Possible for me to achieve close to these proportions with only liposculpture (without BBL)? (Photo)

Question

Hello, esteemed members of the medical community! Is it possible for me to go from my current SpongeBob-esque physique to somewhat close to the proportions of the 2 "after" pictures(courtesy of Pacific Liposuction) WITHOUT a BBL? From what I've read, I don't think I'm up for the kind of recovery associated with the full BBL. Could 360 lipo and a slight fat transfer to my hip dips get me close? And if so, would the recovery be much easier than BBL? Thanks so much!

Randal Haworth, MD, FACS · Answer

Hello ! 
I’ve personally treated patients who had that “SpongeBob physique” (I actually made a video on the procedure that I posted on Instagram) with mild liposculpture and very quick recovery. Based on your pictures, it looks like you wouldn’t need an invasive/extensive procedure and that a liposculpture could offer you the results expected.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether you can achieve body proportions with only liposculpture. Thank you for your history, and thank you for your pictures. Regarding your expected results, the best results would be liposuction and fat transfer. During liposuction, one area is made smaller. During the fat transfer, the other area is made more prominent. This makes the differential of the shapes much better. Suppose you cannot deal with the recovery associated with an entire BBL. You may consider partial fat transfer to the hips. This is much less of a recovery than a BBL. Either way, whether you're doing fat transfer to the buttocks or the hips,, I would suggest 360 lipo. Therefore, my vote is for 360 lipo and a BBL. If you cant do that, I would suggest 360 lipo and fat transfer to the hip dips. If you can't do that, then I would suggest the third option, which would be 360 lipo.

Carlos Marciales, MD · Answer

You can do liposuction 360 and bbl and hips no trouble, I sent mi patients to do workout in 15 days after the surgery, no trouble, you willHave amazing result

Darryl J. Blinski, MD · Answer

Great posted photos! You are confusing terms or were told incorrect terms from that surgery center? You need lipo 360 and Lateral BBL or Hip Dip BBL..... Fees from $6,000 in Miami. Best to virtual consult with...

Mats Hagstrom, MD (license on probation) · Answer

I think you are an excellent candidate for liposuction and you should be able to get a very high quality outcome without eating fat transfer. well done fat transfer can accentuate the results and hyper feminized even further.
It does add a layer of complexity to the procedure.
When it comes to liposuction or BBL results there are generally only two variables that matter. The first is patient candidacy and the second is the skill of the surgeon.
There are substantial differences in outcomes depending on who you choose procedure.
I generally prefer to treat the entire torso when doing liposuction in order to leave people with an even thin natural fat distribution without transition zone between treated and untreated areas. A full torso generally includes upper abdomen, lower abdomen, love handles(beginning at the top of the hip dip), waist, full back and under arm (armpit) all the way to the side of the breast.
I called that a full torso and it is the ideal way to do this procedure.
If you partially treat your torso you will have contrasting areas between treated and untreated areas that don’t always look natural.
The best analogy for treating the entire torso as a single area is painting a house. if you’re painting a house a new color it’s probably a good idea to paint all the walls while you’re doing it.
In regards to the front of your abdomen there are four variables to determine what the abdomen looks like. Subcutaneous fat is only one of four variables. The other three variables that determine what the front of the abdomen looks like include skin laxity, muscle separation and excess visceral fat. Your abdominal wall has slight bulging most likely because of previous pregnancies. Muscle separation can only be improved by having a full tummy tuck. some of the bulging of your abdomen may be due to excess visceral fat and reducing visceral fat through weight loss should improve the front of your abdomen to some degree. it is the one part of your body that will not respond completely to Liposuction because there are issues other than subcutaneous fat that are contributing.
For everything else Liposuction is the correct procedure.
Overall I would say you are a good to excellent candidate.
The following is some overall general information about how to choose providers and go through the process.
You can certainly discuss having that transfer during consultations.
Recognize that Liposuction is one procedure and fat transfer is another procedure. Individuals who have a fat transfer need to vet their providers regarding skill of both Liposuction and fat transfer.
Another thing worth pointing out is that fat transfer results look very different in early postoperative results than what results look like as final results.
When reviewing fancy transfer results always confirm when after pictures were taken.
Early fat transfer results can look very impressive but do not represent final results. it takes a minimum of 3 to 6 months for resolves to be final from both Liposuction and that transfer.
How to find a provider liposuction 
Here’s the process I recommend patient take.
Start by getting pictures of your body the same way plastic surgeons take before and after pictures.
Have someone else take the pictures or use the timer on your camera. pictures should be taken from about six or 8 feet away. Don’t take pictures using a mirror.
Pictures should be taken with the camera at the same height of what’s being photographed. For the abdomen the camera should be at the height of the abdomen. for the thighs the camera should be at the height of the thighs.
Quality pictures require showing your body. Wear loose revealing undergarments that don’t press into your skin. Take pictures of your front, side and back side standing in a neutral position with your arms down by your side.
Print copies of these pictures.
Whenever reviewing before and after pictures whether you’re doing it at home or during a consultation always have your own pictures by your side for a comparison.
Understanding candidacy is key and understanding what the procedure can or cannot accomplish.
When reviewing results look for patients who have similar body characteristics to your own in the before pictures.
If they have different characteristics then what you look like then those results don’t apply to you.
Make a list of all the local board-certified plastic surgeons in your community.
Go to each providers website and document the quantity and quality of Liposuction before and after pictures posted on their website. take a peek at other procedures like tummy tucks etc. for reference. if someone has 25 sets of before and after pictures of the tummy tucks but only has two pictures of Liposuction results then that is probably not The right provider to choose for liposuction. 
This will give you a general idea if providers like doing Liposuction, and do enough liposuction to get enough quality results to post them on their websites. 
Next choose five of those providers and schedule in person consultations.
There’s no correct number of consultation someone needs to find the best provider but the more consultations you have the better you’ll get at doing consultations including the ability to properly vet plastic surgeons and the higher your chance of finding the best provider.
Considering that a substantial number of plastic surgeons simply aren not that good at Liposuction and the number of providers who are excellent at this procedure is rare so you definitely need to have multiple consultations.
Personally I do not believe it’s possible to find the right provider using a computer or by having a virtual consultations.
Virtual consultations are better than no consultation but in my opinion in person consultations are needed to get a quality assessment and to properly vet the provider.
Take careful notes during each consultation. become familiar with what quality liposuction results look like on people who have bodies similar to your own. Create a rating system for Liposuction results.
Recognize that most pictures available on the Internet either represent some of the best results because that’s what the providers usually put out on their website or disastrous results from patients who are seeking help. most average liposuction results don’t end up as pictures on the Internet. In reality the majority of patients get average results and only a few get the very best results. In the end the ability to get great liposuction results as a combination of first and foremost being a good candidate and secondly finding as efficiently talented provider. 
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
Bring printed copies of pictures of yourself to use as reference. 
Ask providers to show you examples of excellent outcomes, average outcomes and outcomes that didn’t turn out as well as they had hoped.
Ask providers to only show you pictures of previous patients who had similar body characteristics to your own.
Again, there’s no point at seeing quality results on somebody who had a different candidacy for the procedure than what you have. 
Providers may be apprehensive to do this and will generally prefer to show you preselected images representing the best results of their career.
Why this perhaps more impressive to look at but it does not represent average results and it is in your interest to find out what the average results look like and to get a clear understanding of how many of these procedures each provider has actually performed.
For reference an experienced plastic surgeon and should have no difficulty showing you at least 50 set of before and after pictures of commonly performed procedures like liposuction. highly experienced surgeons will in fact have hundreds or even thousands of before and after pictures of commonly performed procedures.
Obviously there are those who are earlier in their career.
Personally I recommend staying with skilled and experienced providers.
When reviewing before and after pictures look very closely at all areas treated with Liposuction. Make sure there are no skin contour irregularities in any of the treated areas. ask the provider to point out exactly what areas were treated with Liposuction and what areas were not treated. then look carefully at transition zones between treated and untreated areas.In regards to Liposuction of the abdomen I view the torso as a single anatomic unit and generally prefer to treat the entire torso as a single unit.
By treating the entire torso as a single anatomic unit patients are left without transition zones between treated and untreated areas.
The concept of treating the torso as a single unit without transition zones is less important on low BMI patients. On chubby people with over an inch of subcutaneous fat the impact of liposuction is dramatic enough that it’s not possible to have a natural transition zone between treated and untreated areas even if the procedure is done well. most people simply get a better result if the entire torso is treated uniformly. A full torso includes upper abdomen, lower abdomen, love handles (all the way down to the top of the hip dip), waist, fall back, under arm (arm pit )all the way to the side of the breast.
You should also take careful notes about the overall thoroughness of the consultation including all aspects of a complete consultation like review of medical history, physical examination, assessment, recommendation of procedures, alternative procedures, risks and benefits, complications including what complications a surgeon is had and how they are managed, preparation for surgery, instructions for recovery, revision rates and revision policy etc. 
Take careful notes about both the quantity and quality of before and after pictures any of the provider showed sufficient number of pictures of previous patient that look very similar to what you look like.
Most patients don’t have a lot of experience consulting with plastic surgeons. On the other hand plastic surgeons typically have lots of experience giving consultations.
Recognize that you are the one paying for the procedure and you are hiring someone to do a service for you.
You have all the right in the world to ask for documentation including seeing a variety of results including results that were less than what the provider read hoped for. The goal is to get a clear understanding of what average results look like with your candidacy in the hands of each provider. A sufficient collection of before abd after pictures will generally tell you how much experience each provider has. 
If providers fail to cooperate then simply make a note of that and continue to the next provider.
I think you’ll find that the most talented and experience providers will be the most open minded in regards to showing you a variety of results and being truthful about what the procedure can and cannot accomplish in their hands.
Assessing patience for Liposuction candidacy is not easy or straightforward.
Even mild skin laxity can contribute significantly to contour and some areas simply don’t respond to Liposuction because of how the skin drapes especially in certain anatomic positions or areas. 
Lower extremity liposuction is technically difficult and often does not deliver the results patients had hoped for.
If you have any doubts about providers or having surgery then simply slow down and schedule more consultations.
Nobody has to have liposuction.
Recognize that if provider selection is not done well the procedure can leave you permanently disfigured.
Liposuction results vary more based simply on who does the surgery than any other plastic surgery procedure. 
The truth is most plastic surgeons are not that great at Liposuction.
That is not to say that there are lots of plastic surgeons who are exceptionally talented. It is simply saying that there is great variety of skill out there and being board-certified with years of experience and an overall good reputation does not mean that somebody has mastered this procedure.
It is in the end of the patients obligation and responsibility to properly vet providers to make sure they are in the hands of the best available surgeon for this procedure.
Good luck,
Mats Hagstrom MD

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