Is a BBL revision possible for me to make my butt smaller, rounder, and with no lumps? (photos)

Question

I got A fat transfer 3 years ago Since then I went Back to same doctor for revision with unsatisfactory results One year ago I had Third and last revision with the same dr I want My butt smaller and rounder with no lumps Is that possible

David Shifrin, MD · Answer

Yes you can have a shapelier and smaller buttocks. The lumps can likely be removed as well but it depends on what is causing them. I would consult with experienced surgeons only at this point. You have significant scar tissue from your prior surgeries.Best

Kenneth Hughes, MD · Answer

Hello, thank you for your question. Without before photos, it is difficult to recommend the best procedure for correcting the irregularities.I recommend you to schedule a consultation with a board certified plastic surgeon to determine the extent of the revision that is necessary.

Daniel Barrett, MD · Answer

Dear Mybody111,
It is hard to tell for sure without an examination but based on your photos, it looks like you would benefit from liposuction and BBL revision surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. 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

Rodrigo Rosique, MD, PhD · Answer

Dear, your problem is becoming more prevalent with the mega-transplantations of fat. The correction involves extracting the excess fat through liposuction and address the loose skin that will remain with a buttock lift that, unfortunately, leave a long scar, but that can be hidden by a bikini.

Dhaval M. Patel, MD · Answer

Thank you for your question and photo! I suggest you seek a board certified plastic surgeon and discuss your options! Best of luck!Dr Dhaval Patel
Double Board Certifed 
Plastic Surgeon
Chicago
Hoffman Estates
Oakbrook
Orland Park

Raja Mohan, MD · Answer

A Brazilian butt lift (BBL) is a cosmetic surgery procedure that enhances the shape and size of the buttocks by transferring fat from other areas of the body: Brazilian butt lift (BBL)ProcedureFat is removed from other areas of the body, such as the thighs, hips, lower back, or belly, and injected into the buttocksGoalTo improve the shape and volume of the buttocks, and sometimes to create an hourglass figureResultsMore rounded and fuller buttocks, and sometimes a smaller-looking waistRisksExpensive, can be dangerous, and there are no guaranteed resultsRecoveryPain is usually minimal, and full recovery takes about six monthsMaintenanceResults should last for many years, but it's important to maintain a stable weightA BBL is different from a traditional "lift" procedure, like a breast lift or facelift, because it doesn't improve sagging or excess skin. A BBL is also different from other butt lift techniques because it doesn't use implants. Candidates for a BBL should have good skin tone in their buttocks and hips, be in good health, and not have medical conditions that would impair healing.

Erika Sato, MD, FACS · Answer

It would help to see what your buttocks looked like before your original surgery and to know more about what was done each time. It does appear that you could have improvement in shape, but may not be to the extent that you are looking for. It is important that you and your PS be on the same page for expectations.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,You have a significant and difficult problem. There are multiple issues. Dimpling, cellulite, falling of the buttocks, the dirty diaper look, stretched out skin, migrating fat, contour irregularities.There are few people in this world who can treat this well and he is in Florida. Good luckStephen M. Davis, MD, FACS
Green Hills Plastic Surgery
Certified: American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery
Member: American Society of Plastic Surgeons
Member: RealSelf Hall of Fame

Mats Hagstrom, MD (license on probation) · Answer

It's important to make accurate assessments before prescribing procedures.  In your case there are a number of different things going on and each one needs to be addressed separately in order to understand what's possible and what the treatment options are. 1. Overall size- The overall size of your bottom can be reduced with further liposuction. I say this as a general statement. Considering you've had multiple revisions in the past the potential improvement may be limited. This also depends on what percentage of fat was grafted into your gluteus muscle. 2a. Shape part a- The shape of your bottom is made up first and foremost by the pelvic skeletal structures, secondarily by gluteus muscles, fat and the skin envelope.  I'm guessing the part you like the least is the lower mid part that sags.  Dr. Constantino Mendieta Best describe this as the "dirty diaper bottom" lock. His prescribed treatment is the procedure called the Miami thong lift. It's a skin resection that  lifts this part of the butt up creating roundness where you have droopy shape or more of a square shaped as the two butt cheeks come together in the midline. 2b.  Shape part b- It's possible to shape other areas to some degree with liposuction. One way to assess what can be done with liposuction is to pull up on the skin above the area. If pulling on the skin and making it taught changes the shape then skin laxity is contributing significantly to the contour. If the shape stays  the same when pulling on the skin above then liposuction will often accomplish changes in contour accordingly.  In particular I think  bringing down the upper outer aspect of the butt in what most people call the hip area would be beneficial, Also bringing down the lower outer( lateral ) aspect  would make things more proportionate.3. Skin contour-  what you referred to as lumpiness is in reality mostly cellulite.  Cellulite forms from connective tissue bands that anchor the skin to the underlying muscle fascia in areas that can tolerate lots of pressure. Examples like this are the palm of the hand, the buttocks and back of the thighs.  These connective tissue bands give rigidity and have a set length. A way  to describe this is to pinch the skin on the back of your hand and lift it up. Try that on the palm of your hand.  It doesn't work because the palm of the hand has a lot of connective tissue bands anchoring the skin to the underlying fascia. They will not give and don't stretch.  When the volume is added to the buttocks these connective tissue bands cause dimpling which creates an uneven contour. You had a substantial amount of fat added so cellulite is worsened.  Cellulite is never made better with fat transfer and can often look worse. You can't add volume to create an even contour when the bands are pulling the skin in.  The best treatment for cellulite is a procedure called subsicion with or without a device called Celfina. Areas that are uneven related to uneven fat transfer or previous liposuction can sometimes be made better but it's difficult.  To put things in perspective, if you can't keep the contour smooth from the primary procedure starting with a smooth contour then imagine how difficult it is to create a smooth contour from a distorted one.  The bottom line is there is possibly room for minor improvements but don't expect a lot.  In almost all aspects of cosmetic surgery repeat procedures usually lead to a point of diminishing returns.  In your case you've had four procedures as you stated your post(primary BBL and followed by three revisions). A fourth revision is unlikely to make a substantial change though I suppose a different provider may have a new approach.  For example, if your provider did not discuss the above points then addressing each one of those concerns separately could potentially give you a better outcome.  I do refer to Dr. Constantino Mendieta frequently. He has been innovative and has good experience in doing secondary procedures. Getting his opinion may be a good idea. Real self doesn't like us to mention the name of other doctors but I don't really care.  I think getting his input it would be helpful for you.  So, there you go.  There's no yes or no answer to your question. My answer is fairly extensive and this is the tip of the iceberg even without an examination.  You need an accurate assessment that takes every aspect of your bottom into consideration starting with the  skeleton all the way out to the skin.  Dr. Mendieta does this and has demonstrated this level of thoroughness in his publications.   Your best bet is to get in person consultations. You need accurate assessment and no one can give you an accurate assessment without an examination.  Best, Mats Hagstrom MD

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

Based on your pictures, you are an excellent candidate for a Brazilian Butt Lift (BBL) revision to reduce and smooth out the contours of the butt. Using a buttock assessment tool can be an invaluable tool to communicate to your surgeon the exact buttocks size and shape you are desiring. The optimal BBL outcomes are achieved with: 1) use of VASER liposuction to harvest the 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 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

Is a BBL revision possible for me to make my butt smaller, rounder, and with no lumps? (photos)

Answers (11)

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