My doctor will only inject fat under the skin of the buttock for my BBL: will I still get poppin results? (Photos)

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.
Almost all surgeon now place fat superficially.  Recently, there has been intense scrutinization (rightfully) on BBL surgeries due to the deaths that have taken place.  Two common issues were noted when reviewing these subset of patients:  1) Fat placed deep (NOT Superficial) and 2) Non-Board Certified and Non Trained Surgeons performing the procedures.Because of these findings the task forces recommend ONLY superficial fat injection.  I have always performed this and continue to follow their recommendation.  I believe it does not limit the ability to a booty pop.  I hope that helps!  Best of Luck!
Matthew J. Nykiel, MD#TopREALSELFDoctor#CoreREALSELFDoctorButt Augmentation SpecialistLiposuction SpecialistBoard Certified Plastic Surgeon

Thank you for your question. Based on your photos you appear to be a good candidate for full body intense liposuction to improve your body contour and get better curves especially in your laterals and waist and Dominican Butt Lift transferring the fat that we get to your butt molding and improving your gluteal volume and projection.
Respectfully,Dr. Emmanuel Mallol Cotes.-

The fat should be injected superficially rather than deeply especially in the areas where the large veins run. There is sufficient space for large volumes of fats to be injected in this subcutaneous area. It is good that your surgeon is being cautious and avoiding the most serious complication in this procedure.

Thank you for your question and photos. Based on these photos, you are a great candidate for VASER sculpting technique and a BBL. The “pippin results “ depend on your surgical and artistic abilities. Did you see his long term “poppin results” in his pre and postop results? The sculpting part in the procedure is as if not more important than the amount of fat one places into the buttocks.I personally, do inject into the superficial gluteal muscle, but most of the fat is injected in the deep fat of the buttocks and under the skin. The risks discussed by Dr. Rosas are real and needs to be taken seriously. Good luck with your surgery.

Fat embolus is a very serious and known complication of fat transfer (which has been recently spotlighted in the media). While it is true, injection of donor fat into the infra-muscular plane (within the muscle) increases fat viability, this does come with a significant increase in risk. There are large vessels deep to and within the muscle which can be inadvertently injected while grafting leading to a fat embolus. The consequences of such a complication are very serious and life threatening.
At American Society of Plastic Surgeons Hot Topics (2016), data from AAAASF (ambulatory surgical certifying body) was presented, suggesting that BBL/gluteal lipoaugmentation demonstrates a dramatically higher risk profile than other surgeries. The Aesthetic Surgery and Educational and Research Fund has convened a task force as well. The hope is that we will have more concrete guidelines for addressing these very serious complications.
That being said, the safest way to avoid fat emboli is to stay in the subcutaneous plane (at the expense of fat viability) and avoid the deeper muscular plane. If grafting of the deep plane is planned, surgeons should consider blunt cannulas and aspiration prior to injection. Using a supra-gluteal approach to minimize the risk of inadvertent intravascular injection has also been proposed. While this will likely impact graft viability negatively, it will also lower the risk of a serious complication.
According to AAASF data the risk of death from BBL will range from 1:3000 (subcutaneous grafting should reduce this risk relative to intramuscular grafting). By comparison the risk of fatal complication from abdominoplasty is 1:13,000. It is unclear how the relative risk falls with subcutaneous injection vs. intramuscular injection (however, in all likelihood, it is less).With regards to your specific question, subcutaneous injection will limit results, however, no result is worth risking one's life for. I find that the patients who focus not on the volumization but rather the contouring benefits of the liposuction are happier than those whose sole goal is size (or a "poppin'" result).
In summary, the procedure can be safely performed, however, they should be performed by a board certified (ABPS) plastic surgeon with experience. These risks should be discussed as well as the strategies being employed to avoid them.

Yes you can!
You can absolutely get great results in BBL by avoiding intramuscular fat injections in the buttock.  I would agree with your surgeon, keep it safe and inject in a safer plane.  Results will be good and safety ALWAYS comes first.

It sounds like you and your surgeon are both aware of the risks of this procedure. Don't aim for a volume of injection but for a pleasing final result. The end point of fat fills and injecting is not a volume but a balance between beauty and healthy volumes of fat injection that your tissues can tolerate.

Make sure your surgeon is a well trained, qualified Plastic and Reconstructive surgeon.