Can flat spot/dent be fixed with another BBL? (photos)

Question

Hello, I had a bbl on july 2021, I’m 8 months post op but I did have a complication. I had a blood blister/boil that formed into a scab/necrosis which opened to be a big open wound. I plan to get a scar revision but all the fat that was in that area is now gone so it has left me a flat spot/dent. Super noticeable and my right cheek was left somewhat pointy. Can a bbl fix the flat spot/dent?

Daniel Barrett, MD · Answer

Dear Gorgeous560095,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from fat transfer. 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Darryl J. Blinski, MD · Answer

Sorry for your postoperative severe infection complication & your 'torpedo' buttock effect on opposite side. You will need a few surgery rounds. Start with scar revision and excision of indented scarred area with a layered repair and flap advancement. Also on opposite buttock cheek lipo reduction with specialized taping to correct 'torpedo' butt. That fee $10,000. After 4-6 months round 2 redo lipo with redo BBL + maybe Sculptra injections if not enough donor fat. That fee varies if Sculptra needed.

Arian Mowlavi, MD, FACS (license on probation) · Answer

In your types of cases, a waiting period of 3- 6 months is recommended after initial the surgery. Based on your pictures and now being 8 months post op, you are an excellent candidate for a Brazilian Butt Lift (BBL) revision to improve the severe divots and hollowness created by your complication.

The optimal BBL revision  outcomes are achieved with: 1) use of VASER liposuction to harvest the fat since your fat has already been harvested 2) a closed looped system to process the fat in order to optimize transfer time and  avoid your fat from becoming contaminated and 3) strategic micro-packet transplant technique that maximizes graft take. These three processes have demonstrated over 95% fat graft take. This means that your results will be stable as long as you maintain your weight. Finally, attention must be given to providing you the buttock shape that YOU desire. This means using our proprietary BBL assessment tool. As an official VASER trainer, I am routinely referred unhappy BBL patients. One of the most common reasons for disgruntled BBL patients is that patients are not able to accurately communicate their desired buttocks goals to their surgeons.  Our  buttock assessment tool can be an invaluable tool to communicate to your surgeon the exact buttocks size and shape you are desiring. A Skype or FaceTime consultation with a BBL specialist can help you get an accurate recommendation and pricing.

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

It looks like you developed a pretty serious complication after your BBL.

Most likely there’s a substantial amount of scar tissue that is contracting and causing the flat spot.

Grafting fat will not release the contractile nature of the scar tissue.

Successful approach to correcting this is much more involved than grafting fat and would most likely require a free flap or free tissue transfer.  that may or may not be more surgery than you’re willing to undergo and it would most likely be prohibitively expensive unless covered by medical insurance which it might.

At this point you probably should be talking to plastic surgeons who do a substantial amount of insurance based reconstructive surgery rather than those whose practice is primarily focused on cosmetic surgery.

Simply grafting fat will most likely lead to disappointing results.

Best,

Mats Hagstrom MD

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