3 weeks post-op. Have I damaged the fat in my hips?

No damage incurred for one night.Discuss this with your plastic surgeon for specific guidelines.  I recommend that my patients not apply pressure to the buttocks or hips for 6 weeks.  You have a couple of options:  you can sleep on your sides, or place pillows underneath your thighs and lower back.  I usually recommend about 6 weeks before sitting without a pillow. After 6 weeks the fat has revascularized, and patients will have a very good idea of their final results.  
Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA

Dear kammyb1989,I instruct my patients not to sit for 2 solid weeks. We provide them a specialized pillow that our patients can sit on during that time. They can sleep on their stomachs or sides. Fat viability depends a lot of surgeon technique. The fat has to be placed back into the buttocks as soon as possible so that it has a greater chance of survival. It has to be placed carefully so that not too much fat is placed in only one area.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello kammyb1989,
I appreciate your questions! Plastic surgeons have different post-operative protocols, customized for every patient to achieve the best results. Based on my experience, after performing Brazilian Butt Lift (BBL) you must avoid sitting or sleeping on your back for at least 8 weeks or else the desired outcome will be negatively affected. Putting pressure on your bottom by sitting down or laying on it during the recovery period can stiffen, deform and even cause the transplanted fat cells to reabsorb. In the case you can’t absolutely elude sitting, I would recommend you doing it in a modified position, placing a bolster or rolled-up towel under the back of the thighs while sitting down, as to avoid significant pressure. Moreover, there is a variety of post BBL surgery support cushions available on the market. Getting plenty of rest will also help you remain comfortable and shorten your recovery. I suggest my patients stomach sleeping for least the first 8 weeks after BBL surgery, having different pillows at hand and changing their neck’s position from time to time, to feel more comfortable in bed. Side sleeping (in the rescue position on your side) can also be an option after BBL surgery, but only if you feel certain you won’t end up on your back. Set up an in-person consultation with your plastic surgeon to evaluate the current condition of the newly transplanted fat cells and discuss your specific needs and concerns. Good luck and may God bless you! Dr. De La Cruz.