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Dr. Alex Earle: Sometimes we get patients that are seeking to have a BBL and I recommend a tummy tuck, instead. A lot of times patients are confused as to why. This has to do with the degree of skin laxity that you have, particularly in the abdominal area, especially in the lower abdominal area, below the belly button. If you've had great fluctuations in weight or massive weight loss, if you've had` multiple pregnancies or simply for other reasons, you have poor skin quality and excessive skin laxity in that area, you're not going to do well with liposuction or a BBL alone. That skin's not going to be able to retract well, as skin won't retract evenly and it's due to the poor quality of that skin. Therefore, it is best to do a skin tightening procedure prior to your liposuction or BBL procedure. This comes in the form of either a mini tummy tuck, a full tummy tuck or an extended tummy tuck, depending on how much loose skin you have. Dr. Alex Earle - Miami Plastic Surgeon Another important reason why I may recommend a tummy tuck as opposed to liposuction or BBL has to do with abdominal wall weakness. Certainly after massive weight gain and loss or multiple pregnancies, the abdominal wall maybe come stretched and may become weak and the muscles may separate. When you do that, you may have a little protrusion to the belly and doing liposuction alone won't fix that. The only way to fix that is by doing the muscle repair, which is a part of the tummy tuck procedure. So while I do understand some patients may not want the scar associated with the tummy tuck, the patient has to understand that if we don't do that, they will still have loose skin, they may have uneven skin and they're going to have that weakness of the abdominal wall and they won't be able to achieve that flat, flat belly that they're looking for. So the best thing is to start with that tummy tuck procedure and then proceed three to four months later with your liposuction and BBL. www.pureplasticsurgery.com