How would you suggest fixing these issues from my past surgery in order to achieve my dream bottom? (Photos)

Question

I'm a 46 year old female who has undergone an ETT w/lipo, then an Arm lift w/lipo to braline, upper arms, tummy and thighs with a BBL - at least that's what I paid for. The lipo during the second procedure was only 1600CCs, with 1300CCs reported to be transferred to my upper buttocks and hip dips. I requested to be rounded out to an inverted heart shape, as I wasn't looking for a big size increase. I requested my anterior thighs to be liposuctioned; he ended up doing my inner thighs, which cause a ditch on my right thigh with a roll that falls down over it. After my ETT (which was beautiful), my backside, where he did lipo to avoid dog ears, had an indentation on the left side near the hip, and my right buttcheek was no longer rounded and instead looked fallen. I didn't worry about it much because I had the BBL planned. Unfortunately, there's is virtually no change with the BBL. I am so embarassed about my thigh. What would you advise to do to fix these issues? I want to smooth out and contour my midback, achieve the heart shaped or round bottom, and fix my thigh. I do have lipedema. Are there any nonsurgical procedures or workout regimens that could help? Ultrasonic cavitation, RF, laser lipo, fillers, etc? I am looking at Hivamat for the fibrosis in my thighs from lipedema.

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

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, insignificant hip augmentation, post-deflation sagging, fatty necrotic cyst or scar tissue, 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 additional rounds of BBL most often produces the same disappointing results but at another financial loss.   Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation.

Important note, do not fall victim to anyone recommending fillers, such as Sculptra and hyaluronic acids,  for enhancement or augmentation of the buttock/hips because they are a rip-off and guaranteed to fail, period!

Buttock/hip implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the hips and central buttock, and often help smoothing out lumpiness. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging.  When considering buttock implants make sure that the surgeon is going to be placing the implants within gluteus muscles , (a.k.a. “intramuscular pocket”), and that they are using anatomically correct, oval-shaped implants, such as Stanton Anatomic ®️ implants. 
Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in these 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.

Regarding your thigh dents and surface contour irregularities, although nothing works great at this stage, fat-redistribution liposuction may serve you best +/- a thigh lift.

Glad to help.

Mustafa Aydinol, MD · Answer

From what you described, a few key issues are present: • Volume asymmetry and contour irregularities in the buttocks and hips • Indentation near the hip and a depression in the right thigh • Midback fat retention • Post-liposuction fibrosis in the thighs, compounded by lipedema

How would you suggest fixing these issues from my past surgery in order to achieve my dream bottom? (Photos)

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