BBL-What to ask for?

Your selection of a board certified plastic surgeon (BCPS) who performs thousands of BBLs is key.  During your consultation, express your concerns so that they can be addressed to lessen your anxiety.  Look at the "before and after" photos of BBLs on the BCPS's website and discuss your ultimate goals or outcomes with the BCPS who can access whether they are reasonable.Kenneth Hughes, MD, BCPSLos Angeles, CA  

Thanks for your question. I get a lot of women that ask me this question. My first advice is to consider your motivations for wanting a BBL. Next, decide on what your aesthetic goals are. Next time you meet with your plastic surgeon, bring photos of examples of buttock shapes and patient results that you like or don't like. Then hear what your plastic surgeon has to say about what can be accomplished and what to expect. This sort of dialogue is important because ultimately, your plastic surgeon's ultimate goal is to help you achieve your aesthetic goals and to make you happy.

It's a good question. I assume you're referring to what to ask for regarding your goal look. Really depends, but my senses is that you are looking for something that is proportional to your body. Most surgeons will narrow your waist is much as possible, and then create a smooth S curve running from your upper back your waist, love handle, hips, and thighs. You may consider bringing in wish photos so that your surgeon can get a sense of your goals.

BBL
goals are not quite as easy to effectively communicate as compared to breast
augmentation. There are no cup sizes or informative cc guides. However, I often find that breaking down the technical aspects of the operation can aid in communication by ensuring that patient and surgeon are on the same page.
We
as surgeons tend to describe things in regards to framing and esthetic zones
(as defined by Dr. Mendieta). Beginning with frame, patients are subdivided
into "A" frame, "V" frame based on the relationship of the
A point to the B point. The A point is the most prominent bony point on the
upper hip-the iliac crest. The B point is the prominent bony point on the lower
hip- the greater trochanter. When the A point is wider than the B point you
have the "V" frame which is generally considered less aesthetically
desirable. When the ratio is flipped with the B point being wider than the A
point you have an "A" frame which is more desirable. When the two
points are equal you have a "square" frame.
The
goal of most BBL procedures is to convert "V" or "Square"
frames into "A" frames by understanding the 11 aesthetic units from
which we either harvest or transfer fat. These units are:
1.
Sacrum or "V" zone at the top of the gluteal cleft
2.
Flank
3.
Upper buttock-lower flank
4.
Lower back-just above the "V" zone
5.
Outer leg-below the "B" point
6.
Gluteus-the "apple of the buttock"
7.
Inner gluteal-"Diamond Zone" crucial for emptying the "thong
zone"
8.
Mid-lateral buttock-"C" point between "A" and "B"
9.
Inferior Gluteal/Posterior leg (back of the leg)
10.
Upper back
While
this is all very technical, the goal is to achieve an "A" frame by
emptying zones 1-4, 7, 10 and building up area 6 and 8. The result is a cinched waistline and filled out frame.
With
regards to your specific question, the best way to approach a consultation is
to decide on your frame and then discuss what areas need to be emptied and what
areas need to be augmented. The number and letter guides are a standardized method of discussing what to expect.
As
always, discuss your concerns with a surgeon certified by the American Board of
Plastic Surgeons.

Bringing realistic "goal" photos is always a good idea so that you and your surgeon are on the same page. He can tell you wether he is able to accomplish what you are asking. Most surgeons use the technique of taking down the waist as much as possible with liposuction and then injected into the buttocks evenly. The fat is injected usually from the top of the buttocks (lower back) and/or the bottom depending on the patient's wishes and individual needs. Good luck with your procedure!

You raise an excellent question.
There are many references on the Internet to specific questions to ask a doctor during a consultation.
I often have patients coming in with very similar list.
They typically include questions like are you board-certified?
How many of these cases have you performed?
What type of complications have you had and how did you take care of them?
How many before and after pictures do you have that you can show me?
What is your policy on the cost of revisions should they be needed?
Do you have hospital privileges?
For most patients there number one emotional during the consultation is anxiety.
During the consultation I typically begin with open ended questions for my patient.
I then briefly explain the different aspects of a thorough consultation.
After having given my patient had chance to ask specific questions I generally try to get a report of who the person is.
This could include word lifestyle interest and family.
My goal is to establish a sense of trust, try to understand my patients expectations and educate them about it fairly complex process that will change your life forever.
That's a lot to cover even during a lengthy thorough consultation.
My consultations typically take one hour.
I then share my background, my training and work experience.
My practice is unique in that I only perform liposuction and fat transfer procedures.
This gives me a chance to explain why I've chosen these two procedures and why I became a subspecialist.
I prefer to keep my patients in their clothing during the first half of the consultation.
After I've explained my background I typically talk about the specific procedure the patient is requesting. Consultations should also include alternative procedures when appropriate. 
I generally educate the patient about who does well with this procedure and who will not do well.
Both liposuction and fat transfer are unique in that many patients the request these procedures may not be very good candidates for them.
This poses a potential difficult situation for a patient who may have to choose having a procedure with understanding that the expectations need to be set low and results will not be as good as some that they have seen on other patients. 
At this point I step out of the room and asked the patient to change into a robe.
During my exam I try to explain how well the patient will do with the procedure and why.
At times I'll discuss areas to be treated not brought up of the patient simply for the sake of patient education.
When I'm finished with my examination I step out of the room and the patient gets dressed.
The majority of patients have a fairly high level of anxiety during doctors visits and especially during a surgical consultation.
Having the patients wear their own clothing seems to comfort them and puts me in the patient in a more equal level.
The conclusion of the consultation focus mostly on if the patient should have a procedure, the logistics in regards to pre and post operative care.
I usually bring out numerous before and after pictures at various points during the consultation.
I like to show consecutive cases.
In other words I'll show 10 cases that I did in a row.
It's very important to not show only your best results.
Ideally you should find before and after pictures of patients who have very similar bodies to the person you're consulting with.
Without question, setting expectations correctly is as important as technical expertise in developing long-term patient satisfaction.
A patient who is not a great candidate for a procedure but expects to have results like your best before and after pictures will be disappointed and feel like a procedure was not done correctly unless expectations are set appropriately.
I personally do not engage in talking about prices with my patients.
First of all I find it uncomfortable and secondly I want to separate myself as much as possible for the business aspect of medicine.
I want to be a patient advocate first and foremost someone who will do everything I can for the pure benefit of my patient.
Lastly I give my business card to my patients which has my personal direct contact including myself cell phone number.
Most patients seem to appreciate a thorough consultation.
Developing a rapport before the procedure is always a good idea but becomes particularly important if there any potential issues during or after the procedure.
In regards to board certification. 
Board certification is very important.
In your case please confirm that your doctor is board certified specifically in plastic surgery.
Only doctors board-certified in plastic surgery by the American Board of plastic surgery have a true expertise in training in the procedure you described.
In the end having a sense of trust, confirming board certification with the American Board of plastic surgery and confirming the doctor has extensive experience and great results is what you should hope for during a consultation.
Best,
Mats Hagstrom M.D.

Thank you for your question about BBL surgery. Your desire to have a small waistline with natural but prominent butt and hips is definitely a possible outcome after BBL surgery. In regards to your question, there are different techniques that surgeons use for this procedure. There is also a new technique called VASER high definition liposuction with Pure Graft that is able to optimize the amount of fat harvested from the body which can then be grafted into the buttocks area to increase the volume and improve the contour. If you are worried about the results of this surgery, I would advise that you speak with your surgeon to make sure he/she knows exactly what your goals are for this surgery. Having an open line of communication with your surgeon is very important and will make you feel more comfortable about undergoing this procedure. Good luck with your surgery!

Hello and thank you for your excellent question. Based on your photos and desires, I would suggest that you look into either a BBL, buttock augmentation with implants, or perhaps use of Sculptra to augment your buttocks. Anyone can make a butt larger. The artistry is in giving you a properly proportioned waist, hips, and buttocks that fits your frame and meets your expectations. Of course, you will need an in-person consultation to evaluate you for this procedure. Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. Any treatment plan should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! Best,
Jon Ver Halen, MD FACS 
Harvard educated plastic surgeon