BBL 9 months ago. Unhappy with results, too big and does not blend naturally with my thighs. What can I do to fix this?

Question

BBL done in March 2016. A lot of the fat dropped lower and lower now I feel like it looks way too big for my body and saggy in a way. I hate the side profile, it doesn't blend naturally with my thighs and it hangs over. In jeans its worse because it squeezes my butt to a weird unnatural form I am so self-conscious now. Why did it get saggy looking? I want it to look big but not saggy or fake I want it to blend naturally with my thighs. Should I get lipo to reduce it? Will losing weight fix it?

Matthew J. Nykiel, MD · Answer

Hello and Great Question.  I appreciate the time you are spending researching this procedure.  My name is Dr. Matthew J. Nykiel.  I am a Board Certified Plastic Surgeon, a Fellowship Trained Cosmetic Surgeon, and a Butt Augmentation Specialist
Based on your photos, I understand why you are unhappy.  I do a TON of BBL Revisions/Redos.  I think that you have options.  First, I don't think weight loss will change your results.  Your fat pockets have been changed from the surgery.  In my opinion, I think that we first need to re-sculpt your hourglass and torso.  So that we can blend your Back/waist/hips/butt into a seamless hour glass.  Then I think we need to focus on your butt:  Removing fat from the bottom of your butt bc it is giving a sagging appearance and then smoothing out the remaining amount of fat.  
Best of Luck!  Matthew J. Nykiel, MD#TopREALSELFDoctor#CoreREALSELFDoctorButt Augmentation SpecialistLiposuction SpecialistBoard Certified Plastic Surgeon

Kenneth Hughes, MD · Answer

This will require a redistribution procedure to remove fat in certain areas and redistribute to other areas to create a more favorable contour.

Kirsty Boyd, MD, FRCSC · Answer

Thank you for including photos.  It sounds as though you feel the buttocks are now too large and that you dislike the side profile, where the buttock appears saggy. The problem here is a combination of both too much volume and gravity, which has caused the fat to descend and droop.  The skin of your lower buttock is lax (stretchy).  Losing weight would diminish the size of your buttocks, the same as you lose weight from everywhere else, but it will not address the sagging.  Similarly, lipo to reduce the size would diminish the volume but not address the redundant, sagging skin.  The best way to address this would be to excise (cut out) some of the extra skin at the bottom of your buttock and tighten it.  This would leave a scar in the crease between thigh and buttock, but would create a more favorable profile.  Talk to your surgeon about your dissatisfaction.  A revision with redistribution of fat, tightening of skin, and potentially a reduction in volume would improve your concerns.  Good luck!

Erika Sato, MD, FACS · Answer

I cannot give specific advice to you  as I don't know anything about what you looked like before surgery or in the early post op or what exactly was done during your surgery. You appear to have relatively thin legs. This may be natural or you may have had liposuction there as part of your surgery. What likely happened is that early post op you had more volume in your buttocks which made everything appear higher. When the volume started to shrink away (which is normal), the butt now appears a little saggy. The only way to really make things not look saggy is to add more fat. I am not sure that this is what you want as you already think it is too big. The other option is to move fat from the lower portion to the upper portion to redistribute the shape/volume. Make sure you go to someone who has  experience with this type of surgery as it is not as straight forward as a primary BBL.

Arian Mowlavi, MD, FACS (license on probation) · Answer

The lower buttocks has redundant skin that the surgeon likely tried to fill. It will require a lower buttocks tuck to smoothen out the transition from the lower buttocks to the upper thighs.

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