Would 400 cc’s be enough fat for BBL? 5’4” 118lbs. 2 surgeons said they could get 400 cc’s of fat. Worth it? (photos)

Question

Lipo on my back hips & abdomen. I don’t have enough fat anywhere else. I’m 100% sure that I want the Lipo, just not sure that the fat transfer would be worth it. Neither surgeon would give me a decisive opinion on whether or not to do the fat transfer. They said the Lipo alone would achieve a nice look. I’m basically looking for an opinion of if it’s worth it or not! not going for Kim K here just a bigger round bottom. does anyone think it would be worth it? Or should I just go with the Lipo?

Donovan Rosas, MD · Answer

Patients interested in BBL often ask questions of the necessary volume for transfer. Ultimately, the answer is two pronged and based upon both patient expectations and the nature of fat graft themselves.
BBL and fat transfer is ultimately dependent upon the long term viability of the fat grafted. That being said the resorption rates of fat transferred can be significant. Clinically this translates to a progressive loss of grafted volume in the months following the procedure.
I tell patients that they can expect resorption or graft loss on the order of 50% (at most; prepare for the worst and hope for significantly better). Additionally some harvest volume is lost in processing the fat graft prior to transfer. Thus I generally recommend that patients seeking even the most minimal volume increase have adequate reserves for grafting of 500 cc per cheek (at minimum).  This means that harvest will usually exceed 1 liter (assuming for processing loss).
However, it important to remember that these are recommendations and can be amended based upon a patient's particular expectations. Some patients only want a subtle change and may be willing to accept a less significant result. But the rule still applies you have to have the fat to transfer the fat.
Ultimately, there are limits both on donor yield and recipient capacity. There is no defined space for filling thus there is a component of stretch and expansion that goes along with transfer. Once the limit is reached, injected fat will extrude from the injection sites. Overfilling will only lead to greater loss and place you at risk for necrosis.
Based upon your photos, you have adequate donor sites for a very modest augmentation. You will benefit from the contouring effect of liposuction, irrespective of the yield for fat transfer. I often find that the happiest BBL candidates are those that recognize both the benefits of waistline contouring liposuction as well as the volumizing effect of the fat transfer.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. Based on your photos you appear to be a good candidate for full body intense liposuction improving your body contour and get better curves especially in your laterals and waist. and a Dominican butt lift  transferring the fat that we get to your butt molding and improving your gluteal volume and projection.
Respectfully,Dr. Emmanuel Mallol Cotes.-

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well..Based on the exposed case and the photos shown I see that you are a perfect candidate for liposuction of abdomen, full back and bbl.you have to take into account is not the amount of cc that can be extracted, because when we place the fat there is a high percentage that is reabsorbed and the rest that remains is the shape and technique of the plastic surgeon molds the buttocks.

Paul C. Dillon, MD · Answer

Hi,
Thank you for your question and your pictures, based on your pictures your a good candidate for a BBL. Areas to consider would be your abdomen, back bra rolls and flanks. Removing the fat from the back bra rolls and waist alone can greatly improve your overall shape and enhance your curves. Once your waistline is more defined like an hourglass you will be able to see your buttock shape. Then once the fat is transferred to the buttock you will get more projection. It's best to consult with a Board Certified Plastic Surgeon to get an examination to assess the areas and outcome. Best of luck.

Navanjun S. Grewal, MD · Answer

Hello and thank you for your question. Adding any amount of volume to the buttocks will give it a fuller appearance even if it is very subtle. I see very little reason not to graft the fat. I have witness pleased patients that added similar amounts- but based on reasonable expectations much like the sentiments you seem to echo. No Kim K, but a little more round. Best of luck.

Dr. Grewal
Beverly Hills, CA

Dr. Grewal
Beverly Hills, CA

Melek Kayser, MD (retired) · Answer

Thank you for your question. You are actually a good candidate for fat transfer to the buttocks. It is however, important to understand that it's not so much about volume but contouring. This means that not only are you adding fat to the buttocks area but you're also reducing fat to the surrounding areas both of which add to your final outcome. It is possible and expected that with liposuction alone, you would see a nice Improvement, and indeed, prior to fat transfer, this was the standard approach to achieving and improved Contour in that area. The fact that you can now take that fat and place it in the buttocks area only further enhances the curviness of your shape. 400 CC's seems like it would be a reasonable goal but that would also depend on how much fat is available and the area to which the fat is being transferred. You must be careful to not overgraft fat otherwise you can end up with complications such as palpable and visible irregularities and other problems. Overgrafting is a No-No. This is analogous to a farmer planting seeds in a garden where the distribution of seads in the soil should be even. If all the seads are placed in a single hole, they will not survive. With that being said it is also important to remember that you will lose fat but that the loss of fat should be consistent leaving no irregularities. Needless to say, fat transfer adds additional time to the surgery which would also increase your cost. If you are considering fat transfer, do not waste the fat that you have now because if it is removed, it will be gone forever with liposuction alone. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

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