I had BBL done. Now I have lumps on each side and flat areas. How can I get it fixed? (Photo)

Question

I want one know if it's possible to transfer fat to one area of the butt to make it look fuller. As you can see the top is big but the other area isn't.

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

You are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, unevenness, lack of projection in the central and/or lower buttock, insignificant hip augmentation, post-deflation sagging, fatty necrotic cyst or scar tissue, etc.) as most of the fat melts away. It is not quite as much the quality of the doctor nor liposuction technique but rather the quality of the procedure that is a large part of the problem.  Thus, going back for additional rounds of BBL most often produces the same disappointing results but at another financial loss.   Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation.

Fillers, such as Sculptra and hyaluronic acids,  for augmentation of the buttock/hips are a rip-off, period!

Buttock/hip implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the hips and central buttock, and often help smoothing out lumpiness. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging.  When considering buttock implants make sure that the surgeon is going to be placing the implants within gluteus muscles , (a.k.a. “intramuscular pocket”), and that they are using anatomically correct, oval-shaped implants, such as Stanton Anatomic ®️ implants. 
Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in these buttock implants so be sure to consult with one that is reputable and experienced. Unfortunately you may have to travel long and far away from home to find this particular surgeon. Glad to help.

Daniel Barrett, MD · Answer

Dear lindacoqueta,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is possible to do fat transfer to a certain area to improve it. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

John L. Burns Jr., MD · Answer

I'd make sure to discuss with your surgeon and review before and after photos.  Repositioning fat could be done in a revision

Zoran Potparic, MD · Answer

This is not so unusual result of BBL considering unpredictability of fat grafts take. A combination of  conservative liposuction and fat grafting is good way to correct your deformity. Hope this helps.

Kenneth R. Francis, MD, FACS · Answer

Dear linda,
BBL revisions can certainly be performed.  The single photo that you provide does not give much information.  Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon for an examination and discussion of your options.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

It doesn’t look like your procedure was performed very well.
It looks to me like your surgeon removed fat from the upper part of your otter thigh in hopes that that would make your buttocks look larger.
This typically leads to a deformed outcome, which is undesirable.
I sometimes called this deformity the lollipop look.
To make an accurate assessment regarding the outcome of any plastic surgery procedure we need to see proper before and after pictures. If you don’t have before and after pictures, then ask your surgeon to forward the pictures they took. It is possible to graft fat into areas that had previous liposuction, but it is technically difficult, survival rates are low and it often requires multiple operations.
This kind of work should only be done by those who have mastered, liposuction and fat transfer.
The number of plastic surgeon serve mastered this procedure are in a small minority.
Delivering consistent quality, liposuction and fat transfer results is far more difficult than most people realize.
I cannot emphasize enough the importance of provider selection.
I generally recommend patients do that by having having multiple in person consultations before choosing a provider.
Best,
Mats Hagstrom, MD

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