Dents on the bottom of butt 6 months after Brazilian Butt Lift - what are my options? (photos)

Question

I'm 6 months post & still have dents on the bottom of my butt & not much side projection. At all my virtual post ops I told the NP, that my dents were still there, but she told me the fat would drop. Dents are still there & my butt shrank a lot. I wore my faja faithfully & followed all instructions. I only took the faja off for showers & to take above pics. My last virtual post op, I was told my skin is lax. Surgery was in Florida, I live in Georgia. I'm heartbroken

Daniel Barrett, MD · Answer

Dear Bechy2000,
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

Darryl J. Blinski, MD · Answer

Great series posted photos of poorly artisticly injections of fat. Only further revision surgery with lipo and inferior lateral transfer can offer any improvements. Must also use ultrasound guided injections. Best to virtual consult with... Call for fees

Cagil Meric Erenoglu, MD · Answer

Hi, Bechy2000! Thank you for your question and photos.
The dentations on the bottom is because the skin there is fibrotic and tense. You need a second fat injection, focused on this dent. and a subcisional release of the skin is required. We need to enlarge the pocket that will accept the fat. Over-correction with some over-pressure fat may be needed. This correction may require more than one session.

Mats Hagstrom, MD (license on probation) · Answer

First and foremost I do not recommend anybody travel long distances for elective surgical procedures.
Patients do not seem to understand the importance of having in person consultations, that to find the best surgeon you need to have multiple consultations, the number of patients who have issues, the importance of in person follow up, The number of patients who need revision surgery or that complications actually happen.
For this and many other reasons I recommend patients stay local for elective surgical procedures.Delivering consistent high-quality liposuction and fat transfer results is more difficult than most people believe in this is true for both patients and plastic surgeons. Most plastic surgeons think they are better at liposuction than they actually are. Liposuction and fat transfer has more variance or difference in outcome purely based on who does the procedure than any other surgical procedure I’ve ever seen. Being board-certified in plastic surgery with an overall good reputation is not sufficient to guarantee that somebody has mastered body contouring. Personally I view the torso as a single anatomic unit and either treated the entire torso or don’t do Liposuction. There are of course exceptions but for the most part I believe in treating the entire torso. A full torso includes upper abdomen, lower abdomen, love handles all the way down to the hip dips, waist, the entire back and under arm area all the way to the side of the breast. this leaves people with a natural thin fat distribution without transition zones between treated and entrteded areas. I’ve viewed the BBL as an enhancement to body contouring creating an ideal feminine S-curve that goes from the armpit to the knee. I did not emphasize a large buttocks with liposuction of the outer thigh creating a big round butt on the small leg which I sometimes called the “lollipop look”. Instead I emphasize long smooth harmonious curves creating a slightly hyper feminized balanced figure. To find the most talented and experienced provider in your community I suggest having multiple in person consultations. I do not recommend patients travel for elective surgical procedures and I recommend patients whenever possible avoid virtual consultations. During in person consultations ask each provider to show their entire collection of before and after pictures of BBL results. Always confirm that after pictures were taken at least three months from the time of surgery. anybody who shows early postoperative pictures such as pictures with patients still showing surgical drawings on them, being in the operating room or any evidence of recently having had surgery should be immediately discounted as showing “.fake news”. Early fat transfer results can look very impressive but do not at all represent final results. Ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. Specifically ask each provider to show as many pictures as possible‘s of patients who have similar body characteristics to your own. An experienced provider should have no difficulty showing you a minimum of 50+ sets of before and after pictures. Simply seeing a handful of pre-selected sample pictures which in reality most likely represent the best results of that providers career is insufficient to get a clear understanding of what average results look like for that provider. Highly experienced providers will have hundreds or even thousands of before and after pictures and should be willing to give you access during the consultation to see as many pictures as possible. If somebody claims to of done a lot of surgery but doesn’t have a lot of before and after pictures then you should ask yourself why? Do not commit to surgery or pay a down payment during the time of consultation until you’ve finished all your consultations and have given yourself plenty of time to think about your decision. The results from these procedures are permanent and irreversible. When in doubt slow down and schedule more consultations. Finally I recommend patients read all reviews on all various physician review websites avoiding providers for any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling and having an abundance of positive reviews. Plastic surgeons with the biggest social media profiles are not necessarily any more talented than those who have no websites at all. Famous or likable does not equal talented. Find the right plastic surgeon and everything falls into place. 
In your case I’m not sure if your surgeon did liposuction of your thigh but fat should’ve been grafted onto your outer thigh to create an ask curve not the “lollipop look”. Patients who have cellulite should consider not having fat transfer pick a cellulite is made worse from fat transfer.
These are all things that should be reviewed during in person consultations and surgeons with sufficient experience as well as those with high ethical standards or point this out and steer the patient in the right direction.
In the end your surgeon is responsible for the outcome of the procedure and you are responsible for choosing that surgeon.
If you want a proper second opinion consultation then schedule those as in person consultations and come prepared with a copy of your previous operative report and all before and after pictures.
Good luck, 
Mats Hagstrom MD

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