Cellulite, stretch marks and laxity - what is the best procedure? (Photos)

Question

I am 35 skinny healthy, I have really bad cellulite post bbl I've tried : tons of vials of sculptra/radiesse/potenza RF 3x , pdo threads /endospheres /Venus legacy/ emsculpt neo and it's worsening please help! I am afraid co2 will cause hyperpigmentation

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, 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.

Fillers, such as Sculptra and hyaluronic acids,  for augmentation of the buttock/hips are a rip-off, period!  And, all the minimally/non-invasive skin tightening treatment rarely provide much benefit.

Buttock implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often 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. Glad to help.

Daniel Barrett, MD · Answer

Dear as1733,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Robert M. Lowen, MD · Answer

It  is impossible to tell what is going on from these pictures.  We have to assume the first picture is a BEFORE BBL, because the skin is really deflated. There are a lot of stretch marks.  If the second picture is an AFTER, then all we see is regular cellulite dimples.
  This should be treated with a method that is specific for cellulite, like Cellulaze.  There are a variety of other technologies marketed for cellulite and some of them show some results as well.  However, treatments that just try to modify the skin without releasing the cellulite bands and contracting the skin to some extent will not work.  Stretch marks can respond to fractional erbium lasers, like Palomar Lux 1540, with or without IPL, aerolase, fractional ablative erbium combos.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment on the outcome of a plastic surgery procedure we generally need to see proper before and after pictures. If you don’t have before and after pictures and ask your surgeon to forward the pictures they took. It looks like you had an appropriate liposuction done of your upper thigh it. Fat transfer can make cellulite worse and individuals. Horny have cellulite should be before considering having it fat transfer to the area. None of the modalities you listed are good for treating cellulite. The only thing we know that works for cellulite effective Subsicion. Decisions can be done using various devices that can increase the effectiveness of the treatment. Grafting, fat, or using fillers in conjunction with Subsicion, seems to give higher quality And longer lasting results. 
Of all the different treatment options Aveli in the hands of an experience provider, especially with small amount of fat transfer seem to be the most effective.
I suggest avoiding treatments without seeing a proven track record with copious amounts of impressive before, and after pictures. Understanding what causes cellulite can help understand why certain treatments will not fix the problem.
Best,
Mats Hagstrom, MD

Cellulite, stretch marks and laxity - what is the best procedure? (Photos)

Answers (4)

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