Do I need a Brazilian Butt Lift revision? (photos)

Let me first start off by saying, the buttock is as big as it’s going to be at one week after surgery. From there, as the swelling resides and fat melts away, it only gets smaller from there on out.
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.). 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. 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.

Dear Mya2020,
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

Cases as yours should be told preoperatively you will need many surgery rounds. The main reason is weight loss patients have very watery/thin fat and are not an easy transfer. Thus multiple lipo/BBL surgeries are needed. If you proceed with extended TT in Florida can only lipo 1 liter of fat by rule in office surgery. Therefore small BBL or 500 cc's per cheek. Otherwise if you desire more improved buttock, redo lipo 360 with round 2 BBL. Then wait 4-6 months to have the extended TT.

Dear Mya,
Congratulations on your massive weight loss. Unfortunately, this often comes with excess skin in most areas of the body.
First, you must give your BBL results time to adjust. The shape will continue to change and the lumps disappear over the next 3-4 months. That being said, from your photos, you may consider a buttock lift to reduce the skin and contour irregularities in the future. This might be incorporated with a circumferential abdominoplasty.
Best wishes,
Dr. Taranow

Based on the information posted I don’t think you were a particularly good candidate for a BBL.

Skin laxity and cellulite significantly impaired the ability to deliver good results.

People Who have a flat spot on the lower inner buttocks because of connective tissue anchoring the skin to the underlying muscle fascia tend to not get projection in that area from fat transfer. Surrounding areas on the other hand project nicely and can create contour irregularities.

It’s really difficult to tell if your procedure was done well or not though I suspect it wasn’t. It’s very difficult to get great BBL results on patients who are not good candidates.

Weight loss patients should focus on treating their primary problem which is almost always skin laxity.

That should be first on the list because it represents the biggest problem.

You can either try to revise the BBL or go for the skin tightening surgery. Personally I would recommend going back to the drawing board and dealing with skin laxity which should’ve been done in the first place.

Plastic surgeons definitely differ on their preference of doing a BBL or a tummy tuck first.

In massive weight loss patients I believe the skin should be treated first

Most likely a wraparound tummy tuck a.k.a. body lift is probably your best option.

When posting I recommend showing formal before and after pictures. If you don’t have the ones your doctor took then you should ask for copies.
I just agree with your providers assessment that your buttocks will grow with further time. Most likely the opposite is true. at seven weeks your results are close enough to final that you have a pretty good idea of what it’s going to look like. There will be subtle changes by waiting further but don’t expect any major improvements by giving it more time.

My experience has been that patients were not happy with the results by six weeks and never going to be happy by waiting further.

Plastic surgeons are really good at blaming swelling for the results and kicking the “can” down the road as far as they can.

I’m not sure if you have faith in your provider to do a revision regardless.

I would recommend instead having more in person consultations with experienced local board-certified plastic surgeons to get a more accurate assessment. Most plastic surgeons will want you to wait at least three months from the date of surgery before assessing the outcome.

When seeking second opinions it’s a good idea to bring formal before and after pictures and a copy of your operative report all with your part of your medical records and you’re entitled to by requesting them from your current provider.

Best,

Mats Hagstrom MD