Brazilian Butt Lift Reabsorption Concern?

Since with Brazilian Butt Lift, there is re-absorption, should the PS overfill? I am concerned as I search the internet before my consult.

I am African American with a sizeable backside from the top that just drops off to nowhere from the sideview.

Since there is plenty of fat to take due to my being overweight, is there a certain amout he can take and will there be a limit on number of areas? Thanks!

Doctor Answers 9

Fat graft withering

It can happen.  It usually doesn't more than about twenty or even thirty percent.  I used to tell patients up to sixty percent so they would expect less and be pleased with more.  The lipo transfer techniques have changed and fat banking is an option now in order to reinject without having to undergo the liposuction again.  It's a thought and I offer it to my patients when they are not able to deal with the possibility of resorption.



Dallas Plastic Surgeon
5.0 out of 5 stars 119 reviews

Should I be worried that some of the fat will be absorbed after my Brazilian Butt Lift?

Hi there-

When we perform Brazilian Butt Lifts in our Orlando Plastic Surgery Center, we always overfill a bit, because even with the very best technique there will always be reabsorption of 20-25% of the fat grafted. I think you would find this to be true for almost all of the experienced and skilled Brazilian Butt Lift surgeons you might interview.

With regard to the amount of fat used, there is not really a limit on the areas from which we would be able to remove fat from, but good surgical practice and safety guidelines dictate that we remove no more than 4 liters at a time without hospitalization. This is a very large amount though, and I can tell you it is never an issue in my practice, as most people who need this much fat suctioned are usually advised they should lose weight first...

Once the fat is harvested, the volume of fat grafted to the buttock will depend on your individual goals, your skin, and the technique of the surgeon. Average volumes grafted in my practice are anywhere from 400 cc to 800 cc per cheek, although I have used as little as 300 cc and as much as 1000 cc in the past.

Please be sure to find a surgeon you like and feel you can trust- here's a bit of help understanding how to do so:

In a previous entry, I described how common it is for patients who contact my Orlando plastic surgery center to make the mistake of thinking that:

Anyone offering a plastic surgery procedure MUST be appropriately trained and certified to perform that procedure; this is, unfortunately, not the case.

All plastic surgery training is equal, and so shopping for the best price is the best way to choose a surgeon

In that previous entry, I explained how not all people offering plastic surgery are Board Certified Plastic Surgeons, and in fact, many are not even plastic surgeons! There are now many doctors in other specialties offering to perform plastic surgery procedures without the benefit of the years of training a plastic surgeon receives, convincing their patients that a few weeks of training is sufficient for them to learn what we learn in YEARS.

I explained the potentially dangerous error of choosing based on price.

Finally, I explained how to properly choose not only a surgeon, but also the importance of choosing the facility in which the procedure will be performed and also the anesthesia provider.

For today's entry, we'll assume a healthy understanding of these issues. Having done your homework, and ascertained that the surgeons you are considering are all plastic surgeons Board Certified by The American Board of Plastic Surgery, the facilities in which they operate are all certified by the AAAASF or JCAHO, and the anesthesia providers are all well-qualified, how do you make the final decision?

Here are my recommendations:

Consider the relative quality of the surgeon's medical school educations. While it is true that most medical educations will cover the basics, there is a reason that some institutions grow international reputations and perpetually fight for the best students.

A medical school education among these "Best and Brightest" students and educators could reasonably be expected to produce (and historically has produced) America's finest doctors and surgeons. Ranking lists of medical schools take these things into consideration and are a useful resource. The most respected list, from US News and World Report, can be found here:

Find out where the surgeon completed his/her Plastic Surgery Residency. This is the critical and years long process of going from a medical student to a qualified plastic surgeon, where we learn to do plastic surgery by gradually taking on more responsibility under the watchful eyes of other, already trained and experienced surgeons. Just like medical schools, not all training programs are equal in the breadth, intensity and quality of training offered.

Generally speaking, those programs associated with the best medical schools also provide the best training, as they will be able to attract and retain the best, most experienced and reputable professors of plastic surgery- and the quality of our training will depend on the quality of those training us. For example, I completed my own Plastic Surgery training at Washington University in St. Louis, one of the top 5 medical schools in the United States- and it also happens to be the birthplace of American Plastic Surgery.

It bears repeating that you should be absolutely sure that the surgeon you are considering is Board Certified by The American Board of Plastic Surgery. This is easily done at the Board's site:

Know that surgeons who claim to be "Board Eligible" in plastic surgery are NOT board certified. This may be because they simply have not taken the examinations- but this is doubtfully the true explanation, as The American Board of Plastic Surgery specifically prohibits claiming ANY status with The Board until and unless you have passed all examinations. Much more likely is that they were unable to pass the examinations (or simply never took them), but realize they may lose patients if they don't find a way to fool them into thinking they have status with The Board. Are you starting so understand that not all doctors have integrity?

Spend some time thinking about the interactions you have had with the surgeon and his/her staff. You should realize that having a plastic surgery procedure is NOT a singular interaction, like buying a new handbag, in which once the bag is purchased (or the surgery completed) the interaction can be considered to be complete. Rather, you are choosing to enter into a very important relationship with your surgeon, the critical portions of which should be expected to last at least a few months beyond the date of your surgery, as you recover and heal. This very important relationship should therefore be approached with the same care you would give any other... think about whether you think the surgeon will be responsive to your needs and concerns, whether your personalities will allow healthy interaction, the approachability of his/her staff, etc...

Remember- you don't only want to have achieved a great outcome when all is said and done... you want to have had an uplifting and positive experience you can look back on and smile! You can have this in the best practices.

Finally, never forget that what you are really looking for is the very best OUTCOME you can achieve. Sometimes when I'm asked by friends and family how to sort through all the claims some surgeons make of being the best choice because they (the surgeon in question) were voted "the best" by some magazine, or because the surgeon simply says they are "the best", I am reminded of the first Clinton presidential campaign, in which the slogan "It's the economy, stupid" helped Mr. Clinton win the White House. Once you've done the homework outlined above, it's all about the OUTCOME...

Ask to see photos of the surgeon's previous work- and ask yourself if you would be pleased if you looked like the photos they show you. Think about how many good photos they show you. Do most of the outcomes just look funny, with only a few that you think are attractive and natural, or are all of their results pleasing and attractive, even if every one may not be what you specifically want? If the surgeon can't show you at least a few outcomes you find attractive and pleasing, you should look elsewhere.

Be sure to ask directly whether the photos you are being shown are the surgeon's own work (believe it or not, some actually do try to attract patients by showing them the work of others!)

I also always recommend communicating with a few of the surgeon's prior patients who have had the same procedure they are recommending for you. You can ask the surgeon's staff for a list of patients who may have agreed to be called, or find testimonials online at one of the many plastic surgery websites now available. My favorite, because it is objective, free (surgeons cannot pay to be listed higher, so more credibility exists), and allows you to get a feel for the surgeon's manner and personality, is RealSelf:

I know it seems like a huge amount of work, but after you've read this (as well as my prior post) a few times, you'll have a great understanding of the best way to proceed, and it will feel very comfortable and natural to you. Use the resources I've outlined, and use your gut- there are many great surgeons out there- with these guidelines you should be able to attain the outcome and experience you desire.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Some of the fat will definitely be reabsorbed

But hopefully only a small amount, if all goes well. The biggest determining factor, is what you do after surgery. It is important to follow all of the recommendations of your surgeon to get the best possible result.

How much fat can be removed will depend on several factors...your age, health, where the excess fat is, as well as your weight. There is a limit as to what can be done safely. The recommendation is for a limit of 5 liters of fat removal if you are going home after surgery. More can be taken if you spend the night at the hospital. I frequently remove more and always keep my patients overnight in the hospital for both comfort and safety.

The most important things to look for in a surgeon are excellent results and safety! Credentials are important for safety, but don't adequately represent "artistic" skill. Liposuction is truly an art. Be sure that the surgeon you chose has extensive experience in this procedure and can show you Many long term, before and after photos and allow you to speak with other patients who have had this procedure.

Good Luck.

Daniel P. Markmann, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 114 reviews

Brazilian Butt Lift: Fat Reabsorption After the Procedure, Should I be Concern?

The great benefit of the Brazilian Butt Lift is that is uses your own body fat for the augmentation and avoids the need for implants. The fat however survives as a graft, which means that the fat has to be incorporated to the surrounding tissue. The fat then feels and acts just like fat in another parts of your body. This is why you can have such a natural feel to your butt. It also means that you will have a result that will last you for years to come after the initial fat loss.

There are several things that you can do to decrease the amount of fat that is absorbed. One is not sitting after your procedure. The pressure of sitting can injure the fat and cause the fat that has been transferred to be absorbed. The fat needs time to heal and become incorporated in your butt.

If you are a smoker, stop. Smoking also impedes the healing and incorporation of the fat that has been transferred to your buttock. Smoking causes vasoconstriction, which limits the blood flow to you newly transferred fat. The fat needs that blood supply to survive and give you the best result possible.

Platelet Rich Plasma (PRP) has recently gained popularity for aesthetic procedures including enhancement of fat transfer procedures and particularly the Brazilian Butt Lift. The idea is that the PRP is a collection of growth factors. This collection of growth factors is injected into the area where the fat has been transferred to improve the overall survival of the fat transferred and helping patients maintain their butt enhancement.

With all of the above recommendations patients will still lose some portion of their fat that has been transferred for their Brazilian Butt Lift. In general I do put as much fat as possible into the buttock, that it can safely handle. This will help patients achieve the best aesthetic result possible.

Please consult with your board certified plastic surgeon that performs a high volume of butt augmentations to help guide you through your procedure.

Johnny Franco, MD, FACS
Austin Plastic Surgeon
4.9 out of 5 stars 114 reviews

Brazilian Butt Lift Reabsorption Concern?

About 25 to 30% of the fat will disappear after the procedure. There are multiple factors why this happens. Seek a plastic surgeon who performs hundreds of these procedures, has great reviews and photos, and someone who can review these issues with you.

Ron Hazani, MD, FACS
Beverly Hills General Surgeon
4.9 out of 5 stars 289 reviews

Brazilian Buttock Lift fat Reabsorption

Fat resorption is a very complex process that is determined by many factors - surgeon factors and patient factors. In terms of surgeon factors, we use special published techniques to preserve the fat (low suction pressures, no spinning, a closed system, well hydrated fat, multiple plane micro-grafting techniques etc).  Our labor intensive technique is very impressive, but it works well for us. Our results validates the efforts. Patient factors includes the quality of the fat, and patient instructions.  My patients are asked not to sit for two weeks or longer to avoid pressure on the fat grafts. The fat also needs a good vascular bed to heal. A healthy patient who is well hydrated and with good blood flow to the buttocks area will get the best result.

If you and your doctor have done everything possible to optimize the outcome of the fat grafting. It is not unusual to undergo additional fat grafting if desired. Many of our patients do not require additional fat grafting. The best thing is to work with your Plastic Surgeon.

Stanley Okoro, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 160 reviews

Volume of fat to be transferred in Brazilian Butt Lift

There are several issues that effect the decision on the amount of fat to be transferred which include: amount of donor fat, quality of donor fat, method of fat transfer, skin laxity at the recipient site, desired augmentation volume, etc. However, to answer your question, we do generally overfill to the maximum amount the skin an buttock will tolerate.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Buttock augmentation

There should be anywhere from 20-30% fat resorption with gluteal augmentation using fat, if perfomred correctly.  I don't think that one can do better with the current technology.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
4.4 out of 5 stars 6 reviews

How much fat is restored after a Brazilian butt lift

A Brazilian butt lift is a safe and effective procedure that combines liposuction of the abdomen hips waist and back and grafting this fat to the gluteal (butt) region. This is a safe and great way to create a tight waist and abdomen and a full, beautiful bottom. The ultimate results of this surgery depend on surgical technique that is used and the experience of the surgeon. In our practice, we commonly transplant fat from one area of the body to the other. In our experience, we have noted that approximately 20% of the fat that is moved into a new area will melt away. Patients are informed of this and we therefore add 20% more volume than we ultimately want to have. For your best results, be sure that you are only working with a board-certified plastic surgeon was great to experience and body contouring, liposuction, fat grafting, and gluteal augmentation.

Pat Pazmino, MD, FACS
Miami Plastic Surgeon
4.7 out of 5 stars 101 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.