BBL or butt implants? which procedure would help me achieve my desired look? (photos)

Question

Hello, I am getting a BBL next year and want to make sure it's the best fit for me. I am 128 pounds and 5'1. I am very flat from behind and lack hips. I want to make sure i'm getting the right procedure for me so I achieve the look I want. Photos A and B is the idea of the body I want. Photos C, D, and E are my body currently.

Gregory Lakin, MD · Answer

Thank you for sharing your pictures and wish pics. Based on them, you are a great candidate for liposuction and BBL. The fat should be transferred to the hips and entire buttocks to sculpt your buttocks. Lipo 360 would also be recommended to shape your entire body. Remember, everybody is different (bone structure, etc.), so you will not have the same exact silhouette as the person in your wish pics.

Semih Yildiz, MD, FEPOBRAS · Answer

A BBL is usually the first option to consider when the goal is a softer waist-to-hip transition, but the result depends heavily on how much usable donor fat you have. In the photos, the current view appears to show limited buttock projection and lateral hip fullness, while the goal photos show a fuller hourglass shape.

At 5'1" and 128 lb, you may have enough fat for modest reshaping, but probably not an extreme change from fat transfer alone. Butt implants can add projection when there is not enough fat, but they carry different risks and can look or feel less natural, especially in a smaller frame. An in-person exam is needed to assess donor fat, skin quality, pelvic shape, and whether BBL alone, implants, or a staged/combined approach is safest.

Moises Salama, MD · Answer

Thanks for your question. From your pictures, you seem to be a good BBL candidate. The BBL includes 360 lipo, which is lipo of the upper and lower abdomen, the upper and lower back and the flanks. This helps contour your waist and give you an hourglass figure, and the transferred fat will add projection to your buttocks. In addition, if you do not have enough fat in these areas, liposuction can be performed in many other areas of the body for fat transfer to the buttocks, such as the upper arms and chin. Depending on your desired results, you may be asked to gain some weight. I recommend you schedule a consult for a proper evaluation. Make sure your surgeon you choose has extensive experience with BBLs and clean credentials. Always consult with a board certified plastic surgeon. Take care, Moises Salama MD, Board Certified Plastic Surgeon

Emmanuel Mallol Cotes, MD · Answer

Thanks for the question.

In this regard, I recommend you waist and back Liposculpture, getting better curves especially in the waist, improving your body contour.

Finally, I suggested take the fat we get and transfer to the buttocks and hips, to mold them and get better volume, contour and butt projection, is that we know as "Brazilian Butt Lift" (BBL).

Kind regards

Luis A. Mejia, MD · Answer

Dear Yyrb, thank you for sharing your question. After analyzing your case I can say you're a good candidate for Lipo in your abdomen, flanks and back + Ultrasound guide BBL Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Daniel Barrett, MD · Answer

Dear ingridramosb,based on your photos, you look like a good candidate for a BBL. Liposuction of your abdomen, back and flanks should give you more curves and hourglass shape and fat transfer to buttocks should give you more projection. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Cagil Meric Erenoglu, MD · Answer

Hi! You don't have many fat cells at present. If you have a bbl operation, of course you will look better than you do now. However, in order to achieve the appearance in the photos, buttock prosthesis and hybrid fat injection should be done to the sides, since you do not have this amount of fat. I recommend that the Ultrasonic Safe and Natural BBL method in order to position the injected fats in the right places, to make the fats much more permanent and to be done in the safest way. Best regards.

Darryl J. Blinski, MD · Answer

The posted photos have few issues. The wish pics are not very helpful because in clothing. As is your own posted photos in undergarments - so very hard to tell what your buttock appears as. Please repost... I classify you as a "REGULAR BBL" meaning you have enough donor lipo360 fat to effectively add to your buttock, but gain 5-10 pounds would be a great help. I do not recommend Butt Implants for higher risks of complications and longer healing phases. Fee for lipo 360/BBL from $6,000+. Best to virtual consult with...

Mats Hagstrom, MD (license on probation) · Answer

Choosing the correct procedure should be based on first and foremost an accurate assessment including a clear understanding of the difference between your body and what you’re hoping to achieve.
The biggest difference between you and your wish picture is not fat distribution. The biggest difference comes from two individuals who have strikingly different skeletal structure.
For that reason your Waze pictures are not realistic and you should not focus on trying to get a body that looks like that.
You can get improvement but it needs to be based on your body the way it is.
To make assessments from photographs we need really high-quality pictures.
Pictures should be taken by someone else or you seen the timer on your camera from about 8 feet away. Pictures should show your body from your neck to below your knees showing your front side, side and behind wearing revealing undergarments.
We need to see your lower extremities because that has a lot to do with how your torso looks.
You also didn’t include pictures showing you from behind
Gluteal implants is generally not a good procedure. Most plastic surgeons in the United States don’t offer gluteal implants and there’s a good reason for that.
The procedure has very high complication rates and high failure rates.
That means the number of people who get gluteal implants and have long-term high quality outcomes is low.
Liposuction with fat transfer is your best option but you need to dial in your expectations to match what’s possible on someone with your body type.
Look at lots of before and after pictures and look very carefully at the before pictures to make sure they look similar to yourself.
To do that do you need to start by having quality pictures of your own body.
Look at how plastic surgeons take before and after pictures and try to simulate posting the same way and cropping pictures so they show your body more completely and from all angles.
A BBL is in fact two procedures done at the same time. liposuction and fat transfer. It’s possible to be a good candidate for Liposuction but not a good candidate for fat transfer just like it’s possible to be a good candidate for fat transfer but not Liposuction.
And making a quality assessment I need to get a good understanding regarding your own candidacy for both procedures.
The surgeon needs to be able to create improvements with Liposuction and harvest sufficient amounts of fat to do a quality fat transfer.
There are multiple variables that determine candidacy for both Liposuction and fat transfer.
Generally speaking ideal candidate should have fairly tight skin without skin laxity due to weight fluctuations or previous pregnancies, muscle separation from previous pregnancies, excess visceral fat and other variables that are not treated by liposuction or fat transfer.
For a fat transfer that needs to be sufficient host tissue to support grafted fat. 
Delivering consistent liposuction and fat transfer result is more difficult than most people believe it. The number of plastic surgeons who can do the procedure really well on a consistent basis is a relatively small.
Liposuction in particular has more variation and outcomes based purely on who does the operation than any other plastic surgery procedure.
Being board certified in plastic surgery with overall good reputation and years of experience does not mean someone has mastered either Liposuction or fat transfer.
To get an assessment in regarding to your potential and selection of procedures will require having a few in person consultations.
I highly recommend avoiding virtual consultations whenever possible.
I also highly recommend people avoid traveling long distances for elective surgical procedures.
For some individuals there simply is not sufficient local talent and travel may be needed. when that’s the case try to keep the distances to a level where you can have in person consultation and have in person follow up appointments after surgery.
The next step is a vetting and choosing the right provider.
This is far more difficult than most people believe because most people do not have access to unbiased information.
Start the process by making a list of local plastic surgeons who seem to do a lot of BBL procedures and seem to have a good reputation for that operation.
Start by scheduling at least five in person consultations with local plastic surgeons who seem to have experience with the BBL.
Before scheduling consultations begin reviewing lots and lots of before and after pictures.
Whenever Reviewing before and after pictures always have pictures of your own body present. There’s no point at looking at results unless the person in the pre-op pictures looks like you.
In the end there are only two variables that determine cosmetic surgery outcomes.
The first is patient candidacy and the second is the surgeon’s skill and experience. 
Create a rating system for quality outcomes of BBL results of patients who have similar body characteristics to your own. you should begin to judge results based on liposuction separately from fat transfer. you should learn to clearly recognize areas that have been treated with Liposuction and what areas were treated with fat transfer.
Fat transfer becomes a little more difficult to make assessments because the results change so drastically over time.
Early fat transfer results can look very impressive but they do not represent final results.
Whenever reviewing before and after pictures for fat transfer results always confirm the amount of time between the procedure and when the after pictures were taken. Never assume after pictures or final long-term results.
After pictures should be taken at minimum of three months from the date of surgery but preferably six months or longer. seeing early results really means nothing because there’s such a drastic change over the first few months.
Schedule five in person consultations with providers in your community.
Most people do not have much experience consulting with plastic surgeons let alone vetting plastic surgeons to determine their skill and experience level.
During each consultation bring pictures of your own body to use for reference.
Bring a notepad and take notes during the consultation.
Take notes about the overall thoroughness of the consultation including how many minutes the surgeon spent with you.
Consultations with anybody other than the surgeon who is actually going to do your procedure is worthless.
If you’re not consulting with the surgeon who is going to do your operation you’re in the wrong place.
When it comes to reviewing before and after pictures ask each provider to first and foremost only show you pictures of previous patients who have similar body characteristics to your own. Ask them specifically to open up their portfolio and show you their entire collection of before and after pictures. do you want to get an idea of how many of these procedures they have actually done.
Providers may be apprehensive to do this and may instead prefer to just show you their “show and tell” “best of their career” photos.
While this may be impressive and serve the plastic surgeons need it is totally insufficient to get a clear understanding of what the average results look like or how many of these procedures each surgeon has actually performed.
Ask surgeons to show you examples of excellent outcomes, average outcomes and results that did not turn out as well as they had hoped. again make sure that they are only showing you examples of previous patient whose body looked relatively similar to yours.
For reference an experienced plastic surgeon should have no difficulty showing a minimum of 50 sets of before and after pictures of commonly performed procedures like the BBL.
When reviewing results look very carefully and Liposuction results first and make assessments regarding the quality of the outcomes. look carefully at all areas treated to make sure there are no skin contour irregularities anywhere in any of the treated areas. Ask the provider to point out exactly what areas were treated with Liposuction and what areas were not treated. then look very carefully at transition zones between treated and untreated areas to make sure they look attractive and natural.
Personally I view the torso as a single anatomic unit and generally try to treat the entire torso when doing liposuction. by treating the entire torso as a single unit I leave a patient with a thin even fat distribution that’s normal and consistent and looks natural. Treating a full torso includes upper abdomen, lower abdomen, love handles(generally down as low as the top of the hip dip), Waste, full back and under arms(armpits) all the way to the side of the breast.
The potential impact of liposuction is directly related to the thickness of your subcutaneous fat layer. this should be reviewed during your assessment.
If somebody has 1 inch of subcutaneous fat then they should expect 50 to 75% of that fat to be able to be removed which will bring in the skin contour by 1 1/2 to 3/4 of an inch.
If someone’s subcutaneous fat layer is 1/2 inch then the skin surface will come in by one 1/4” to 3/16” of an inch. It is not possible to contour the body more then you have fat for removal. This is one of the reasons looking at results from patients who have completely different skeletal structures is not in your interest.
For fat transfer results make sure that the entire female body looks attractive with an established feminine smoothing and continuous S-curve that goes from the armpit all the way down to just above the knee. make sure the transition from the buttocks to the thigh look completely natural. there is an inappropriate tendency to do liposuction of the upper thigh in order to give the illusion of a larger buttocks. I called is the “lollipop look”. Doing this destroys the natural S-curve which surgeons should be trying to create. Different plastic surgeons have very different views of how this procedure should be done including what an attractive female body looks like.
Maintaining a smooth continuous S-curve is paramount and delivering stunning results.
The contour needs to have graceful sweeping curves that are natural balanced and proportionate.
The number of plastic surgeons who can do this procedure well on a consistent basis including the ability to make an accurate assessment and predict accurately what results will look like and can show you numerous before and after pictures exactly of what your results would look like it’s quite rare.
If you have doubts regarding any aspect of the consultation then simply slow down and schedule more consultations.You should’ve seen what seemed like an endless number of before and after pictures including sufficient number of patients with almost identical body characteristics to your own with consistent quality results with some variation but overall good outcomes. The surgeon should explain the procedure well including your candidacy, preparation for surgery, recovery, revision rates and revision policy and the likelihood of you getting the type of results you want.
Patients should be more selective for liposuction and fat transfer then they think they need to be.
I recommend patient start with five in person consultations but this may not be sufficient depending on how well you choose your initial consultations.
If there is any reservation regarding the providers skillet experience then simply slow down and schedule more consultations.
Liposuction and fat transfer to some degree should be considered permanent and irreversible.
It’s perform poorly people are left disfigured. once done it is very difficult to improve the outcome after liposuction.
This procedure is very much “do it once do it right”. Because there is so much variation in outcomes between different surgeons patience simply have to go through the vetting process an interview lots of plastic surgeons insisting on seeing their entire collection of before and after pictures or at least enough pictures to get a very good understanding of what average results look like in the hands of each provider.
In order to be able to remember the information you will need to take notes.
This may also require going back for a second consultation with any one provider if you forget to ask questions or you don’t remember exactly what they said or what their results look like.
Do not go by seeing one or two really impressive outcomes.
You need to see what should be an almost endless list of before and after pictures that represents an entire career of doing this procedure.
Providers who do not have significant numbers of before and after pictures I can’t show you pictures of previous patients who looked almost identical to you should be an immediate red flag.
Finally I recommend reading all the 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 far more telling then having an abundance of positive reviews.
Having a high number of positive reviews doesn’t really mean all that much. It is the absence of justified negative reviews that differentiate those who are truly great.
If someone can practice plastic surgery for a decade or more without upsetting enough patients to write justified negative reviews then they’re probably doing it correctly.
In the end if you have doubts it’s better to slow down and schedule more consultations.
Unfortunately there is a substantial amount of bad work being done and once performed patient’s bodies cannot be restored.
I cannot emphasize enough the importance of provider selection when it comes to this procedure.
You’ll be reminded of your decision every day for the rest of your life so please choose carefully.
Best,
Mats Hagstrom MD

BBL or butt implants? which procedure would help me achieve my desired look? (photos)

Answers (9)

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