How can I treat fat necrosis two years after BBL?

Question

Hello I’ve had my bbl about two years ago I have a visible lump and now it’s has been giving pain…I contact my doctor but I’m actually afraid to let him work on my body again because of the unprofessional things I went threw can anyone give me options on who I can get to remove it without particularly involving him

Kenneth Hughes, MD · Answer

Dead fat, unlike living fat, cannot be removed by liposuction, or removal of fat through a cannula by pressure extraction. The dead fat hardened by calcium must be removed in total through an incision in the skin, much like a cyst or a tumor is removed. If the removal is extensive, reconstruction with additional fat grafting may be necessary as well. Thus, the issue of fat necrosis requires an expert skill set to create the optimal result. The goal is both optimal removal of the dead fat while sparing any living adjacent tissue to minimize the overall defect and allow for the best possible reconstruction.

Daniel Barrett, MD · Answer

Dear Gorgeous970691,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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

Darryl J. Blinski, MD · Answer

Must obtain a scan of buttock initially to determine size of fat necrosis area. In my experience the method to improve is directed liposuction with small caliber cannula. then some lipo with nano fat graing to area. Expect fees in the $6,500.

M. Shuja Shafqat, MD · Answer

Good morning,
It is difficult to tell without an in person examination. Typically areas of fat necrosis that have not improved in 2 years would need to be removed. This can leave a divot and a scar. Depending on how things heal, you can have fat transfer again to correct it but it is a challenging issue. 
You would need to be seen in person by a board certified plastic surgeon to determine your options. Good luck!

Douglas Taranow, DO, FACOS · Answer

You have basically two options:
One is to inject steroids into the lump;  up to three injections 4-6 weeks apart
Two, excise the lump under local anesthesia.
Best wishes.
Dr. Taranow

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

There are several reasons for butt lumps after a BBL and these include fat necrosis, pseudocapsules created around an area where too much fat was grafted (called a blow out), and even areas of skin redundancy that can create contour irregularities. Regardless, all of these areas can be corrected once we appreciate what you have going on. A virtual consultation with a BBL revision specialist would be very helpful to provide you definitive guidelines.

You will likely be an excellent candidate for a Brazilian Butt Lift (BBL) revision. The optimal BBL revision  outcomes are achieved with: 1) use of VASER liposuction to harvest the fat since your fat has already been harvested 2) a closed looped system to process the fat in order to optimize transfer time and  avoid your fat from becoming contaminated and 3) strategic micro-packet transplant technique that maximizes graft take. These three processes have demonstrated over 95% fat graft take. This means that your results will be stable as long as you maintain your weight. Finally, attention must be given to providing you the buttock shape that YOU desire. This means using our proprietary BBL assessment tool. As an official VASER trainer, I am routinely referred unhappy BBL patients. One of the most common reasons for disgruntled BBL patients is that patients are not able to accurately communicate their desired buttocks goals to their surgeons.  Our  buttock assessment tool can be an invaluable tool to communicate to your surgeon the exact buttocks size and shape you are desiring. A Skype or FaceTime consultation with a BBL specialist can help you get an accurate recommendation and pricing.

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

If you’ve lost faith in your provider then you need to schedule in person second opinion consultations.

Each provider will tell you what they can or cannot accomplish.

Revision Work is many times more difficult than primary Liposuction or fat transfer. The only way to find out is to have consultations and those need to be done in person.

Best,

Mats Hagstrom MD

How can I treat fat necrosis two years after BBL?

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