Over the muscle BBL - does this reduce the amount of fat that can be injected? What are the chances of fat surviving?

This is a good question. Nowadays, plastic surgeons in the United States try to avoid injecting fat into the muscle for safety reasons. Research and investigations have found there is a higher risk of complications like fat embolisms that is potentially fatal when injecting the muscle. Theoretically, there is less fat that can be injected into the buttock region if fat is not being injected into the muscle, however, the increased risk of an extremely dangerous (and potentially fatal) complication does not make it worth it. For this reason, every effort is made to avoid injecting fat into the muscle to make the procedure as safe as possible. An intra-operative ultrasound can help guide surgeons inject fat superficially, or above, the gluteus maximus muscle. Hope this helps!

Unlike breast implants where there is a definitive plane created, either above or below the pectoralis muscle gluteal fat transfer does not work this way.
Almost 100% of the plastic surgeons in the United States avoid grafting fat into the gluteus muscle, because this has been associated with a serious complication is that can be fatal fat embolism. Some state lost grafting, fat muscle, for mold, societies, recommend surgeons, avoid grafting muscle muscle, and I am pretty sure there are very few if none who purposely graft fat into the gluteus muscle.
Delivering consistent quality, liposuction and fat transfer results is more difficult than most people realize. The number of plastic surgeons who mastered these procedures are in a small minority.
Are liposuction and transfer can leave people just figured, and poor outcomes are extremely difficult to correct.
Being board-certified and plastic surgery with years of experience, and an overall good reputation does not mean somebody has mastered any one single procedure, especially not Liposuction and fat transfer.
I cannot emphasize enough the importance of provider selection when it comes to this procedure.
To find the right provider, I suggest patients have multiple in person, consultations with local plastic surgeons, who seem to have a lot of experience doing the BBL procedure. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of the previous patient who had similar body characteristics to your own. Recognize that when it comes to fat transfer early results can look very impressive, but not in any way represents final results. Always confirmed that after pictures were taken at least 3 to 6 months from the date of surgery. do not assume after pictures represent final long-term outcomes. Always confirm.
An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 15 previous patient. In fact, highly experienced surgeons should have hundreds or preferably thousands of before, and after pictures to choose from.
Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider, what the results based on your candidacy is going to look like or how many of these procedures, the surgeon has performed.
There’s no correct number of consultations needed to find the right provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. Considering how much variation there is a Liposuction and fat transfer results. I suggested patients start the process by having at least five in person consultations before even considering choosing a provider.
The outcomes of these procedures are permanent and irreversible.
Are the time to be critical of plastic surgeons is there in the vetting process while having consultations.
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures.
When, in doubt, slow down and schedule more consultations.
The biggest mistake people make with this procedure is either having virtual consultations, scheduling, only one consultation, and not putting in an effort to properly vet providers.
In my opinion, your cell phone or computer is not a good way to choose a provider
Are provider selection is labor-intensive and takes time. The consequences of not doing this first initial step well can be catastrophic.
Patients will be reminded of their decision making every day after surgery for the rest of their life
Find the right plastic surgeon and everything else into place.
Are all plastic surgeons should be grafting fat above the gluteus muscle
Best,
Mats Hagstrom, MD