Dr said I'm not a candidate for round 2 because he was only able to harvest 600cc and a second time he'd get less? (Photo)

Question

Had an awake bbl in 2021 (I was 25 5'4 119lb) but wasn't happy with the results as I saw no difference in my shape. The dr I went to only specializes in awake bbls and told me I'm not a candidate for another because he will harvest less fat then the first time. Is that true or is he telling me this because he can't give me the results I want since he only does awake bbls and can't be as aggressive as when your asleep? I'll post my before and after pics. Thank you!

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, 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. Long story short, your doctor is being honest with you.

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

Buttock implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often 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 Rational2683,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

Only on the basis of in person evaluation, an experienced, board certified plastic surgeon, could help you with decision. Liposuction and fat transfer performed in general anesthesia definitevly allow surgeon to havest fat more aggressively. Hope this helps.

Geuris Cruz Quiroz, MD · Answer

Thank you for your questions dear @Rational2683. 
Sorry to hear your results are not the one you was looking for with your BBL procedure, but Unfortunately awake BBL will never give you amazing results as a conventional Liposculpture and BBL procedure. I understand you want to minimize the risk with general or epidural anesthesia, awake BBL do not allow the surgeon to be aggressive as a conventional procedure, in order to archive the results you are looking for I definitely will recommend you another BBL round with a board certified plastic surgeon, you are a good candidate for a BBL procedure. 
Good luck!

Darryl J. Blinski, MD · Answer

Thanks for the 2 posted photos. You did not use a boarded Plastic Surgeon for round 1 because SKINNY BBL require light general anesthesia to be more lipo aggressive to obtain fat to transfer. Plus if doing awake lipo in Florida allowed only 1 liter lipo as max. To you decided to use a limited surgery process, thus poor results. You need under light general anesthesia redo lipo 360 with BBL with ultrasound guided injections. Fee 6,000+ Best to virtual consult with.....

Douglas Taranow, DO, FACOS · Answer

We really need naked photos of your front, sides, back and arms to evaluate if you have residual fat available.  Make sure to include the upper thighs in the photos.
Best wishes,
Dr. Taranow

Malik Abaci, MD · Answer

Hello, we can help you with any revision or problem related to BBL, which is your area of expertise. Can you share your photos with us. We can give you information about the whole process.

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment, we need quality pictures. When discussing body contouring using liposuction, especially when it comes to reviewing results and the potential of secondary procedures, it’s very important to be specific about what areas have been treated previously. It looks like you have enough subcutaneous fat to be able to get a competent second fat transfer if enough areas are included with the Liposuction treatment. I generally try to treat the entire torso when doing abdominal liposuction. This means including the entire back and under arm areas all the way to the side of the breast. If that doesn’t give enough fat, then I usually turn to extremities either arms or inner thighs. The amount of fat that can be harvested from secondary liposuction depends, in large part on how aggressive the first treatment was. I am generally able to harvest 25 to 30% of what was obtained during the first procedure during a typical secondary liposuction treatment. There are major differences in skill and experience among plastic surgeons when it comes to both Liposuction and fat transfer. The approach and potential results very dramatically based on who you choose as your provider. Finding the right provider is key to getting a quality outcome and an accurate assessment, with a clear understanding of what the procedure can, or cannot accomplish. to find the best provider, I suggest patients have multiple in person consultations. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who have similar body characteristics to your own. An experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients. For fat transfer results always make sure that after pictures were taken at least 3 to 6 months from the date of surgery. do not assume plastic surgeons have the skill and experience because of titles or certifications. Doing these procedures, well on a consistent basis, is far more difficult than most people realize. The number of providers have truly mastered the BBL procedure is in a small minority. There are major differences in approach and competence. Patients need to put in a significant effort to find the right providers. 
Best,
Mats Hagstrom, MD

Dr said I'm not a candidate for round 2 because he was only able to harvest 600cc and a second time he'd get less? (Photo)

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