My doctor says no garment is needed for BBL, and sitting and laying on back is ok. Should I worry?

I am getting a extended tummy tuck and bbl. My doctor told me no garment is needed after surgery other than the binder. He also told me i can sit and lay down on my back and that it does not affect the bbl. Should i worry?

Doctor Answers 7

BBL Post-op Sitting Lying

I am so proud of you for looking ahead and considering your post op care and optimizing your outcome to best possible result. Many patients do not realize their result could be far better if they stay off the fat grafts after surgery for up to 2 months or more. This is one of the most common questions in the office.

PREVENT DVT:

Tummy tuck with muscle tightening is one of the most cosmetic procedures associated with increased risk of DVT formation and PE. Abdominoplasty with muscle repair will raise the pressure inside your abdomen and reduce the rate of blood flow from your thighs. Adding a garment can increase the effect and for that reason some surgeons do not use it. Also, if the garment is too tight it can limit the oxygen to the incision and cause openings in the incision with infection and drainage. But if the garment is fitted properly, it can limit the amount of inflammation and swelling after surgery and allow the drain to come out earlier.

So with the increased intra-abdominal pressure form the tummy tuck muscle tightening, some surgeons try to match the pressure in the thighs with waist high compression stocking (10-20 lb.). This allows the pressure to be constant form toes to rib cage and keep blood moving uniformly. Use for approximately 2 months.  Some surgeons consider using daily Lovenox 40mg subcutaneous injections after surgery for the first 3 days at minimum to reduce blood ability to form clots.

Always remember to be mobile in walking or do calf raises will standing still to reduce the risk for DVT as much as possible. Remember the suggestions below may increase your risk of DVT due to compression the posterior thighs, so stand up and lay on your abdomen as much as possible.

FAT GRAFT SURVIVAL:

Experience with facial fat grafts and BBL fat grafts in practice and current literature supports the thought that the low oxygen state of the fat grafts send signals to stem cells for new cell growth and new blood vessel growth into the low oxygen area. Anything that would decrease oxygen supply to the area would delay growth and cause more reabsorption on the fat grafts.

A few of the research supported factors that would delay oxygen supply to the grafts include:
Decrease blood circulation due to blood pressure changes:

  • body weight compression ( Sitting and lying) greater than systolic blood pressure (main cause of nursing home bed soars)
  • decreased blood supply form generalized hypotension

Vasoconstrictive agents which decrease the rate of oxygen flowing to the fat grafts:

  • nicotine ( one inhalation of puff of a cigarette will constrict vessels for 16 hours)
  • caffeine (watch your tea, 5 hour energy, decaf, chocolate)

Reduced angiogenesis:

  • A diet rich in green vegetables has been proven to reduce the ability for new blood vessel branches to grow into the low oxygen area

SITTING:

Many patients have given me feedback over the years with tips and tricks to stay off their buttocks and have a normal life style during recovery. The most recent and economical way I have seen to stay off the buttocks in the sitting position would be to use of two bath towels rolled up like a cinnamon roll and wraped with a little tape to hold their shape.  Before sitting, place the towel bolster you just madeunder thighs just below your buttocks. The towel rolled bolster will touch the front edge of the seat and cause your buttocks to hover off the seat. Adjust the thickness of the towel roll mat as necessary so there is no contact of your buttocks with the seat. An additional rolled mat can be used behind the lower back just above your buttocks. The position of the back towel roll mat can be maintained with the carrying strap over the back or head rest of the seat.

Full support of the thigh from back of knee to lower buttock crease with the foam mat will be the most comfortable position per patient feedback. 

LYING IN BED:

Many patients have given me feedback over the years with tips and tricks to stay off their buttocks and have a normal life style during recovery. Past patients have had success in sleeping on their sides and back without their buttocks touching the mattress. They describe the easiest way is to elevate your back and legs on coach cushions placed over your original mattress.  There should be no pressure on the buttocks when lying on back or sides. If there is still contact with buttocks, consider adding more thickness to coach cushions for more lift.
Great question! Wish you well on your journey toward your tight abdomen and full buttocks.James McAdoo DO FACOS

  • AOA dual board certified general and plastic reconstructive surgeon 
  • Microsurgery fellowship trained 
  • 20 years experience 
  • 33,000 operative cases
  • 10,000 BBL

Post-op Brazilian Buttock Lift techniques

Thanks for your question -
We perform this procedure about twice a week.  It is a procedure that requires experience and technique to get good results.

Our post-op protocol includes a compression garment.  Compression garments have very clearly been shown to improve liposuction results over a certain volume.  They help minimize swelling and may play a role in aiding in some skin tightening.

Regarding pressure (sitting or lying) the concept of avoiding pressure makes sense.  Fat transfer is essentially a tissue transfer.  Until the fat transfer establishes a new blood supply the fat is vulnerable to stresses including pressure.

We advise our patients to avoid sitting for more than 15 minutes at a time.

Laying down actually is less harmful as your body weight is spread over a larger area minimizing direct pressure on your buttocks.

I hope this helps.  Make sure you evaluate long term results of your plastic surgeon (over one year post-op) to really see what your doctor should be able to achieve.

My doctor says no garment is needed for BBL, and sitting and laying on back is ok. Should I worry?

I recommend a compression garment for the liposuctioned areas. The transferred fat needs to revascularize soon compression is necessary. Please follow up with your doctor as these issues require the attention of a plastic surgeon.

Ron Hazani, MD, FACS
Beverly Hills General Surgeon
4.9 out of 5 stars 261 reviews

Post-op care

Thank you for your question.  Each surgeon will offer his or her own opinion regarding post-op care.  It is best that you follow the instruction given to you.  If it is negatively affecting your recovery, please voice your concern with the surgeon.

All the best,

Dr. Results
Miami, FL

My doctor says no garment is needed for BBL, and sitting and laying on back is ok. Should I worry?

I recommend avoiding sitting or placing pressure on the buttocks for 6 weeks after the Brazilian buttlift. Most patients get an immense benefit with maximal liposuction of the abdomen, sides, and back to obtain the smallest waist possible and then maximal fat transfer to the buttocks and hips.

Kenneth Hughes, MD

Los Angeles, CA

Sitting and lying on back after BBL/Postop BBL

This is a good question and one that I get asked frequently by patients. I have performed this procedure for over 13 years now and have acquired substantial experience with this procedure.

In theory, it would make sense not to have the patient sit on the buttocks or lie on their back after a BBL for 6 weeks or more. However, in a mobile patient who will go back to work in 1 to 2 weeks after the procedure this is not practical, unrealistic, and virtually impossible. Furthermore, I have never seen a peer reviewed article in any of the major plastic surgery journals comparing patients who did not "sit" on their buttocks after a BBL VS those that did.

In short, I do not have any restrictions for my patients sitting on their buttocks after a BBL and to my knowledge it has not adversely effected my results. Keep in mind, that in most patients it is painful for them to sit on their buttocks after a BBL and in a way this will restrict sitting.

Mark A. Jabor, MD
El Paso Plastic Surgeon
4.4 out of 5 stars 19 reviews

BBL postop

Getting a nice result with a BBL means that a good majority of the fat transferred to your buttocks has survived.  Fat can only survive if it finds a permanent blood supply in the grafted area, and is not injured during the first 6-8 weeks.  This is the critical period where the fat is susceptible to damage, injury and fat cell death.  The single most preventable thing you can do to protect the fat is to keep pressure off your buttock for minimum 6 weeks.  This means sitting on a pillow balanced under your thighs so your buttocks are "floating".  Also, you should sleep on your stomach.  Hope this helps.

Kyle Song, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 29 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.