6 months post-op. I have no results. Should I go for round 2, or get implants for bigger hips? (photos)

Question

I had a BBL 6 mo. ago. I have no results. What would be the next thing for me to do? BBL round two? Implants? I want to be much curvier with larger hips to balance my broad shoulders. My liposuction is also disappointing.

Kenneth Hughes, MD · Answer

Having the BBL done a second time is an option as long you have enough fat to be transferred. You have to consider not only which areas will have perhaps the best fat, but also you have to consider which donor sites will have the fewest problems afterward with the liposuction.  In general, the abdomen and thighs are preferred. The revision implies that there is less fat than the first time, and scar tissue will make the surgery much more difficult on the surgeon.  The percentage of fat survival in the BBL the second time should be about the same. 
Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

George Marosan, MD · Answer

Thank you for your question and photos. Based on these photos you do have some improvements. The problem I see is with your surgeon's understanding the aesthetic units of the buttocks and ability to contour the rest of the torso. You had a long buttock to start with and you still have the same shape. If you were my patient, I would do VASER Hi Def Lipo 360 degrees. This would include removing fat from the posterior outer pelvic rim (fat over the gluteus medius muscles) to round off the current upper "square look" of the buttocks and place fat into the trochanteric depressions and more projection. The torso needs to be sculpted to give you an hourglass figure. The right anterior depression needs to be grafted to get rid of the violin deformity of the thigh/hip junction.You can go for round 2, but choose a surgeon who understands and can deliver female aesthetic results. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Every one will tell you that they are "experts", but look at lots of preop/postop photos to see if they can deliver what they promise. Good luck.

Daniel Barrett, MD · Answer

Dear rtuk,
based on your photos, you look like a good candidate for a BBL revision. Liposuction of your abdomen, back and flanks should give you more curves and hourglass shape and fat transfer to buttocks should give you more projection. I would suggest you to consult a board-certified plastic surgeon because 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

David Shifrin, MD · Answer

So sorry to hear of your disappointment. I would return to your original surgeon to discuss your concerns and see if your results can be improved. If you’ve done that and are still looking for an answer an in person consultation would be helpful. It’s important to discuss what specific areas you want improved and what your exact expectations are. Best

Tania Medina de Garcia, MD · Answer

Hello dear!
Thanks for the question and provided information as well.
Based on your pictures, you are a good candidate for liposuction with a second round of BBL, and I think you'll get very good results. 
Liposuction allows your plastic surgeon to transform your entire shape. You can improve your abdomen, hips, back and flanks, and of course your buttock, to give you a nice shape.
In general, you need to be physically healthy and at a stable weight, have realistic expectations, be a non-smoker and your BMI needs to be 30 or less.
l recommend you to make an appointment with a board certified plastic surgeon to talk about your goals and anything you need to know.
Good luck :)

Johnny Chung, MD, FACS · Answer

Thank you for your question. Based on your photos, I don’t think another BBL is going to give you the results you want. I don’t believe you have enough donor fat. In my experience a buttock implant will give you projection but not width. Even if you try a wider implant in the buttocks, the implant it self will be palpable. I would recommend contouring your waist line a bit more to give you a better waist line. Best of luck with your procedure.

Karol A. Gutowski, MD, FACS · Answer

Based on your pictures, I doubt another BBL will make a difference. You have very little fat to transfer. An implant may be a better option for you.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Do you know what technique your doctor used? Having a 2nd round of BBL is an option. The optimal BBL outcomes are achieved with: 1) use of VASER 360 liposuction to harvest the most fat, 2) a closed looped system such as Puregraft to process the fat, and 3) strategic micro-packet transplant technique. These three processes have demonstrated over 95% fat graft take. This means that your results will be stable as long as you maintain your weight. As an official VASER trainer, I am routinely referred unhappy BBL patients. One of the most common reasons for disgruntled BBL patients is that patients are not able to accurately communicate their desired buttocks goals to their surgeons.  A buttocks assessment tool can be an invaluable tool to communicate to your surgeon the exact buttocks size and shape you are desiring. A Skype or FaceTime consultation with a BBL specialist can help you get an accurate recommendation and pricing.
Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

you definitely had some changes from your procedure. perhaps not nearly as much as you had wished.  I don't think you were a candidate for a massive body transformation.  Perhaps the emphasis could have been more to fill-in hip dips and give volume on the lateral buttocks. This area typically does not do all that well with implants.  It's possible you could have a second round of fat transfer. If so you should expect slightly less of a result then the first time around. There results could be spot focused on where you need volume the most. It appears you still have some fat they can be harvested from your back, arms and most likely from parts of your abdomen.  Without an in person examination it's hard to tell how much fat is still left to be harvested and what areas you could benefit from further liposuction.  I think you and others realize where you could use the fat grafted the question is can fat be harvested and does it justify having a second go around.  I don't think implants would be that beneficial because of where you need volume placed but that's just my opinion.  Best, Mats Hagstrom MD

George Lefkovits, MD - Account Suspended · Answer

Occasionally a BBL can be disappointing because of significant fat absorption. Every pt needs to be informed of this possibility before undergoing this procedure. The good news is that in the vast majority of such patients a second BBL will usually lead to a very good result, assuming you have enough donor fat.

6 months post-op. I have no results. Should I go for round 2, or get implants for bigger hips? (photos)

Answers (10)

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