How to fix botched BBL? (Photo)

Question

33 y/o female, 5’4’, 170 The concerned area did NOT look like that prior to surgery in 2020. Zero pain, no rashes, it’s very soft and is killing my mental state. I am looking for recommendations on how to fix this issue non-surgically if possible.

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

You are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, unevenness, lack of projection in the central and/or lower buttock, insignificant hip augmentation, post-deflation sagging, fatty necrotic cyst or scar tissue, etc.) as most of the fat melts away. It is not quite as much the quality of the doctor nor liposuction technique but rather the quality of the procedure that is a large part of the problem.  Thus, going back for additional rounds of BBL most often produces the same disappointing results but at another financial loss.   Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation.

Fillers, such as Sculptra and hyaluronic acids,  for augmentation of the buttock/hips are a rip-off, period!

Buttock/hip implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the hips and central buttock, and often help smoothing out lumpiness. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging.  When considering buttock implants make sure that the surgeon is going to be placing the implants within gluteus muscles , (a.k.a. “intramuscular pocket”), and that they are using anatomically correct, oval-shaped implants, such as Stanton Anatomic ®️ implants. 
Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in these buttock implants so be sure to consult with one that is reputable and experienced. Unfortunately you may have to travel long and far away from home to find this particular surgeon. Glad to help.

Daniel Barrett, MD · Answer

Dear Persistent251746,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment regarding the outcome of any plastic surgery procedure, we generally need to see a complete set of proper before and after pictures.
If you don’t have before, and after pictures, ask your surgeon to forward the pictures they took.
It looks like you had inappropriate liposuction of your thigh, most likely in attempt to make your buttocks look larger.
You chose the surgeon who simply didn’t have the proper skill or background work.
 Correct this is going to be very difficult because fat was not only inappropriately removed but removed aggressively.
Rebuilding the fat layer that was removed during surgery be done with fat transfer, but this will most likely require multiple procedures.
Revision work is many times more difficult than primary surgery.
Considering how few plastic surgeons are truly excellent at liposuction and fat transfer, it’s going to be challenging to find a surgeon who has enough skill and experience to make equality assessment to help you make the correct decisions. 
Any attempt at revision surgery by providers who have not mastered this kind of work can lead to worsening the outcome.
This kind of work is very difficult and usually only partial improvements are possible.
To get a significant improvement will probably require multiple operations.
In the end, whether this is worth it is something that needs to be thought through very carefully.
The first step is to find the right provider to be working with.
That probably means having a lot of in person consultations.
I generally do not recommend people rely on virtual consultations for any operation.
Plastic surgery outcomes are generally based on patient candidacy and the skill of the provider.
I also generally recommend people avoid traveling long distances for elective surgical procedures unless necessary.
During each in person consultation, ask each provider to open up their portfolio and show you before and after pictures of both Primary BBL work and revision work.
 Generally speaking the best doctors for doing revision work are the same doctors who do the best primary procedures.
To start with get a complete copy of your entire medical record, including all before and after pictures.
When having a second opinion consultations, you should always come prepared to bringing with you a complete set of proper before and after pictures and a copy of your operative report.
Best,
Mats Hagstrom MD

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