Why does my butt look asymmetrical after a BBL? Should I get a revision?

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.) as most of the fat melts away. It is not quite as much the quality of the doctor nor liposuction technique 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. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging. 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 Exquisite857452,
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

Sorry for moderate to poor outcome. Would like to see before surgery photos to determine how flat your buttock was? Also appears you have higher BMI? Best to virtual consult... since a round 2 surgery much more difficult to preform. And you would especially need the ultrasound guided injections.

Add two weeks it’s too early to Judge results. Patient’s need to wait a minimum of six weeks before even contemplating judging results. In reality final results take up to three months.To make an assessment on the outcome of an operation we always need to see before and after pictures. There’s no possible way to assess the outcome of an operation if we don’t know what you look like before.If you don’t have before and after pictures then ask your surgeon to forward the ones they took before your operation. If you’re going to have a second opinion consultation then you should schedule those as in person consultations and come prepared with copies of before and after pictures and a copy of your operative report. They are part of your medical record and available for you if you ask your current surgeon.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. Best, Mats Hagstrom MD