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

Dear Straightforward923090,
most plastic surgeons transfer fat above the muscles in order to avoid blood vessels and reduce the chance of complications. 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

Dear Straightforward923090,

Your safety-first mindset is commendable! The decision to place fat over or into the muscle during a Brazilian Butt Lift (BBL) is primarily guided by safety concerns, especially with recent research and guidelines.

Over the Muscle vs. Into the Muscle:
- Over the Muscle: Placing fat over the muscle is generally safer. Injecting fat into the muscle increases the risk of fat embolism, a severe complication where fat gets into the bloodstream and can travel to the lungs.

- Into the Muscle: Some believe that placing fat into the muscle might provide a better scaffold for the fat to survive and a more "lifted" appearance. However, it comes with the aforementioned risks.

**Volume and Fat Survival**:
- Over the Muscle: There's a limit to how much fat can be safely injected over the muscle because of the limited space. However, with a skilled surgeon, significant enhancement is still achievable. Fat survival over the muscle may vary, with some studies suggesting that 50-70% of the transferred fat might survive. The rest is naturally absorbed by the body.

- Into the Muscle: While there might be a perception that more fat can be transferred into the muscle, the risks associated with it make it less common in recent practices.

Your desired results of a larger bum and wider hips can still be achieved with over-the-muscle injections, but it might depend on the quality and quantity of the donor fat, the technique used, and post-operative care. Always maintain an open dialogue with your surgeon, discussing expectations and potential outcomes.

Remember, a skilled surgeon prioritizes safety and will use their expertise to give you the best results within the safe parameters of the procedure.

#Staybeautiful @RealDrWorldWide

For safety reasons and to prevent fat embolism fat should never be placed into the butt muscle called the gluteus. Fat should be placed in volumes that are in proportion to the butt. Packing too much fat in a single session can result in fat loss and deformity.

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