Huge banana rolls. What are my options? (Photo)

Question

Hi all, A few years ago I had a lipo on my outer thighs. The end result is assymetric and I now have very explicit banana rolls. I am 29 years old and feel extremely insecure about my buttocks area: I always wear long shirts to cover it up and shorts to tighten it :(. I eat healthy and have a healthy weight but that area is just incredibly ugly. I would do whatever to get it nicely shaped but I hear so many talking about lipo risks in that area. What are my options?

Alan Gonzalez, MD, FACS · Answer

Hello @Versatile731105, thank you for your question. You could benefit from a Brazilian butt lift (BBL) revision to achieve the desired symmetry and balance. However, it is important to note that revision surgery can be more complex than the initial BBL procedure. It's best to consult with a board-certified and experienced plastic surgeon to perform revision BBL surgery to discuss your specific case and determine the most appropriate course of action to address the asymmetry. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Connie Hiers, MD, FACS · Answer

You might try EMSCulpt to help reshape your buttocks with no surgery and no downtime. Once reshaped, then see if liposuction is needed in the banana roll areas.

Jeffrey S. Yager, MD · Answer

That area is very difficult, as if you are too aggressive, you can cause the buttocks fold to drop. Not seeing a lateral photo, it might be possible to do a targeted lipo of the area to reduce the fullness. Skin excision can be done, but only for extreme loose skin.

Mats Hagstrom, MD (license on probation) · Answer

Thigh liposuction, it is technically challenging, and there are a lot of potential pitfalls that are easy to oversee when making assessments and doing the procedure.
This is especially true on the posterior, lateral upper part of the thigh, or the backside of the outer thigh.
In this area, the full flexion of the hip joint requires enough skin laxity, which is redundant in an upright standing position. how the skin drapes can be affected by removing fat in the ways that were not anticipated. The banana roll represents a skinfold from skin redundancy in an upright standing position. The problem is generally not related to excess subcutaneous fat in banana rolls. Generally they do not respond well to Liposuction.
To make an accurate assessment on the outcome of a plastic surgery procedure we need to see proper before and after pictures. If you don’t have before and after pictures and try to contact your previous provider and ask them to forward all before and after pictures taken.
Having had previous liposuction, makes creating an assessment much more complex in the chance of having quality outcomes, goes down significantly with having previous operations.
If Liposuction was done in appropriately, then you may need fat to be grafted in place. For some individuals, it may be better to cut your losses and stop before things get worse. Recognize that any attempt at revision surgery can always make things worse.
Delivering consistent quality, liposuction, results is more difficult than most people realize. The number of plastic surgeons who truly mastered these procedures are in a small minority. Most plastic surgeons think they’re far better at Liposuction than they actually are. This operation has more variation in skill and experience among providers than any other plastic surgery procedure I’ve seen.
I cannot emphasize enough the importance of provider, selection and properly vetting plastic surgeons before having a permanent irreversible body contouring procedures, especially Liposuction.
In the end, there are generally only two variables that determine what the outcome is going to be. The first is the patient’s candidacy for the procedure, and the second is the skill of the provider.
To find the right provider, I suggest patients have multiple in person, consultations for local, board-certified plastic surgeons, who seem to have a lot of experience with Liposuction.
During each consultation, ask each provider to open up their entire portfolio and show you all of their before, and after pictures of the previous patients who had similar body characteristics to your own. And experience plastic surgeon should have no difficulty showing you the before, and after pictures of at least 50 previous patients. Being shown a handful of preselected images, representing the best results of a providers career is insufficient to get a clear understanding of an average results look like or how many of these procedures babe actually performed.
There’s no correct number of consultations needed to find the right provider. Considering how much variation there is in skill and experience, I suggest patience consider having at least five consultations before considering choosing a provider.
I don’t think anyone is going to be able to give you a quality assessment based on the information provided. You really need an examination and especially reviewing before and after pictures.
Considering that revision work as much more difficult than Primary Liposuction, the importance of provider selection goes without saying saying. The best providers for revision work are generally the same providers to do the best primary Liposuction.
Contour issues in this part of the body are not just related to fat distribution, but also have a lot to do with skin, especially related to the range of motion of your hip joints. If you have pictures taken of the same area, leaning forward, you’ll see that the contour changes significantly. Because we usually make assessments with patients in an upright standing position, this can often lead to erroneous conclusions. That fat is the primary problem when it may be only partially contributing. 
Best,
Mats Hagstrom, MD

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