Q: Can a BBL revision help reduce cellulite?

A secondary BBL alone can’t treat or reduce cellulite . In fact, it may actually make it worse. Cellulite dimples are caused by septa, fibrous bands that connect skin to the fascia that covers muscles. Fat lies in compartments between those tight bands. When more fat is added, the dimples can become even more noticeable. Cellulite treatments like Avéli sever the septal bands, to release the skin and smooth out dimpling.

Question 1

What is Brazilian butt lift revision surgery?

Accepted Answer

Brazilian butt lift revision surgery is performed to enhance or correct the results of an initial BBL procedure.

An expertly performed BBL revision surgery can:

increase the buttock size and projection
address contour irregularities, dents, lumps, rippling, or “skin trenches”
improve symmetry

Your surgical plan will depend on your unique concerns, anatomy, and desired results. Some revisions involve transferring more fat to enhance the buttock shape or size, while others selectively remove fat via liposuction.

“Sometimes I do a combination of butt implants and more fat grafting, depending on the individual patient needs,” says Austin, Texas, plastic surgeon Dr. Johnny Franco. For instance, if a patient is too thin and doesn’t have enough excess fat to be harvested and transferred to the buttocks, butt implants can round out the area and create more projection.

Most surgeons on RealSelf advise patients to wait at least six months (possibly a year) before a gluteal fat augmentation revision. It can take up to a year for the fat to be revascularized and survive on its own, and for the swelling to resolve so you can see the final results from your original procedure. At this point, you and your surgeon will be able to assess your options to improve them.

“Doing surgery before this point is typically like trying to hit a moving target, since your body is still changing from surgery,” says Dr. Franco. “Also, giving your body time to heal allows the scar tissue from liposuction to soften and give the fat transfer a chance to heal, so that the next surgery can be as precise as possible.”

Some issues may work themselves out during this waiting period. For instance, fat necrosis, which occurs when transplanted fat dies and becomes nodular (which feels like a firm, round lump), usually softens with time and resolves within 6 to 12 months. If it persists or causes pain, it can be carefully removed with liposuction.

Related: Don’t Like Your Butt Augmentation? Here’s How to Reverse BBLs, Injections, and Implants

When considering revision surgery, patients need to manage their expectations, cautions Dr. Ricardo Rodriguez, a board-certified plastic surgeon in Lutherville, Maryland. “Every time you go back, there’s a little bit more uncertainty.”

These factors make it all the more crucial that the surgeon performing your surgery has extensive experience in secondary BBL procedures. Many of the best BBL revision doctors specialize in correcting the results of procedures performed by less experienced surgeons.

Brazilian butt lift surgery has a higher incidence of post-op complications than most cosmetic procedures because of the wide range of techniques used and varying skill levels of the surgeons performing it. Not all surgeons who offer gluteal fat augmentation have the training necessary to perform this complex procedure or know the safest and most up-to-date techniques, so doing your homework and choosing a board-certified plastic surgeon is essential.

Most BBL complications are related to poor processing of fat, Dr. Rodriguez explains. He recommends asking detailed questions about how your prospective surgeon processes the fat. “Does the surgeon harvest the fat at low pressure? Does the surgeon rinse the fat, to rid it of impurities? Does the surgeon inject the fat little by little or in large chunks, which have lower survival rates?”

According to Dr. Rodriguez, poorly processed fat can undergo necrosis (cell death) once injected. “This will cause inflammation that can lead to nodules, infection, and pain, among other complications.”

Question 2

What are the pros and cons of Brazilian butt lift revision surgery?

Accepted Answer

Pros

BBL revisions can address complications and help you reach your goal of creating a fuller, rounder, shapelier backside.
The surgery can often be performed through the existing scars. If new scars need to be made (for instance, if a different donor site is going to be used to harvest the fat), the incisions are typically very small (less than half an inch long) and can be well-concealed.
The transferred fat should survive at the same rate or possibly better than it did during the first BBL procedure.
Secondary procedures may cost less than primary procedures, especially if you return to your original plastic surgeon.
If you just need a touch-up, the downtime will be shorter than after your initial surgery.

Cons

You need to wait at least six months to have a revision procedure. “If fat must be harvested from the same areas, I’d recommend waiting six months to a year for any scar tissue to soften and resolve,” says Miami plastic surgeon Dr. Sam Gershenbaum.
It may require multiple treatment sessions to correct what you don’t like.
You may not have enough fat to achieve the result that you want.
Depending on the goal of the surgery, recovery—which includes not sitting directly on your butt for at least two weeks—may be as lengthy as it was the first time around.
The BBL revision risks are largely the same as those for a primary Brazilian butt lift procedure, but there’s an increased risk of contour deformity and/or skin damage (especially if liposuction is performed in areas where you’ve previously had liposuction).
Results can usually be improved, but it’s not a guarantee that you’ll like your revision result. During your initial consultation, make sure you and your surgeon are aligned on realistic expectations for the outcome.

RealSelf Tip: Make sure your BBL revision surgeon is a board-certified plastic surgeon who has years or decades of experience in advanced body-sculpting techniques; has great reviews and before and after photos; and is a member of a reputable society, like the American Society of Plastic Surgeons or American Society for Aesthetic Plastic Surgery.

Question 3

How much does Brazilian butt lift revision cost?

Accepted Answer

Costs for a BBL revision vary greatly. You’ll have fees for anesthesia, the facility, and surgical supplies. Beyond that, the surgeon’s fee will depend on the complexity and length of your procedure.

Touch-up procedures can be relatively reasonable, especially if you return to your original surgeon. Some surgeons even waive their fees for certain revision procedures.

If you have a more complex case that requires lipo in multiple body areas (for fat harvesting or body contouring), your surgeon will probably have to charge you more for their time.

Some patients also opt for complementary procedures, such as breast augmentation or a tummy tuck, that can dramatically inflate the final bill.

The experience level, credentials, and practice location of your plastic surgeon will also influence the cost. You’ll likely get the best rate from your primary surgeon, while one who’s fixing a poor result from your original provider may charge a premium.

Cosmetic surgery procedures aren’t covered by insurance, but most plastic surgeons offer payment plans or accept third-party financing options, such as CareCredit.

Question 4

Brazilian butt lift revision before and after pictures

Accepted Answer

The Brazilian butt lift revision photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

What happens during BBL revision surgery?

Accepted Answer

Depending on what’s being done, BBL revisions can take anywhere from 30 minutes to two hours or more.

It’s possible to have a minimal touch-up under local anesthesia, but more complex BBL revisions are typically performed under general anesthesia or intravenous sedation.

Revision surgery is always more difficult, and revision BBL is no exception, says Dr. Rodriguez. “If you perform liposuction in the same area as in the first surgery and have scarring, you’ll likely have more bleeding—and it may be more painful for the patient. Everything just gets kicked up a notch.”

There are three possible components to a BBL revision procedure:

Liposuction and contouring of abnormal areas in the buttock (if there are any)
Liposuction to harvest additional fat or contour around the buttocks
Additional fat grafting in targeted areas

Just prior to your procedure, your surgeon will mark other areas of the body that will be liposuctioned for fat harvesting and outline the areas they plan to augment or correct.

Once the fat has been harvested, it will be purified to isolate the most viable fat cells.

The purified fat will be loaded into syringes or cannulas and carefully injected into the buttocks, to increase their size or improve contours. Your surgeon may use a technique of precise layering and massaging so that the fat settles correctly, with a smooth result.

Surgical drains may be inserted to prevent fluid buildup (seroma) that can lead to infection, though drains are not needed if the surgeon uses small liposuction cannulas and small injection cannulas.

When the procedure is complete, you’ll wake up wearing a compression garment. You’ll be groggy, so make sure someone you trust is there to get you home safely.

RealSelf Tip: The gluteal area is very vascular. Fat that enters a vein can be carried into the heart or lungs, creating a fat embolism that blocks those critical vessels—a potentially life-threatening situation. Before signing up for more surgery, find a plastic surgeon who knows and follows the latest safety protocols.

Also ask your potential surgeon if they’ll use ultrasound to image your buttocks before or while performing a secondary surgery. According to Dr. Rodriguez, there’s a solid rationale for doing so. “In normal virgin BBLs, the planes between the skin and the muscle fascia are soft and well-defined. But in a return case, you can hit adhesions that can drive you into the muscle. The use of ultrasound will help the surgeon stay in the right plane—above the muscle.”

Question 6

What is BBL revision recovery like?

Accepted Answer

The initial recovery after a BBL revision can take between two and six weeks, depending on the extent of your procedure.

Plan to take 10 to 14 days off work and avoid sitting directly on your buttocks for at least two weeks, unless your surgeon says it’s safe for you to sit for 30 minutes or less, every two hours.

“Too much pressure on the area can compromise the blood supply to the new fat and cause it not to ‘take,’” says Dr. Rodriguez. Venous congestion (fluid build-up) can also affect fat graft survival.

You’ll need to wear a compression garment for up to six weeks to reduce bruising and swelling, and to help any loose skin retract.

Pain, swelling, and bruising should begin to decrease after about a week. However, pain from liposuction in a previously liposuctioned area may be worse than after the first procedure. Follow your doctor’s instructions for pain management.

Your provider may also recommend avoiding strenuous exercise for six weeks.

Question 7

When will you see BBL revision results?

Accepted Answer

You’ll see your initial results immediately, but it can take four months or more to see your final results, once most of the swelling goes down.

About 60–80% of the transferred fat survives a primary BBL, and the percentage of fat survival for a revision procedure should be about the same, if not more.

To maintain your results, it’s best to stay within 10 to 20 pounds of your operative weight. Weight loss can lead to lost volume, while gaining weight can emphasize areas with a high fat volume and create asymmetry. Doctors on RealSelf recommend a healthy diet and exercise to shed unwanted weight, for a more natural-looking result than a surgical solution.

Question 8

Can a BBL revision help reduce cellulite?

Accepted Answer

A secondary BBL alone can’t treat or reduce cellulite. In fact, it may actually make it worse.

Cellulite dimples are caused by septa, fibrous bands that connect skin to the fascia that covers muscles. Fat lies in compartments between those tight bands. When more fat is added, the dimples can become even more noticeable.

Cellulite treatments like Avéli sever the septal bands, to release the skin and smooth out dimpling.

BRAZILIAN BUTT LIFT REVISION

Ricardo L. Rodriguez, MD

Karyn Repinski

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Ricardo L. Rodriguez, MD

Karyn Repinski

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