One Side Bigger, Visible Dents, Fat Doesn’t Hold. What Can I Do? (Photos)

Based off your photos (without an exam) - first thing I notice is likely you gained weight (I don't have previous pics to compare it to but I can see areas that have more growth secondary to weight gain. BBL is a procedure that will not look good if weight gain happens after and there are NOT a lot of solutions to fix all the things that can happen after weight gain either. I recommend trying to lose a decent amount of weight with weight lifting for the glutes (you need to cut down on your body fat content to reduce these dents and cellulite areas). Filling them with sculptra or more fat is not going to help much with it especially if you gain more weight.
One side is more than the other and this can happen because first your butt cheeks are asymmetric to start with (even before the first surgery), two - fat grafted could have been different at any time to address the asymmetry, resulting in asymmetric fat survival which leads to different butt cheeks, three - you've had many surgeries, each time can be something done to one side more than the other, four - gaining weight with more fat cells on the bigger side shows more.
The main thing for you if you were my patient would be weight loss with weight lifting. You won't be able to fix the dents or cellulite and any more weight gain only makes that worse. You need to tighten your butt skin by losing weight slowly and building muscle to counter the sagging skin possibility - so that is the hardest part. Then after you've achieved a noticeable decrease - a revision surgery can be done to only clean up some things - not make anything symmetrical, not fixing the dents.

Dear ENAXY73WY3B9I5,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.


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, insignificant hip augmentation, post-deflation sagging, fatty necrotic cyst or scar tissue, 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 additional rounds of BBL most often produces the same disappointing results but at another financial loss. Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation.

Fillers, such as Sculptra and hyaluronic acids, for augmentation of the buttock/hips are a rip-off, period!

Buttock/hip implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the hips and central buttock, and often help smoothing out lumpiness. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging. When considering buttock implants make sure that the surgeon is going to be placing the implants within gluteus muscles , (a.k.a. “intramuscular pocket”), and that they are using anatomically correct, oval-shaped implants, such as Stanton Anatomic ®️ implants.
Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in these 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.