Can barely tell a difference after my Brazilian Butt Lift - What should I do now? (photos)

Question

I’m so disappointed because I got a bbl but my butt is still small, to be honest I can barely tell a difference. I’m so upset because I wasted so much money and went through so much pain for nothing. I was skinny to begin with but I’ve seen many doctors still extract a lot of fat out and inject into the buttocks, leaving a perfect round butt. I wanted projection and fullness. What should I do now?

Ryan A. Stanton, MD · Answer

Unfortunately you were never a good candidate for BBL. However, 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, 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 round 2 BBL most often produces the same disappointing results but at another financial loss.   Buttock implants indeed provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often smoothing out lumpiness. Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in 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 a,karolina24,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Adolfo Sesto, MD · Answer

Hello. If there are fat deposits in your body is easy to harvest more fat and trasnfer it to the receptor area, meaning your buttocks. Try not to get massages in the area, nor use laser lipo or any other non traditional method that will damage the fat cell to be able to survive in the receptor area.

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality liposuction and fat transfer results is more difficult than most people believe.
This definitely includes plastic surgeons who more often than not think they’re better at the procedure than they actually are.
The number of plastic surgeons who can consistently deliver predictable quality results including the ability to make an accurate assessment and show precise before and after pictures with comparable results being delivered regularly is actually quite small.
There are also a significant number of patients who not only lack results but her left disfigured from these procedures as well.
When it comes to Liposuction the potential for change is directly related to how thick the fat layer is we have to work with.
Fat grafting success is based on a number of factors which include the amount of host tissue available to support the graft, the amount of fat grafted and technique used(basically skill and experience).
Both Liposuction and fat transfer has more variation in outcomes than any other plastic surgery procedure I’ve ever seen.
For that reason I continue to encourage patient to be highly selective when it comes to choosing a provider and making sure you’ve gotten a quality assessment by multiple providers before committing to this procedure.
Finding the right provider and also having a clear understanding of your own candidacy by having an accurate assessment is absolutely critical to having consistent quality outcomes.
I recommend each patient begin this process by first having multiple in person consultations with local board-certified plastic surgeons who seem to have experience with the BBL procedure.
A BBL is in fact two operations done at the same time. The two procedures need to be assessed separately.
For example someone may be an excellent candidate for fat transfer but not a good candidate for Liposuction, a good candidate for Liposuction but not a good candidate for fat transfer, a good candidate for both or not a good candidate for either of the procedures.
For fat transfer there are a lot of things to take in the consideration especially when it comes to reviewing before and after pictures.
First and foremost is recognizing that final results after fat transfer are drastically different than early results.
There are plenty of pictures floating around the Internet of highly impressive fat transfer results taken early after the procedure.
These, from providers, patients and influencers.
The BBL has more unrealistic results being displayed online than any other plastic surgery procedure.
It is unfortunately too easy and perhaps too tempting for people to only show honest long-term outcomes.
To find the right provider I recommend patients first learn to recognize what quality results look like for both Liposuction and fat transfer.
Do that by looking at lots of pictures online specifically looking at previous patients who had very similar body characteristics to your own. Once you feel like you have a good idea of what good results look like create a reading or grading system for deciphering outcomes especially of patients who have similar body characteristics to your own.
There’s no point in comparing results of patients who have different body characteristics.
Candidacy for the procedure has a major impact on what’s possible.
During each in person consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures of the procedure you’re interested in.
For Liposuction you need to review exactly what areas they recommend being treated and when reviewing before and after pictures review all areas treated and confirm that with the provider.
Ask the provider specifically to show you as many pictures as possible of a previous patient who had very similar body characteristics to your own.
Ask the provider to show you examples of excellent outcomes, average outcomes and outcomes that did not turn out as well as they had hoped for.
Ask what their revision rate is and what the revision policy is.
Being shown a handful of sample pictures which were preselected and most likely represent the best results of the providers career is totally insufficient to get a clear understanding of what the average results look like or how many of these procedures a surgeon has actually performed.
For reference and experience provider should have no difficulty showing you at least 50 sets are before and after pictures of commonly performed procedures.
Providers may be apprehensive to open up their portfolio and show you anything other than their preset “show and tell” photo albums.
Insist on seeing more pictures. If the provider doesn’t show you sufficient number of pictures then let them know that it is one of the major determining factors for which provider you choose.
Bring pictures of your own body during the consultation for reference and rate or grade all of the before and after pictures and count exactly how many they showed you.
You should also make a notes of the overall thoroughness of the consultation including reviewing medical history, preparation for surgery, risks and benefits, recovery, alternative procedures, examination, review of before and after pictures etc. etc.
If you’re uncertain about certain aspects of the consultation of any one provider then schedule a second follow up appointment.
There’s no correct number of consultations patients should have before selecting a provider but I suggest patients start by having a minimum of five consultations and scheduling more if they’re not completely sure that they found the most talented and experienced provider for this procedure in their community.
Recognize that most patients are not experienced at vetting plastic surgeons or how to do consultations effectively. practice helps becoming better at doing plastic surgery consultations including the ability to select the right provider.
The process for picking a second opinion plastic surgeon is more or less the same.
Well revision surgery is more challenging and more difficult than primary liposuction and or fat transfer the process of finding the provider is more or less the same.
The biggest difference is providers will not have nearly as many before and after pictures of revision or secondary procedures.
The best plastic surgeons to do revision or secondary procedures are most likely the ones that are best at doing primary procedures.
Finally I recommend reading all reviews on various physician review websites avoiding providers with any significant number of justified negative reviews.
The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.
When in doubt slow down and schedule more consultations.
At this point you should go back and discuss your concerns with your provider. You should have copies of your formal before and after pictures.
You should compare those with the before and after pictures the provider showed you during the consultation.
If they are significantly different then ask the provider why your results are not as impressive as the results he or she showed you. If the outcomes are substantially less than what had been promised then sometimes it’s worthwhile discussing asking for a refund. Surgeons are typically not obligated to do this but it never hurts to ask especially if there’s a substantial variation in what was promised and what was delivered.
Perhaps you need a second round of fat to transfer.
This might be a good idea especially if your provider did not cause any contour irregularities or any problems for you.
For individuals who have bad outcomes I recommend they stay away from their first provider for doing any secondary work.
If it’s simply a matter of getting more of the same then having your provider do a second procedure may be highly appropriate and potentially cost saving.
When in doubt always schedule second opinion consultations.
For affective second opinion consultations patient should come prepared with proper before and after pictures and a copy of your operative report. These are all available from your surgeons office upon request.
To make an assessment on the outcome of any plastic surgery procedure we need to see proper before and after pictures. The distances and angles need to be the same.
All areas involved need to be shown from standard angles.
If you don’t have a proper before and after pictures and ask your surgeon to forward the ones they took.
The time to sweat the details about choosing the right provider should ideally be before you schedule surgery.
In the end your surgeon is responsible for the outcome of the procedure including setting accurate expectations while you are responsible for choosing that surgeon.
Either work with your current provider or get a proper second opinion consultation.
Always avoid having virtual consultations when possible and avoid traveling long distances for elective surgical procedures unless absolutely necessary.
Best,
Mats Hagstrom MD

Can barely tell a difference after my Brazilian Butt Lift - What should I do now? (photos)

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