Are revision BBLs as successful as the initial procedure, especially as I'll be transferring to a different area?

First, congratulations on a successful first round BBL at achieving upper buttock fullness.

However, 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.). It is not quite as much the quality of the doctor 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. Generally, the fat survives reasonably well in the upper third of the buttock but relatively poorly in the central and lower part of the buttock. Buttock implants provide a much 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. 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.

Hi,Sometimes the skin of the lower buttock will not allow expansion. Without photos it is difficult to tell but you have to consider the future, and the fact there is less support of the lower buttock than there is in the upper. Too much fullness in the lower buttock will sag over time and it might not be aesthetically pleasing. An experienced plastic surgeon who has done many of these procedures would be able to know ahead of time if that would be a concern for you. Best of luck.

Dear Bri3218,
fat viability depends a lot of surgeon technique. The fat has to be placed back into the buttocks as soon as possible so that it has a greater chance of survival. It has to be placed carefully so that not too much fat is placed in only one area. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

As a general statement BBL revisions are much more difficult than the primary procedure.

This is typically the case when patients are not happy with the outcome. When patients are happy with the outcome and I just want more of the same the secondary fat transfer procedures typically work better than the primary procedure.

In order for fat transfer or grafting to be successful one of the primary ingredients is the presence of sufficient and quality host tissue to support the graft.

The lower inner buttocks often fails to project because of connective scar tissue that anchors the skin to a certain distance from the underlying muscle fascia. This is the case on many areas of the body they can tolerate great pressure like the soles of the feet, palms of the hand, upper back of the thighs and lower buttocks.
The best way to describe this is to compare to the palm of the hand. If you pinch and lift the skin on the back of your hand you can easily do so. Now try doing that in your mid palm. The skin will not project because it’s attached to the underlying palmar fascia.

The buttocks can also tolerate a lot of pressure and has the same type of fascia that prevents it from projecting further than the length of the fascia.

Patients who present with a flat spot or lacking projection in this area should be told before the procedure that fat transfer will not increase projection very much however surrounding areas that don’t have this limitation project very nicely in some ways making the condition worse.

The topic is complex and cannot be answered by simply posting on real self. At a minimum we require and seeing quality before and after pictures.

Experienced providers should have a clear grasp and understanding of these concepts making quality assessments accurately without some kind of guessing game of it works “sometimes”

If you’re happy with the work of your provider than follow up with him or her.

Best,

Mats Hagstrom MD