The majority of plastic surgeries are permanent—you can’t undo a facelift or a tummy tuck. But there are always exceptions, and a handful of procedures can actually be reversed, should you not be happy with the end result and/or your aesthetic desires change. Buttock augmentations fall into that category—although this doesn’t mean reversals are easy or something to take lightly. “Be careful with what you wish for when it comes to butt augmentation. When people go too extreme, it often doesn’t work out the way they had hoped. And reversals, while possible, can often be more challenging than the original procedures,” explains Dr. Johnny Franco, a board-certified plastic surgeon in Austin, Texas.
There has been a recent uptick in butt augmentation reversals, particularly with Brazilian butt lifts, says Dr. Matthew Nykiel, a board-certified plastic surgeon in Newport Beach, California. “We’re seeing a similar shift to what we saw in the ‘90s, with breasts. Huge breasts fell out of style in favor of a more natural hourglass shape, and now that’s happening with the butt. People are coming in wanting it to be balanced, not huge and dramatic,” he says. (Case in point: Google “Kardashian BBL reversal” for plenty of fan theories.) Here, more on how—and when—you can reverse the results of three types of butt augmentation procedures.
How to reverse a BBL
“If someone thinks their butt is too big after a BBL, the first thing I tell them to do is to wait,” says Dr. Nykiel. “A lot of things are shifting and changing after the surgery, so I always advise giving it a full year before going back and reducing the volume.” (Waiting also minimizes the likelihood of potential complications from the reversal.) If you’re still not happy, the antidote is fairly straightforward—liposuctioning out some excess fat. That is, unless you had a BBL in another country, where the fat was injected into the muscle—a technique rarely performed in the U.S.—in which case, liposuction isn’t an option. “You can’t put a liposuction cannula into the muscle, as you’d essentially be turning it into a piece of Swiss cheese and poking holes throughout,” explains Dr. Nykiel. Lipo is only the solution if the fat was placed over the muscle.
“I’ve never had anyone want to go back to baseline,’’ says Dr. Nykiel. “Most people get a BBL because they feel their butt is a little deficient. If they overshot it and had too much put in, then we can go in and remove some of it but not all of it,” he says. While the exact amount depends on the patient, he says, he never removes more than 400–500cc of fat per buttock cheek: “That tends to make a significant difference without losing the butt entirely.”
And BBL reversal isn’t just a matter of simply removing the fat. It’s tricky to reduce the volume while still having a good-looking butt; there’s a level of sculpting and artistry required, notes Dr Nykiel. As with any type of liposuction, there is also a risk of fibrosis and scar tissue as well as inadvertent lumps and bumps. Waiting at least a full year after the original procedure gives the tissue enough time to heal and minimizes the likelihood of these developing, he says. It also bears mentioning that while the skin on the buttocks does tend to snap back nicely, it is common to utilize an energy-based skin tightening device, such as BodyTite, during BBL reversal, to further help the skin shrink up a bit once the volume is reduced, adds Dr. Franco.
How to remove butt implants
According to Dr. Franco, requests for butt augmentation reversal most often come from patients who chose too large a butt implant. “The options are to either remove the implant entirely or replace it with a smaller one,” he says. In the instance of complete removal, it’s important to consider the size of the implant. “You can remove a 300cc implant just fine, but if you’re taking out a 700cc or 800cc, you’re likely looking at doing some other type of revision procedures after the fact,” says Dr. Franco. That can include anything from a traditional butt lift (during which an incision is made along the top of the buttocks, to remove excess skin); a thong lift (during which skin is removed from the bottom of the butt); and/or energy-based tightening treatments, he says. Still, the skin on the buttocks does tend to be pretty tight and snaps back nicely, unlike the skin on the breast, where a lift is almost always needed after implant removal, points out Dr. Franco.
He adds that post-explantation butt lifts are typically needed in patients who have extreme skin laxity to begin with, often due to major weight loss. More common is a mini BBL, after implant removal, in order to add a little more shape or volume, he says. For that—or any of the other post-removal options mentioned—it’s imperative to wait at least six months after the explant surgery in order to allow enough time for swelling to go down and the tissue to heal.
Replacing a larger implant with a smaller implant is another possibility, but the challenge is creating and keeping the pocket for the implant super tight. “You really need a hand-in-glove fit for a butt implant so that it’s not moving around. And if you’re downsizing from a 700cc implant to 300cc implant, there’s going to be a lot of excess space in there—and it will be tough to make it fit exactly right,” notes Dr. Franco.
How to reverse butt injections
In his experience, Dr. Franco says, it’s rare that people are unhappy with the results of nonsurgical butt augmentation from injectable fillers. More often than not, patients don’t want a reversal but the opposite—they don’t realize how much product they need and actually want more, he says. If they aren’t satisfied, hyaluronic acid fillers can be dissolved with hyaluronidase—but the more-often-used Sculptra and Radiesse cannot, and patients simply need to wait the three to five years for them to be metabolized by the body. Those who feel their butt is too large after these injections are usually coming in immediately after, when there’s still a lot of swelling and excess fluid, points out Dr. Franco. Once things settle, they’re happy with the results.
Both doctors we spoke with underscore the dangers and extreme challenges that come with reversing illegal butt shots. Silicone is a common illegal filler, and it creates massive inflammation and chronic problems; because it becomes incorporated into the tissue, the only way to remove it is to cut it out. “You often end up needing huge incisions that look like shark bites. It’s essentially impossible to correct while still ending up with aesthetically pleasing results,” cautions Dr. Nykiel.
