My butt needs serious help, which would be my best option: Emsculpt, CoolSculpting, or a BBL? (Photos)

Question

Okay, god, I've been going down an internet black hole trying to figure out what I'm the world I can do to fix my incredibly flat, crazy cellulite, big hip dips/love handles backside. I don't think I'm ready for a BBL because I'm scared of it (or should I?) so I was thinking Emsculpt in combo with CoolSculpting of love handles and possible cellfina for cellulite ? And then there's sculptra but I think that's too expensive so I'm not sure. Somebody please give me a suggestion!

Ryan A. Stanton, MD · Answer

Typically a combination of sculpting the waistline with liposuction and augmenting the buttock with implants +/- the hips with implants provides the best chance for a long lasting and desirable "hour-glass" figure. However, please keep in mind that a physical exam is always first necessary before providing any final surgical recommendations. Based upon your photos, a Stanton Anatomic shape buttock implant may serve you best.  Please read on:There are currently only two acceptable surgical options for augmenting and enhancing the buttock/hip area: 1) Brazilian Butt Lift (aka BBL) - utilizing the patients own fat from liposuction then transferring it into the buttock and/or hips and 2) Buttock and cosmetic Hip Implants (soft silicone rubber implants that cannot rupture &/or leak). Both are options but what it comes down to, like any surgery, is proper patient selection and long-term results. Implants provide the only guarantee of sustained permanent results and tend to be ideal for plumping/perking up deflated buttocks. Fat typically melts away leaving disappointing results after 12 months.  BBL is also known to be the most deadly procedure of any cosmetic  surgery with an estimated death rate of ~1:3000 to 1:10,000.  Emsculpt and Sculptra will provide literally provide only puny results to the buttock and thus are huge waste of hard earned money.

Jason Emer, MD · Answer

id suggest surgery / liposuction / body contouring to get you a new shape and size and then maintain with TRUSCULPT FLEX, sculptra, and RF treatments like venus legacy or forma.  
You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

David S. Rosenberg, MD · Answer

I suggest doing the BBL , none of those noninvasive treatments are going to match the results of a BBL and you will spend less money with a BBL than with doing all those noninvasive ones

Richard E. Moore, MD · Answer

Thank you for your questions and posting your pictures. Let's begin with cellulite (difficult to assess from the pictures). Cellfina remains the best long term solution for cellulite characterized by dents and dimples. I often combine it with Sculptra or Bellafill to firm the skin in the most problematic areas. RF devices which target cellulite such as Venus Legacy are also effective but with shorter lasting results. 
For volume restoration in patients who do not want to have a BBL or have insufficient fat, I recommend the combination of Sculptra and Emsculpt. In your situation, adding Coolsculpting to pull in the waist line would also help to give more curvature to the buttocks.

I hope this was helpful - Dr. Moore.

Ray Bayati, MD · Answer

Hello
Although I offer BBL in my office but I always evaluate the clients to assure if this is feasible option. 
During consultation, I would try to find out the expectations and goals as well as lifestyle.
It is necessary to comply with post op care for 3 months.
being said that, based on the photos, the amount of fat harvested may not be as sufficient for the BBL.coolsculpting is not a method for BBL and it is not going to help.Emsculpt: improves muscle tone temporarily but not adding volume as you need.
Consult with an expert and have in-office consultation
All the Best.

Andrew Gear, MD · Answer

Based on analysis of your pictures, I believe that body contouring plus fat grafting or a BBL would be your best option. You can certainly start with some muscle building technology like EMsculpt or Cooltone plus or minus Cellfina plus or minus Sculptra, but I find it unlikely you will be satisfied.

Mats Hagstrom, MD (license on probation) · Answer

The BBL is the correct treatment for you. I don’t think you would find anything else to be worthwhile or money well spent.It will not correct your cellulite and could potentially worse than this condition but it would do wonders for your body contour.Second option is well done Liposuction of your full torso.This would at least bring your torso down in size in comparison to your bottom half.Most likely your sources of information to do research or highly biased or often not accurate.I suggest having multiple in person consultations with local board-certified plastic surgeons who have expertise with these  procedures.Best, Mats Hagstrom MDLinea Nova Body Contouring

My butt needs serious help, which would be my best option: Emsculpt, CoolSculpting, or a BBL? (Photos)

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