How Soon After a Brazillian Butt Lift Can You Get More Fat Added?

Question

I had a bbl done 6 weeks ago, and am not satisfied with the volume. I had 960cc's put in each cheek, but feel that a lot was absorbed since the surgery. How soon can I schedule to go back to get more fat added? And will that give me better results as im adding more fat after the initial surgery? With the compression garment on I am happy, but without it on im not happy with the projection of my butt, and i dont wanna hafto wear a compression garment everyday just to have the projection i want

Germán Newall, MD, FACS, FICS · Answer

I generally advise patients to wait 3-4 months after surgery before considering a revision procedure. You also need to make sure you have enough fat to be harvested and injected into your buttocks.If the majority of the fat transferred did not stay in your buttock, it probably means the surgeon did not spin down the fat in a centrifuge before injecting it back into your buttocks. I have found that my fat cell survival rate is between 75-85% when I spin down the patient's fat and use a power-assisted mechanism for fat grafting. This method provides much better results for my patients.

Johnny Franco, MD, FACS · Answer

The majority of patients that have a Brazilian Butt Lift surgery performed are extremely happy.  However occasionally patients do not receive the aesthetic result that they were hoping for from their procedure.  This can be for any of several reasons such as the patient is very thin so there was a limited amount of fat, or the fat did not take as well as the surgeon and patient were hoping.

First of all I would wait at least six months before proceeding with any type of revision.  This time will allow all the swelling and scar tissue to settle.  Then both you and the surgeon will know exactly what the results are and he or she can give you options to improve the results.  Doing surgery before this point is typically a moving target as your body is still changing from surgery.  Also giving your body this time to heal will allow the scar tissue from liposuction and fat transfer a chance to heal so that the next surgery can be as precise as possible.

There are several ways to go about enhancing the results of your Brazilian Butt Lift depending on the individual desires of the patient.  The first and most common is a second session of liposuction and fat transfer.  In patients that have enough fat this is a great option as the liposuction will further sculpt their body and then the fat can be used to add volume and enhance the appearance of the buttock.

However if patients are too thin and there is a limited amount of fat available then other options will need to be considered such as butt implants.  The implants are a great option for thin patients and for patients that have an extremely flat buttock.  There are a wide range of implants that can be used add shape and volume to the buttock after a Brazilian Butt Lift (fat transfer) surgery.

Many patients that come see me get a combination of fat transfer and butt implants to improve the results from their previous Brazilian Butt Lift.  Though the exact treatment plan depends on the individual patient.

The good news is that there are options to enhance your buttock.  Please consult with your board certified plastic surgeon that performs a high volume of butt augmentation surgeries.

Miguel Mota, MD · Answer

Hi. It is best to wait as much as possible before getting another BBL. It is normal for your butt to get smaller at this stage in your recovery. Butt please be patient, it will get bigger with time. It takes at least six months to see something remotely similar to final results. First you lose some volume because swelling goes down first. Then, the fat that does survive goes through a ''hibernation like process". Eventually the skin relaxes and the fat starts to thrive and grow, this is commonly called the fluff fairy affect... and it is real. A second BBL would work. Giving you more volume and projection if you have enough fat for harvest. For the best results possible, suggest you wait at least 6 months for your second round. Best of Luck,Dr. Miguel Mota

Sam Gershenbaum, DO · Answer

The pre op consultation is vitally important to make sure each is on the same page, and to make sure what you are expecting is something the surgeon feels he can reasonably deliver. Many before and after photos should be reviewed to ensure that you are confident in the type of results that surgeon routinely produces. Understanding that no Surgeon can guarantee results of any kind, there should be some understanding of what will be completed and the intended ideal result. With proper liposculpting and 960cc of fat to each side, results should be dramatic. It is difficult to say without an exam, or at least photos of before and after. Is it possible you have nice results and your expectations unrealistic, or are your results simply less than ideal ? Secondly, you have to make sure you are a good candidate for a second BBL. This would need to be determined by at least photos, a consultation and exam being best. Can your liposculpting contours be improved? Is there enough fat remaining to harvest and produce desired results? What areas were treated with liposculpture the first time as compared to remaining excess fat in other areas. If there is enough available fat in areas where liposculpting was not performed the first time, the second BBL could be performed from between 3 and 6 months. If fat must be harvested from the same areas, and assuming there is enough fat, i would recommend waiting from 6 months to one year. The reason to wait longer when performing liposculpture on the same previously treated areas, is to wait for the the firmness and scar tisssues to soften and resolve. You can't see it or feel it, however, areas previously treated with liposculpture can be very firm with scar tissue making the procedure of viable fat harvesting very difficult. Firmness and scar tissue from previous surgery can even continue to soften and and resolve over one year.

Paul Vitenas, Jr., MD · Answer

I would reccommend that you wait at least 12 months before you have more fat injected into your butt. The amount of fat you had placed is a fairly large amount, however, without knowing what technique was used it is difficult to say what the resorption rate will be. It will take about a year for you to see the final result from the grafting as it takes time for the fat to be revascularized and then to grow on its own. Please be patient.

Wilberto Cortes, MD · Answer

This is a very unusual request from somebody having a fat transfer procedure so early. What you are really describing is a poorly performed Brazilian butt lift. Only 20% of the fat is reabsorbed after the procedure. You have almost 1000cc of fat injected into each buttock, which is a significant amount to increase projection.  Was the fat processed after it was harvested?  Were the non &ndash; fat products removed prior to injection? You see, when doing liposuction, only 30% of the collected fluid is fat. If you inject this fluid without processing, then, 70% of this &ldquo;1000 cc of fat&rdquo; will be reabsorbed within the first month. 

	Assuming that you have enough fat for a second fat transfer procedure, then, you will need to wait about 6 months before you can go under knife again.

Armando Soto, MD, FACS · Answer

Hi there-

	Without examining you, it is difficult to say whether further fat grafting would be in your best interests or not.

	Based on what you say about being happy with your butt when your are wearing the support garment, I would be a bit concerned that whats keeping you from being happier with your butt is not an ongoing lack of volume, but the quality and quantity of the skin envelope.

	Discuss this with your surgeon.

Wendell Perry, MD · Answer

In my patients who have had liposuction and fat injection it takes 3 months and sometimes more to see the final result. At 6 weeks is still early and you probably are not close to your best result. You probably still have swelling and your skin has not contracted as much as it probably will.

	Whenever you operate on an area you do not want to go back to that same area until all the swelling has resolved. In liposuction is maybe 6 or more months later. If you go back to try to operate on an area that still have swelling it would be like operating on a rock and you will not get a good result.

	Wearing your garment and considering massage may be a way to help speed up the healing and get your best result. Talk to your doctor about your concerns.

Ayman Hakki, MD · Answer

Thank you for this question. It gives me a chance to dispel a myth: Early results mean  something. Some good early results look poor later and some poor ones look great. I I feel that the surgeon's skills determine the outcome, and that only she (or he) may suggest whether you are being impatient  and should wear a girdle. The question becomes; how do I find a surgeon who can give me good advice  if not happy? I think it is simple; find a plastic surgery board certified surgeon who has done hundreds of Brazilian butt lifts, and has the credentials to perform this surgery at a local university hospital (even if surgery&rsquo;s done in an office setting, it&rsquo;s your way to have others check all credentials). Do some investigating but most of all; wait until the fourth of July before you judge your surgeon, or your result.

	fou

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