Follow-up Question - Indent post op Brazilian Butt Lift. (photos)

Two weeks post op there's an indent and flat spot only present on one cheek. I really don't believe it's from the compression garment or else it would be present on both sides. The skin under that one side hangs lower as well. The marks on my skin are from the garment.

To see previous question, please click here. 

Doctor Answers 5

Indentation after BBL

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The indentation in could be caused by one of several reasons or a combination.

The buttocks is full of connective tissue stabilizing the skin it's in the underlying muscle structures.

This gives the buttocks some firmness of stability required to hold your body's weight while sitting.

Just like the skin on the palm of your hand does not move around nearly as much as the skin on the back of your hand.

The skin on the palm of your hand also has lots of connective tissue holding it in place.

The fibers in the buttocks stabilizing the skin sometimes do not allow for volume expansion to happen evenly.

Is this the same phenomenon that causes cellulite.

When fat is added certain areas tolerate the volume expansions while some individual areas may not allow the skin to expand because connective tissue fibers have a certain length and do not stretch.

This is probably the most common reason some people develop a flat spot on the lower part of the buttocks after a BBL.

Some of these people may have had a slight in the Tatian or flat spot there prior to the BBL but it was not nearly as visible before volume was added.

The second reason could be that the volume was simply added in an uneven fashion.

This is somewhat unlikely because it would be very obvious during the procedure.

A third explanation is that the fat could have survived in an uneven distribution.

This could potential he be from sitting on an area causing less fat survival because of the pressure in one particular area.

Scar tissue develops after all surgery or injury.

Scar tissue will with time contract and this can lead to uneven contours or indentations.

If the area feels somewhat more rigid or does not bulge up when gently squeezed like areas adjacent then there are probably connective tissue fibers(more likely) or scar tissue (somewhat less likely )keeping the area from having the desired contour.

The careful examination by your plastic surgeon may help determine if this area will respond to a second fat grafting procedure.

If the area does not respond to add volume then the underlying connective tissue needs to be cut in conjunction with fat transfer.

One way to determine if an area will respond to add volume such as a fat transfer procedure is to temporarily inject saline(IV solution)

If the area response from the saline injection creating a nice even smooth Contor then this should be able to be achieved by adding a substance like fat.

If after injecting saline the area maintains an indentation then adding fat alone will not fix the problem.

There are too many variables to know exactly what or why you have this indentation.

It could be from connective tissue, sitting after the procedure, how the procedure was performed or a combination.

Please follow up with your plastic surgeon.

I'm sure he or she would be happy to address your concerns and offer some type of revision procedure if needed.

Not everyone is a candidate for a great result from a BBL no matter how well the procedure is performed.

Remember that few if any plastic surgeon will show pictures of their less than desirable outcomes.

The image created from doctors promoting their work can create an image of potential perfection with every procedure.

This is far from the truth and the importance of honesty during preoperative consultations cannot be over emphasized.


Mats Hagstrom M.D.

San Francisco Plastic Surgeon
4.8 out of 5 stars 20 reviews

Follow-up Question - Indent post op Brazilian Butt Lift.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello dear, thanks for your question and provided information as well... Are you sitting without a boopy pillow? You have to know that for at least 8 weeks you have to use it to protect your buttocks shape...get to your surgeon to check what's happening..

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 441 reviews

Contour irregularity after your BBL

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You seem to have a contour irregularity. It is very early so it is possible that it can get better over time....or it may get worse. There are several explanations but none of us can guess without seeing your before pics and also seeing exactly what was done during your surgery. The best person to discuss this with is your surgeon. It is possible that you may need a small revision in the future.

You might also like...

Contour irregularity

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Contour irregularity following BBL is not common; you probably have scar tissue in the area that prevented the fat to be grafted in that localized area; what you need is to release the scar tissue with a special lipo cutting tool and then fat graft overlay this area. A consultation would be very helpful to provide you a definitive recommendation.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 106 reviews

Follow-up Question - Indent post op Brazilian Butt Lift.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There is no way that we can tell you what is causing this dent. It is best to ask your PS as they saw you pre-op and performed the BBL. It is important to go back through your pre-op photos as it is very common for asymmetry and therefore, the butt cheeks will not be twins post op. What I can tell you is that although this can improve with time, it will not correct 100%. You will like need some sort of revision. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.