At the end of October, a British outlet sent an undercover reporter to message an overseas clinic about a tummy tuck. Fourteen minutes in, with no exam, the quote had a “skinny BBL” attached. I am not naming the clinic. I want to give you the questions that would have ended that chat.
A fat transfer added to a tummy tuck can be good surgery. The tummy tuck already harvests the fat.
“Every Agullo tummy tuck includes liposuction of the abdomen and flanks, which is factored in.”
“Adding a BBL or fat transfer to the buttocks to improve the hip and buttock contour.”
The difference between a plan and an upsell is whether somebody examined you first. Ask these.
1. Who examined me, and when?
If the answer is “send photos,” you have not been examined. The fat map, the pinch test and the shape of the hip cannot be read from a phone picture.
2. How many cc per side, and from where?
A real answer has numbers in it.
“At your current height and weight, it is possible to obtain enough fat to fill in the indentations in the lateral hip. I would estimate being able to obtain 250 to 300 cc for each buttock.”
3. What is my BMI, and what is your cutoff?
“I recommend a BMI less than 35, although some exceptions can be made.”
4. How long will the case take, and how much fat will you remove?
“Since I perform my procedures in a certified surgery center, certified by QuadA, I can safely remove up to five liters in one session.”
“The ideal is to keep a surgery under six hours, and at higher BMIs each procedure can take longer than usual. Many times we will opt to perform liposuction first and the excisional surgeries later.”
If a tummy tuck plus a BBL does not fit inside those two limits, it is two operations, not one.
5. Do you inject above the muscle, and do you use ultrasound?
“The most important thing is whether the surgeon is using ultrasound or not. No matter the experience level of the surgeon, there’s always a risk that you can misjudge and be in the wrong plane, and this is completely avoidable with direct visualization.”
“That’s especially true of male patients, who have a very thin fat layer, and also massive weight loss patients, who have a very thin fat layer, so they’re at higher risk for intramuscular injections.”
The thinner you are, the thinner the fat layer, and the more this question matters. A “skinny BBL” without ultrasound is the wrong way round.
6. Is the facility accredited, and by whom?
Ask for the name of the accrediting body. Ours is QuadA.
7. Who sees me on day three, day ten and week six?
A BBL has sitting restrictions, compression and follow-up visits. If the plan has you on a plane in the first week, nobody is seeing you.
| Question | Real consult | Fourteen-minute chat |
|---|---|---|
| Exam | Hands-on, in person | None |
| Volume per side | A number, with a source | “Skinny BBL” |
| BMI and limits | Stated, with a cutoff | Not asked |
| Case length and lipo volume | Under six hours, under five liters | Not discussed |
| Plane and ultrasound | Above the muscle, ultrasound-guided | Not mentioned |
| Facility | Accredited, named | Not mentioned |
| Follow-up | Scheduled | A flight home |
The full version, with how I decide whether a combination is right for a given patient, is in the post on Agullo Plastic Surgery. My commentary on the report is on Dr. WorldWide. The safety checklist that took the BBL off the deadliest-surgery list is here, the candidacy questions are here, and the cost conversation is here.
Ready to Talk?
Book a consultation at Southwest Plastic Surgery: call (915) 590-7900, text 1-866-814-0038, or request an appointment at swplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
