Botched BBL results. Is there any way to fix this? (Photo)

Question

Hello I was l“botched” disfigured by my plastic surgeon whose team blamed me for these horrible results what can I do to fix my butt.

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, 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 implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often 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 B_kisses,
I understand your concern. Based on your photos, it looks like you would need revision surgery. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

Blaming the patient is the first trick in the book, plastic surgeons, sometimes use for failing to take ownership of their own work.
The list of excuses and explanations for less than optimal result is fairly long and extensive and certainly can get creative.
In the end, there are really only two variables that matter when it comes to quality cosmetic surgery outcomes. The first is the patient’s candidacy for the procedure in the first place and the second is the skills and experience of the surgeon.
To make a quality assessment on the outcome of the plastic surgery procedure we always need to see quality before and after pictures. If you don’t have proper before and after pictures, then ask your surgeon to forward the pictures they took.
You should also ask them to forward a copy of your operative report, which could be useful for any other surgeon, who is going to attempt an assessment or revision work.
Revision work is more difficult and complex than primary procedures. You should recognize this when I have been consultations with other providers. There may be opportunities to improve your outcome, but once an operation has been performed it’s never going to be the same potential as somebody had before the first operation. Generally speaking the more procedures, someone has had the less likely they are to get a quality outcome in the more difficult and complex things become.
I cannot emphasize enough the importance of provider selection. While your surgeon is responsible for the outcome of the procedure, you intern are responsible for choosing that provider.
To find the right provider, I suggest patients have multiple in person, consultations with local, board-certified plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own. And experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, representing the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider, How many of these procedures that surgeon has performed or what your results are likely to look like. 
There’s no correct number of consultations needed to find the right provider. Delivering consistent quality Liposuction and fat transfer results is far more difficult than most people realize. The number of plastic surgeons of Shirley mastered this procedure are in a small minority. For this reason, patients should recognize they need to consult a significant number of providers before choosing the right surgeon in order to maximize quality outcomes. For Liposuction and fat transfer, I suggest patients consider having at least five in person consultations before choosing a provider. Sometimes patients need to have more consultations, and that sometimes they might find the right provider earlier.
Take care for now it’s during each consultation, especially regarding the quantity and quality of before and after pictures. Prefer to transfer results. Make sure after pictures were taken at least 3 to 6 months from the date of surgery. Early fat transfer results can look very impressive, but do not in anyway represent final results.
The process of finding the right provider to do revision work is more or less the same as finding providers to do primary procedures. Start the process by having multiple in person, consultations with local plastic surgeons, who seem to do a lot of BBL procedures. Generally speaking, I suggest taking your time and having more consultations than you may think necessary.
Be careful I providers who think they can give you perfect outcomes, or that revision work is simple.
I’ve already discussed the numbers before and after pictures patients should expect to see during a consultation. Those numbers are applicable for primary procedures, but may not apply to revision work since revision work is not nearly as common as primary BBL procedures.
To get an accurate assessment do you need to present providers with quality information. That starts by getting copies of your before and after pictures and your operative report.
Best,
Mats Hagstrom, MD

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