Is there a way to correct BBL dents after surgeon didn't do micro-incision? (Photo)

Question

Hi. I had a BBL by a double certified plastic surgeon in NYC but he didn't do a micro incision when injecting the fat rather injected the fat straight onto the buttocks and hence leaving me with these butt dents on both cheeks where you can see exactly placement of each injection. It's visible through clothes as well and even more pronounced when I move around. It's frustrating. Is there a way to correct this? Or learn to live with it. I feel like a walking dartboard.

Ryan A. Stanton, MD · Answer

As always, some before photos would be extremely helpful in evaluating the outcome. That being said, 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, 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 round 2 BBL most often produces the same disappointing results but at another financial loss.   Buttock implants indeed provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often smoothing out lumpiness. Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in 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.

Jeffrey Lisiecki, MD · Answer

This may be exacerbation of existing cellulite or unreleased ligaments, or contour irregularities from the BBL (which is a possible complication of any liposuction and fat grafting procedure). Examination would help determine the cause. There are revision options for each of these, either release of the cellulite with subcision or a device like Aveli, filling the irregularities with a biostimulatory filler like Radiesse, or revision BBL with fat redistribution vs more fat grafting depending on your goals. Some of these options can even be done in clinic under local anesthesia without returning to the OR.

Zoran Potparic, MD · Answer

Unfortunatelly, regardless of the technique used, only around 50% of fat injected into buttocks will servive. Dead fat tissue will partially be reabsorbed by the body and, in part, create areas of inflamation resulting in scarring and fibrosis. These deep and superficial scars which adhere to the skin are most frequently reason for irregularities and dimpling like you experienced. Revision with release of skin adhesions and additional grafting may improve this condition. Hope this helps.

Daniel Barrett, MD · Answer

Dear plasticgirl41,
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 posted photo! YES I offer treatment/surgery to effectively improve those "dents" or " cellulite" areas of the buttock. Using the new AVELI instrument release techniques with injections of macro/micro fat grafts or Radisse/Sculptra injections. Fee $5,000. Best t virtual consult with...

Douglas Taranow, DO, FACOS · Answer

The buttock dents may be released with subcision (using a needle to cut any bands under the skin) then placing small amounts of fat into each dent. 
Dr Taranow

Mats Hagstrom, MD (license on probation) · Answer

Your picture shows classic cellulite which is often made worse by fat transfer. It should not be related at all to what size cannula was used.
When asking for an assessment on the outcome of a procedure patient should always include proper before and after pictures. Patients who have very slight cellulite in the before pictures can expect it to get worse from having fat transfer.
That is the most likely explanation and is a fairly common outcome for those who have very slight cellulite. The anatomic area is very typical for developing cellulite.There’s a reason it happened just in that area. Inner lower parts of the buttocks.
There are a variety of cellulite treatments some better than others.
I don’t think this is related to the BBL other than that adding subcutaneous fat will always make cellulite worse.
Ideally individuals who have any cellulite should be warned that the condition could be made worse from having fed transferred.
Best,
Mats Hagstrom MD

Is there a way to correct BBL dents after surgeon didn't do micro-incision? (Photo)

Answers (7)

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