Alexander Hamers, MD

There are worldwide recommendations from the Task force for Safety in Gluteal Fat Grafting to reduce the risks in BBL surgeries.Fat embolism during surgery can happen when there is injury to deep veins. They are deep to the gluteal muscle fascia. So buttocks lipoinjection should be performed carefully and it should be avoided to inject into the muscle. There are also other tools and techniques to reduce the risks like ultrasound mapping, special patient positioning during the surgery, canullas that are resistant to bend during injections. I hope this answer can help you. Kind regardsAlexander T. Hamers MD

In general this is a question your plastic surgeon should explain to you. The recommendation should be: the first at least two weeks you lay flat in the prone position (on your belly) on the rear seats. in order to full-fill local regulation, maybe you need to somehow use a seatbelt in this position and I would recommend to try this prior to the surgery

Dear Cosmopolitan12, A BBL fat grafting should result in healthy and living fat cell transfer from not desired areas like abdomen, love handles, etc. to hips and buttocks. Therefore weight chances results directly to volume chances of the buttocks. It is not important how you achieve this weight chances, in your case body weight reduction due to glutides. Think about fat cells like they are bags for storage- if you reduce your body weight, they will shrink, if you gain weight, they will increase in size and so will your buttocks

Dear ak887 in general this is a question your plastic surgeon should explain to you. The recommendation should be: the first at least two weeks you lay flat in the prone position (on your belly) on the rear seats. in order to full-fill local regulation, maybe you need to somehow use a seatbelt in this position and I would recommend to try this prior to the surgery

Dear lucieluv2these are two completely different techniques of liposuction BodyJet or Water Jet assisted Liposucction (WAL) is liposuction with this special device consisting of a liposuction canula that sprays Water (to be true normal saline) into you fat tissue and in the same time aspirates the fat. Meaning in total you probably use more liquid than in a tumescent liposuction but: the fat is shorter in contact with the water (there is less tissue swelling DURING the surgery) and there is less swelling of the extracted fat cells. The swelling of the fat cells is just relevant if you are planing to use the fat for fat grafting - like in BBL, fat grafting for breast or face.In lip-edema patients this technique is deemed to be safer and better as well. Using BodyJet in losse skin patients therefore needs an additional technique for skin retraction (mostly radio frequency (RF) or laser) that can be added in the same surgery at the end. Vaser on the other hand is an ultrasound technique for liposuction that in the same time gives some skin retraction. Therefore no other skin retraction technique may be needed and if combined, there may be a higher risk of skin damage.Due to the ultrasound there may be more harm to the extracted fat cells, that may be negative in case of fat grafting.Normally Vaser is performed in tumescent (so a certain amount of liquide is injected prior to the liposuction) resulting in fat cell swelling with negative impact in case of fat grafting.

Dear Syh093, first of all, after the primary healing fase of a vaginoplasty (mostly 6 weeks) yes you should and need to do some Kegel! Since the vaginal tightness depends on its muscles and these can only be tightened by training (Kegel) like any other muscle. A vaginoplasty can only treat the entrance and the outer 3 to 4 inches (10cm) and not up to the cervix, but this should make the important improvement to you and your intimate live with your partner. The dilated pelvic flor muscles mostly on the posterior wall are sutured and tightened. the question if a rectocele always needs to be treated in the same surgery depends on the severity and on the decision you took with your treating surgeon, either it is a plastic surgeon or a (cosmetic) gynecologist

Dear sorch2332, normale this should not be a problem. Depends for sure, why and how long you are going to take the antibiotics. You should of course tell you plastic surgeon and the anesthesiologist about the antibiotics, why and how long you took them.

Dear unknownlux, in your case, as in quite a lot of body feminization surgeries, you have just very little tissue on the hips, so se recipient tissue is limited. Since fat grafting only works in a certain relation from recipient tissue and grafted fat, the amount of fat for grafting (at least in the first round) is limited. you would probably benefit from at least 2 rounds of BBL. Regarding Implants, these give mostly more projection to the back, but limited widening of the hips - here fat will work better. In summary, the best option would be step one 360° Lino and BBLstep two: either 2. round BBL or supercharged BBL (implants and fat grafting) (And no, doing so in the first step will reduce the possible amount of fat grafting, so this is not the best option) regarding tightening devices with either laser or radiofrequency (RF - like in Bodytide, J-plasma or similar devices): these will NOT treat the visceral fat, because visceral fat is around the intestine and below the abdominal muscles - this fat can just be treated by sport, diet and weight loss! Yes it can tighten the skin, but not the muscle.

Dear Lovesnowbunny2020, you should at least wait a minimum of 6 month after a chemotherapy before considering any major elective surgery and a fat grafting. If your GY or breast surgeon deems you fit and healthy enough, and your 6 month follow up on the breast cancer was ok, and you feel ready, you can go for a round 2

Dear @Bright813121 based on your pictures and BMI you would be a good candidate for a "Skinny BBL". With the amount of fat that can be grafted it is possible to fill in your Hipdips for a rounder hip. To come closer to your desired result, you need to add weight. The best results we have seen are patients with a BMI from 24-27. A good option for you is a so called "supercharged BBL" , this combines fat grafting plus buttock implants in one surgery. Plus the liposuction of the abdomen and back will already improve your shape and your waist to hip ratio. I recommend you to find a board certified plastic surgeon and talk about your expectations, aftercare etc. Best regards!Dr. Alexander Hamers , MD Board certified plastic surgeon