Interested in a BBL to cover partially atrophied glute? Would the risks outweigh the possible benefits? (photos)

Question

I have an atrophied glute minimus. There’s no medical explanation for it. Scans don’t show anything that could have caused it. No accidents. Just happened over time. I can deal with the discomfort of an atrophied muscle, but I can’t stand the way it looks every day. Would a BBL be the one solution to this? Or would the risks outweigh the possible benefits?

Semih Yildiz, MD, FEBOPRAS · Answer

The photos show some buttock and hip-contour asymmetry with a hollowing/indentation pattern, but photos cannot confirm which muscle or soft-tissue layer is responsible. A BBL or targeted fat grafting may be able to camouflage a contour depression if there is enough donor fat and the skin quality is favorable, but it will not restore gluteus minimus muscle function or treat the cause of atrophy.

The benefit depends on how much of the visible change is from soft-tissue volume loss versus muscle imbalance, posture, or deeper anatomy. The risks do not automatically outweigh the benefits, but BBL has specific safety concerns, so you should see a board-certified plastic surgeon with substantial BBL experience. Fat should be placed only in the safe subcutaneous plane, not into the muscle. If discomfort is a major part of the problem, it is also worth continuing evaluation with an orthopedic, sports medicine, or neurology specialist before choosing a cosmetic camouflage procedure.

Emmanuel Mallol Cotes, MD · Answer

Thanks for the question.

In this regard, I recommend you waist and back Liposculpture, getting better curves especially in the waist, improving your body contour.

Finally, I suggested take the fat we get and transfer to the buttocks and hips, to mold them and get better volume, contour and butt projection, is that we know as "Brazilian Butt Lift" (BBL).

Kind regards

Alan Gonzalez, MD, FACS · Answer

Hello @LM456, thank you for your question. It is possible to improve the shape of your buttocks with the help of glutes liposhaping. In such procedure, the buttock's shape is improved and lifted to create a greater sense of harmony. For more information and recommendations, it is prudent to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez

Andre P. Marshall, MD · Answer

Hi LM456, 
Gluteal atrophy is a rare condition but in itself rarely presents a health risk. Fat can be safely used to used to provide improved symmetry. Although muscle and fat are completely different in their properties and feel, a moderate transfer on top of the atrophied muscle would likely help to improve your current situation. When done safely and in the hands of board certified plastic surgeon, a BBL has been proven time and time again to be safe. Proper lipocontouring in itself will also help to highlight the aesthetics of your buttocks while undergoing fat transfer. 
Dr. Andre P. MarshallDouble Board Certified Plastic SurgeonBeverly Hills, CA 90210

Zoran Potparic, MD · Answer

Base don these few photos, fat transfer to atrophic buttock would be the best reconstructive option one has to offer. Liposuction of torso is going to further enhance result. In person consultation with a board certified plastic surgeon with expertise in fat transfer to buttocks is recommended. Good luck.

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a good candidate for a BBL and this will improve the appearance of the buttocks. I hope this helps.

Daniel Barrett, MD · Answer

Dear LV456,
based on your photos, you look like a good candidate for a BBL. 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

Cagil Meric Erenoglu, MD · Answer

Hi, LM456! Thank you for your question.
It is an interesting diagnosis that you have "Atrophied Gluteus Minimus" This muscle lies deep to the bigger gluteal muscles and as already a small muscle, how was it diagnosed as "atrophied". When I inspected your pictures I can see a mildly sagging buttock that requires fat injection for the depressions and for correction of the saggy appearance. It looks like you have fat tissue to apply for this procedure.

Douglas Taranow, DO, FACOS · Answer

You are a great candidate for a BBL (either unilateral or bilateral). This would even out the asymmetries

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment we need high-quality pictures. To get an idea of how to take pictures look at how plastic surgeons take before and after pictures. Used a timer on your camera or have someone else take the picture from about 8 feet away standing straight in a neutral position including your torso from your neck to your knees wearing undergarments showing the front, side and back.
I see no reason why you cannot have Liposuction and fat transfer. You are a reasonably good candidate but you should be aware that cellulite can be made worse from fat transfer. 
Delivering consistent high-quality liposuction and fat transfer results is more difficult than most people believe in this is true for both patients and plastic surgeons. Most plastic surgeons think they are better at liposuction than they actually are. Liposuction and fat transfer has more variance or difference in outcome purely based on who does the procedure than any other surgical procedure I’ve ever seen. Being board-certified in plastic surgery with an overall good reputation is not sufficient to guarantee that somebody has mastered body contouring with liposuction and fat transfer. Personally I view the torso as a single anatomic unit and either treated the entire torso or don’t do Liposuction. There are of course exceptions but for the most part I believe in treating the entire torso. A full torso includes upper abdomen, lower abdomen, love handles all the way down to the hip dips, waist, the entire back and under arm area all the way to the side of the breast. this leaves people with a natural thin fat distribution without transition zones between treated and entrteded areas. I’ve viewed the BBL as an enhancement to body contouring creating an ideal feminine S-curve that goes from the armpit to the knee. I did not emphasize a large buttocks with liposuction of the outer thigh creating a big round butt on the small leg which I sometimes called the “lollipop look”. Instead I emphasize long smooth harmonious curves creating a slightly hyper feminized balanced figure. To find the most talented and experienced provider in your community I suggest having multiple in person consultations. I do not recommend patients travel for elective surgical procedures and I recommend patients whenever possible avoid virtual consultations. During in person consultations ask each provider to show their entire collection of before and after pictures of BBL results. Always confirm that after pictures were taken at least three months from the time of surgery. anybody who shows early postoperative pictures such as pictures with patients still showing surgical drawings on them, being in the operating room or any evidence of recently having had surgery should be immediately discounted as showing “.fake news”. Early fat transfer results can look very impressive but do not at all represent final results. Ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. Specifically ask each provider to show as many pictures as possible‘s of patients who have similar body characteristics to your own. An experienced provider should have no difficulty showing you a minimum of 50+ sets of before and after pictures. Simply seeing a handful of pre-selected sample pictures which in reality most likely represent the best results of that providers career is insufficient to get a clear understanding of what average results look like for that provider. Highly experienced providers will have hundreds or even thousands of before and after pictures and should be willing to give you access during the consultation to see as many pictures as possible. If somebody claims to of done a lot of surgery but doesn’t have a lot of before and after pictures then you should ask yourself why? Do not commit to surgery or pay a down payment during the time of consultation until you’ve finished all your consultations and have given yourself plenty of time to think about your decision. The results from these procedures are permanent and irreversible. When in doubt slow down and schedule more consultations. Finally I recommend patients read all reviews on all various physician review websites avoiding providers for any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling and having an abundance of positive reviews. Plastic surgeons with the biggest social media profiles are not necessarily any more talented than those who have no websites at all. Famous or likable does not equal talented. Find the right plastic surgeon and everything falls into place. Good luck, Mats Hagstrom MD

Interested in a BBL to cover partially atrophied glute? Would the risks outweigh the possible benefits? (photos)

Answers (10)

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