would recommend a gluteal implants at a later time preferably minimum 2 months.