3 years post-op - very lumpy, what is this and what can I do? (Photo)

Thank-you for your question. It would be better if we could see your pictures from before the surgery as well. Based on your photographs, you have fatty deposits which are uneven and superficial. My usual approach for this would be do a Thermitight tight procedure followed by another session of Fat grafting. This would tighten the skin, add volume and even out the contours. Please find an experienced Board certified Plastic surgeon near you who specialises in these procedure who can examine you and help you with your concerns.

Hello @LadyParis, I appreciate your question. Whenever you are carrying out your surgical, it is important to take into consideration what you expect and what you may be able to achieve in the long run. To determine the best course of action, a personalized consultation is necessary, in which all aspects are considered. Best wishes! Alan Gonzalez MD, FACS.

Dear LadyParis,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hi, LadyParis ! Thank you for your question and photos.
Sometimes, the injected fat migrates downwards and worsens the appearance of the cellulites. The cellulites basically result from the attachments between the connective tissue and skin. So the best result can be provided by a skin-removal surgery, where these connections are released and skin excess is removed on both sides, so that buttocks are lifted and smoothened at the same time.

Thanks for posting photos. Appears as very severe cellulite with some dermal to sub cutaneous dents. I recommend a combination of hyper dilutedRadisess/Sculptra injections in a few sessions . The fees are based on the # of syringes or vials used. I usally start at $6,000 per session. I believe you may need 3 + sessions.

In order for us to make an assessment on the outcome of a procedure we always have to see proper before and after pictures. If you don’t have before and after pictures then please contact your surgeon and ask them to forward the ones they took.
If you’re not happy with the outcome of your procedure and the first thing to do is to follow up with your provider and discuss your concerns with him or her.
Delivering consistent quality liposuction and fat transfer results is more difficult than most people believe and this includes plastic surgeons.
Likewise the approach to have the BBL should be done varies between individuals as well. There is a tendency to do liposuction of the outer thigh and create caricature looking excess of bottoms which destroys the natural feminine S-curve providers should be trying to obtain.
In my opinion there’s a lot of bad BBL‘s being done. in a large part it’s because the providers simply don’t grasp what an attractive body should look like and focus exclusively and just making the buttocks as big as possible.
Without taking the rest of the body into context results often don’t look good.
Without knowing what you look like before we can’t assess the change that was done.
To get a proper second opinion consultation you should rely exclusively an in person consultations and come prepared which means bringing copies of your before and after pictures as well as copies of the operative report from your previous surgery. These are all available if you contact your previous surgeons office.You may or may not have been a good candidate for a BBL in the first place. It looks like you have some cellulite in the flat spot on the lower or mid buttocks. That area has a lot of connective tissue and often fails to project with fat transfer. The surrounding areas will project nicely and the flat spot is made worse from the BBL. This is predictable before surgery and experienced providers should steer patients towards or away from having the procedure accordingly based on who is a good candidate or at least warn them about inherit limitations.
I continue to say that delivering consistent quality results with these procedures is difficult and considering the revision work is many times more difficult than primary work it goes without saying that if you’re going to have revision surgery it needs to be done by someone who can consistently deliver quality results.
Defined the best provider try to stay local and insist on in person consultations whenever possible.
Patients should avoid virtual consultations whenever possible and this is especially true for revision work.
During consultations ask each provider to show their entire collection of before and after pictures especially of patients who have similar body characteristics to your own. Simply seeing sample pictures or representative pictures which most likely represent the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of that provider. Ask the provider to show as many before and after pictures of patients were similar body characteristics to you around. Also ask them to show you examples of excellent outcomes, average outcomes and less than outcomes.
An experienced provider should have no difficulty showing you a minimum of 50 sets of before and after pictures. Highly experienced surgeons will have hundreds or even thousands to choose from.
With revision work providers may not have that many pictures to choose from but it’s the same general idea of vetting plastic surgeons correctly and interviewing enough of them to know who do you think will deliver the results you’re hoping for consistently.
Most providers will tell you they have lots of experience and are good and procedures so that needs to be confirmed by reviewing their work.
With fed transfer make absolutely sure that after pictures are always taken at least three months from the date of surgery. Early fat grafting pictures can look very impressive but do not at all represent final results.
The flat spot on the back of your buttocks represents connective tissue that is not going to project by adding the volume. Adding volume and all the surrounding areas made the flat spot worse.
The best analogy I can use to demonstrate how connective tissue prohibits skin projection is the pinch the skin on the back of your hand and see how you can tent up the skin and the skin can freely move in this area. If you try that in your mid palm you’ll recognize that you cannot get the skin to project at all in this area. That is because just like the lower inner buttocks the palm of the hand has connective tissue that anchors the skin in place and this does not allow the skin to move it very much.
This is usually predictable and before pictures and patience should be told in advance that the results will not have the curved round appearance they were hoping for.
If you’re ready to have a revision procedure then start the process of finding the most talented and experienced provider for BBL procedures in your community. It requires a substantial number of consultations and some providers may not be willing to do revision work from poor outcomes from other providers.
Start consulting, vet each provider appropriately and continue until you feel you found the right provider to help you with your needs.
Best,
Mats Hagstrom MD