I need to know how to describe the shape that I want for my BBL?

Question

I told my plastic surgeon that I didn't want a butt with a high shelf, but I did want projection. I just wanted it to look like a more gradual slope. He responded by saying, "Oh, you want the bubble shape", but I am not sure that this it the shape I want because we didn't discuss options for shapes and I am not sure that "bubble" describes what I want. Can you please tell me (and show with photos) the different options for shapes?

Donovan Rosas, MD · Answer

BBL goals are not quite as easy to effectively communicate as compared to breast augmentation. There are no cup sizes or informative cc guides.We as surgeons tend to describe things in regards to framing and esthetic zones (as defined by Dr. Mendieta). Beginning with frame, patients are subdivided into "A" frame, "V" frame based on the relationship of the A point to the B point. The A point is the most prominent bony point on the upper hip-the iliac crest. The B point is the prominent bony point on the lower hip- the greater trochanter. When the A point is wider than the B point you have the "V" frame which is generally considered less aesthetically desirable. When the ratio is flipped with the B point being wider than the A point you have an "A" frame which is more desirable. When the two points are equal you have a "square" frame.The goal of most BBL procedures is to convert "V" or "Square" frames into "A" frames by understanding the 11 aesthetic units from which we either harvest or transfer fat. These units are:1. Sacrum or "V" zone at the top of the gluteal cleft2. Flank3. Upper buttock-lower flank4. Lower back-just above the "V" zone5. Outer leg-below the "B" point6. Gluteus-the "apple of the buttock"7. Inner gluteal-"Diamond Zone" crucial for emptying the "thong zone"8. Mid-lateral buttock-"C" point between "A" and "B"9. Inferior Gluteal/Posterior leg10. Upper backWhile this is all very technical, the goal is to achieve an "A" frame by emptying zones 1-4, 7, 10 and building up area 6 and 8. The goal being to cinch the waistline and fill out the frame.With regards to your specific question, the best way to approach a consultation is to decide on your frame and then discuss what areas need to be emptied and what areas need to be augmented.As always, discuss your concerns with a surgeon certified by the American Board of Plastic Surgeons.

Miguel Mota, MD · Answer

Hi. The best advice I can give you is to show your plastic surgeon wish pics. I feel wish pics are great in helping surgeons understand, not only what the patient wants, but most importantly WHAT THE PATIENT LIKES! Knowing what the patient finds appealing, makes it much easier to communicate and understand the patient's goals. It also makes it easier for me to let her know what I can actually offer her.In conclusion wish pics and a thorough conversation is the best way for me and my patients to be on the same page as far as goals and expectations.Best of luck!Dr. Miguel Mota

Richard Zienowicz, MD · Answer

This is a great question as it is important that you and your surgeon are on the same page for the ideal BBL that meets YOUR goals and objectives. The attached link is from the Plastic & Reconstructive Surgery journal and is an excellent guide to the standards of hip to buttock ratios based on your personal ideal for the size and shape. It is a measure that can be objectively defined and then followed in surgery.  You will see the visual guide in the link that I have attached. I also always recommend that my patients bring me in photos of their ideal result. We will review these from various positions always understanding that no two bodies are the same and everyone has different areas and amount of fat that can be lipo-suctioned to the buttocks.

Steven Wallach, MD · Answer

Best to bring photos with you to your appt if you are not sure how to describe it to your doctor. Good luck.

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