RAS Medical Aesthetics

A: Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made. Based purely upon your photos, the problem may be that your implants are not within a total intramuscular pocket but rather on top of the muscle (a.k.a. subfascial or subcutaneous). The classic scenario is that subcutaneous/subfascial buttock implants look good at first but then become saggy/droopy over the next 6+ month’s postoperatively. If this is in fact the case, revision surgery is indeed possible. The current implants can be removed, a brand new total intramuscular pocket created, then new implants placed into this new pocket. Final note, because an extremely few number of board certified plastic surgeons specialize in buttock implants, you may have to travel far and away from your local area to seek consultation with this particular type of surgeon. Glad to help.

A: Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made. Unfortunately I see this outcome from a hard fall onto the buttock not infrequently. Because, by evidenced by the dent, there is significant scar tissue left behind, fat transfer (aka BBL) does not survive well and fillers (eg Sculptra and hyaluronic acids) are a complete waste of money. So, the only reliable and permanent option is a buttock implant to pop out the dent and provide long term natural buttock convexity. Please note that an extremely few number of board certified plastic surgeons specialize in buttock or hip implants, so you may need to travel far and away from home to find this particular surgeon. Glad to help.

A: Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made. There are currently only two FDA approved surgical options for augmenting the buttock/hip area: 1) Buttock and cosmetic Hip Implants (which are soft semi-solid silicone rubber implants that cannot rupture &/or leak) and 2)Brazilian Butt Lift (aka BBL) - which utilizes the patients own fat from liposuction then transfers this fat into the buttock. On the other hand, BBL using Sculptra is a dangerous, guaranteed waste of money, and is NOT FDA approved. So what it comes down to, like any surgery, is proper patient selection and long-term results. Implants provide the only guarantee for a sustained permanent result and tend to be ideal for perking up not only lean or deflated buttocks but also providing substantial projection to any butt, which is what every single patient wants. Typically a combination of sculpting the waistline with liposuction and augmenting the buttock with implants +/- the hips with implants provides the best chance for a long lasting and desirable "hour-glass" figure. Based upon your photos, you obviously do not need liposuction but, a Stanton Anatomic®️ shape buttock implant may serve you best for permanently enhancing the contour of your buttock. Please read on for more general information. Unfortunately, fat typically melts away leaving disappointing results after 12 months, often sooner. Unless your BBL surgeon is injecting only 200 to 300 ccs of fat into each buttock cheek, a large percentage of that fat is going to die. Dead fat leads to dents and dimpling like cellulite, unevenness, loss of projection, and fatty necrotic oil cysts which are hard marbles and can be very tender Unfortunately, because ~70+ % of the fat transferred will melt away within a year or two, most patients are not good candidates for BBL because they lack an adequate amount of fat to harvest. Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation. Even those patients that had adequate amounts of fat pre-operatively, still end up seeking buttock implants after a year or so because most of the fat transferred melted away leaving them with minimal result. Fillers such as Sculptra are cost prohibitive, provided enough volume is injected (i.e. at least 400 cc of active ingredient costing over $300,000) and last only 12 - 18 months. So, if you're looking for a reliable, predictable, and long-term permanent option that also provides projection in the central buttock, buttock and hip implants are your solution. Please note that an extremely few number of board certified plastic surgeons specialize in buttock or hip implants, so you may need to travel far and away from home to find this particular surgeon. Glad to help.

A: Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made. There are currently only two FDA approved surgical options for augmenting/enhancing the buttock area: 1) Buttock and Implants (which are soft semi-solid silicone rubber implants that cannot rupture &/or leak) and 2)Brazilian Butt Lift (aka BBL) - which utilizes the patients own fat from liposuction then transfers this fat into the buttock. On the other hand, BBL using fillers like Sculptra are a dangerous, guaranteed waste of money, and NOT FDA approved. So what it comes down to, like any surgery, is proper patient selection and long-term results. Implants provide the only guarantee for a sustained permanent result and tend to be ideal for perking up not only lean or deflated buttocks but also providing substantial projection to any butt, which is what every single patient wants. Unfortunately, fat typically melts away leaving disappointing results after 12 months, often sooner. Unless your BBL surgeon is injecting only 200 to 300 ccs of fat into each buttock cheek, a large percentage of that fat is going to die. Dead fat leads to dents and dimpling like cellulite, unevenness, loss of projection, and fatty necrotic oil cysts which are hard marbles and can be very tender Unfortunately, because ~70+ % of the fat transferred will melt away within a year or two, most patients are not good candidates for BBL because they lack an adequate amount of fat to harvest. Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation. Even those patients that had adequate amounts of fat pre-operatively, still end up seeking buttock implants after a year or so because most of the fat transferred melted away leaving them with minimal result. In your case with a buttock dent resulting from trauma, there has been loss of fat +/- some muscle mass and undoubtedly scar tissue left behind. Fat grafting would otherwise be a good option except within a bed of scar tissue. Unfortunately, this may be the rate limiting factor when considering fat grafting as an option. So, if you're looking for a reliable, predictable, and long-term permanent option that also provides projection in the central buttock, buttock and hip implants are your solution. Please note that an extremely few number of board certified plastic surgeons specialize in buttock or hip implants, so you may need to travel far and away from home to find this particular surgeon. Glad to help.