Concerned BBL Paitent. Wanted 800, but Only Got 500 in Each Cheek? (photo)

I wanted 800cc in each bum cheek. After the surgey I woke up and I was imformed that there was only 500 cc in each cheeck due to the fact that 1000 cc of my fat was not good fat and too bloodly is this possible. Im scared that the more swelling that goes down the more of the butt size that i am going to loose. i have hard bumps on my stomach which hurt and stick out, my stomach is also hangy and skin looks nasty, is it to early to work out on week 2, when does the swelling go down ?

Doctor Answers 17

Concerned BBL Paitent. Wanted 800, but Only Got 500 in Each Cheek?

   It is a bit hard to comment about how much fat could have been transferred in your particular situation.  In general, I can get 5 liters from the liposuction in almost all patients, but I am more aggressive than most.  In addition, I tend to transfer 1200 cc to 1500 cc or more to achieve the results patients want.  The swelling should resolve a great deal by 6 weeks but may take 6 months if more fat was suctioned.  Kenneth Hughes, MD Los Angeles, CA


Los Angeles Plastic Surgeon
4.9 out of 5 stars 485 reviews

Not enough fat injected

Hi, since we cannot see how much fat you had previous to surgery, it is hard to evaluate how much fat they could've injected. In your case, it will be too soon to start exercising 2 weeks after the procedures, we recommend to wait at least 2 months to start working out again, otherwise, the fat will burn and get completely reabsorbed. For the hard bumps on your stomach, we recommend for you to have lymphatic massage therapy with ultrasound in order to soften the tissue and prevent scar tissue to be permanent. 
Always ask for a Board Certified Plastic Surgeon for answers.

Salvador Pantoja, MD
Mexico Plastic Surgeon
4.8 out of 5 stars 332 reviews

How much volume can I expect with a Brazilian Butt Lift?

Thank you for your question.  While I can appreciate your concern regarding how much fat you had anticipated being transferred to the buttock at the time of your surgery, it is nearly impossible for me to determine exactly how much fat could have been injected in your particular situation without having seen you pre-operatively.  Unfortunately, the biggest limitation of a Brazilian Butt Lift is how much excess body fat a surgeon has to work with.  This amount of fat a surgeon can inject is dependent upon how much fat was available for harvest, how much fat was agreed upon to be harvested, the baseline volume of your buttock, surgeon experience, surgeon expertise and lastly surgical technique.  

Since you are only a few weeks out from your surgery, I would recommend holding off on final judgement until you have allowed enough time for the swelling to subside.  Fat reabsorption rates are variable and while I have seen some fat reabsorption in my practice, I have had very high patient satisfaction rates with my Brazilian Butt Lift patients.  

I would recommend following up with your operating surgeon to discuss your concerns and to monitor your progress.  Best of luck!

Stephen T. Greenberg, MD
Woodbury Plastic Surgeon
3.8 out of 5 stars 56 reviews

Concerned BBL Paitent. Wanted 800, but Only Got 500 in Each cheek?

Thank you for your question and photos!


The amount of fat you have to liposuction will determine the amount of volume to be re-injected in your buttock. If you are very lean, then you may have a relatively small amount of fat to augment your buttock. There is a lot of swelling if after the swelling goes down you still feel your buttocks still small consult with a Board Certified Plastic Surgeon to have a revision.

 

Orlando Llorente, MD
Miami Plastic Surgeon
4.6 out of 5 stars 193 reviews

Good communication with your surgeon is key...

It’s important to understand that no two brazilian butt lift patients are ever exactly alike.These patients have unique anatomic findings and specific aesthetic goals.For this reason, patients shouldn’t become fixated on the amount of fat transplanted.In some cases, 200cc may be appropriate, while in other cases 800cc may be necessary to obtain contour improvement and projection of the buttocks.
Several factors may limit the amount of fat that can be transferred to the buttock area.These may include the adequacy of donor sites and the amount of fat that’s available for transfer.It’s therefore important to understand that in some cases, there’s an upper limit to how much fat can be harvested.It’s also important to realize that there’s a limit to how much fat can be placed in a recipient site before the blood supply becomes inadequate to support additional fat cells.Anything beyond this point doesn’t survive and ultimately undergoes cell death.
The method utilized to process, purify and concentrate the harvested fat prior to transplant can also dramatically impact the volume of fat available for transfer.In other words, not all transferred fat is created equal.In some cases, a lesser volume of fat may actually have more viable fat cells depending on how it was processed.
For these reasons, the surgeon must have the latitude to make appropriate intra-operative judgements.Without a physical examination it’s difficult to say whether additional fat could have been harvested, but based on the description of your abdomen and the bloody quality of the aspirate this seems unlikely.
In your case, 500cc’s per side may be enough to accomplish your aesthetic goals.It’s important to be patient because it takes time for swelling to resolve.In many cases, it takes two to three months to see the final result.
It’s important that you have good communication with your surgeon.Your surgeon should be able to alleviate your anxiety.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Concerned BBL patient who only got 500cc into each buttock but wanted more

This is a great question and appreciate the pictures you have provided. I frequently get asked this question about how much fat will I be able to reinject into each buttock. This depends on a variety of factors, but I make it clear to each patient that I will try to achieve a certain amount, however, it is not uncommon to inject a little bit less. Patients get too focused on a certain CC amount, but an experienced plastic surgeon understands that technique and placement of the fat are the most important factors. Obviously if someone is very lean, there may be less to liposuction and therefore less to reinject. The fat needs to be "sprinkled' throughout the buttock so as not to create "puddles' of fat that will not survive. In addition, if you transfer too much fat, the ability of the buttock to re-vascularize the fat droplets may be lost secondary to the increase in pressure.

Robert Najera, MD
Frisco Plastic Surgeon
5.0 out of 5 stars 26 reviews

Volume of fat injected with a Brazilian buttock lift

Regardless of how much volume you or your plastic surgeon may think or predict you will get, you can only have injected the amount of available fat on your body. Just because you wanted 800 cc does not mean you have that much fat available to inject. It is true that the bloody/watery component of the fat is strained off and typically not injected. You will see how much volume of fat has survived as you get closer to 6 weeks- 3 months after your procedure. If you have enough donor fat you can always have more fat injected at a second stage procedure. The number of cc's of fat injected is not important- what is important is the amount of volume that survives.

Best wishes,

Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 370 reviews

Doctor Discretion

The reasons as to why your doctor might have chosen to only do 500 might have to do with some safety issue still it is unethical for him to perform a different procedure than he had already agreed upon with you. It would be a good idea to contact the doctor and find out the reasons for this change. Also the pictures are a bit out of focus and the flash makes it hard to see.

Jonathan Fisher, MD
Miami Plastic Surgeon
4.4 out of 5 stars 1,081 reviews

I wanted MORE Fat Transferred...But Got Less

Hi and great question.
I appreciate the time you are spending researching the follow-up.

AMOUNT OF FAT INJECTED:  

It is hard for me (or any surgeon) to comment on the quality of your fat and/or what was available to inject because I (or any surgeon other than your surgeon) was not present at your surgery.  In my hands, I will typically have about 1/2 of high quality fat that can be re-injected after liposuction and fat processing.  Typically, I will perform between 4-5 Liters of liposuction (The maximum amount in most states is 5L and in some states i.e. Florida it is 4L).  

The minimum I inject for fat transfers to the butt is 1200cc and I usually have a range of 1200cc to 3000cc.  Why is there such a large variation?  Because, in order to transfer the fat I need:

  1. Fat is available to transfer. Typically, after processing the liposuction fluid, I have about about 50% of viable fat to inject. Most surgeons, myself included, will attempt to perform a maximum of 5 Liters of liposuction. The question then is: Is there enough fat to perform 5L of liposuction.  My goal is to perform 5L but that is dependent on your anatomical fat present.
  2. How “stretchable” is the skin? Your skin will only accommodate so much fat. I liken it to a water balloon under a faucet.  I can leave the water balloon under a running faucet all day; however, there is a maximum that the water balloon will fill up.

If you are unhappy with the volume transferred, I think the most important thing you can do is speak to your surgeon; discuss with him/her your concerns/thoughts.  He/she is your best resource and able to discuss your options with you:  second fat transfer, butt implants, and/or fillers

SWELLING & FIRMNESS:  

Lumps and bumps after liposuction is completely normal and should resolve.  I will typically have my patients start massage after 1 week of liposuction to help soften up these areas.  
Swelling is also completely normal; and it will not even begin to resolve until week 3 after surgery; and it will take at least 6 weeks to 3 months for it to completely resolve.  For this reason, I utilize compressive garments to help encourage the swelling to get out!  

RETURN TO WORK:  Most of my patients are back to work in 1 week or less.  

ACTIVITY:  After 1 week you can Run/Jog or go to the gym.  Prior to 1 week, I want you walking around as much as possible.

RETURN TO GYM:  After 1 week you can go to the gym.  You can do any upper body work out and/or Run/Jog.  No lower body squats or any activity that requires you to place pressure on your Butt/Gluts (i.e. Leg Press, Back Row etc) until after 4 weeks from surgery. 

WHAT IF WHEN THE SWELLING GOES DOWN YOU ARE UNHAPPY WITH YOUR BUTT VOLUME?

Multiple Fat Transfers:  If you have enough fat still, you can have another fat transfer.  Many of the Butt Models and Notable Curvy Hour Glasses/Big Butts have had multiple fat transfers.  This can be performed as early as 3 months after your initial procedure.

Fillers:  If you do not have enough fat or simply do not want to undergo another surgery.  You can have your butt/hips further filled Non-Surgically with Fillers.  The fillers can be permanent and actually cause your body to lay down new collagen.  

Best of Luck!

Sincerely, 
Matthew J Nykiel, MD
Butt Augmentation Specialist, Board Certified Plastic Surgeon
#RealSelfTopDoctor
#RealSelfCoreDoctor 

Matthew J. Nykiel, MD
Ontario Plastic Surgeon
5.0 out of 5 stars 12 reviews

Concerned BBL Paitent. Wanted 800, but Only Got 500 in Each Cheek?

I routinely transfer 1200 to 1800 cc on primary BBLs but revisions are more demanding and need additional fat from the thighs and arms. Seek a plastic surgeon who performs hundreds of these procedures, has great reviews and photos, and is an expert in this field.

Ron Hazani, MD, FACS
Beverly Hills General Surgeon
4.9 out of 5 stars 281 reviews

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.