I'm terrified of fat embolism during a BBL. How does the doctor even know where the veins are underneath my skin?

Question

Someone, please educate me on the logistics of the fat transfer part of a bbl. I'm so scared the doctor is going to hit my vein and I'll have a fat embolism. Part of this fear is also because I'm not sure how it especially works. If the doctor is just poking fat in my rear end how does he know he's not going to hit a vein? Everyone's anatomy is different right?

Daniel Barrett, MD · Answer

Dear whsteveridk,
vein thrombosis and pulmonary embolism are possible complications of fat transfer but with appropriate pre-operative and post-operative protocols, the rate of these complications is very low. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

this is a blind procedure. Obviously if I could see the veins we wouldn't inject fat even close to them.  And hence here lies the problem.  Plastic surgeons are the true surgical anatomists.  I have scoured every anatomy book including an atomic atlases to get the best understanding of where the vains are. Consistently they are deep to the muscle so avoiding injecting deep is a good idea.  For now if you're terrified of this procedure then you shouldn't have it.  No one needs a BBL.  There are providers who insist that they inject fat in the subcutaneous plan only.  Personally I question how much of this actually happens but without question there are plenty of plastic surgeons who put safety first and simply don't inject into the muscle at least to the best ability.  I do think the results can never be as great as those willing to inject into the muscle.  You can't have one without the other.  High-volume impressive results is going to mean taking some increased risk.  If you're not sure then don't do it.  You will not be able to figure this one out. Lots of talented plastic surgeons have been working on some way to make the safe but to date the only thing we really have is not injecting deep, use large cannulas and in my personal opinion use plenty of vaso-constructive numbing solution in the buttocks and wait at least 15 minutes before injecting the fat. Best, Mats Hagstrom MD

I'm terrified of fat embolism during a BBL. How does the doctor even know where the veins are underneath my skin?

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