Would I be a good candidate for butt lift or BBL? (Photo)

Question

I have lost a lot of weight over the years but left with loose skin. I had a mummy makeover about 4 years ago which I am happy about but I am left with bulging hips and my lower back and hip area has lots of loose skin and fat. I am steering towards a buttlift to remove excess skin and reduce bulging hips. However a few people have suggested bbl. Do you think I would be a good candidate for Buttlift? Do you think I should consider bbl?

J. Timothy Katzen, MD, FACS · Answer

Hi Angela4281 in Glasgow,
Thank you for your question about whether you'd be a good candidate for a butt lift or a Brazilian Butt Lift (BBL). I appreciate the history and pictures you've shared.
Based on your information, I believe you would be an excellent candidate for a butt lift, also known as a posterior body lift or posterior butt lift. In this procedure, an incision is made across the top of the buttocks, connecting at the center of the gluteal cleft. It extends over the superficial aspect of the buttocks and can join your existing tummy tuck scar over the hips. I suggest extending the incision slightly forward to address the excess skin and fat on the hips. The procedure typically takes about four hours under general anesthesia, with an expected recovery period of 2 to 3 weeks. Drains may be in place for about 10 to 14 days, and it’s crucial to keep your back straight post-surgery to avoid tension on the incision.
Regarding the BBL, I would not recommend it in your case. A BBL aims to enlarge the buttocks, which does not seem to align with your goals or ideal body proportions. Additionally, after significant weight loss, the skin often does not respond well to liposuction as it may not retract as expected, making liposuction a less reliable option.
In conclusion, a butt lift seems the most suitable choice for your needs, considering your weight loss and desired body shape. I would advise against a BBL for someone with your specific circumstances and body type.
I hope this provides clarity on your suitability for a butt lift as opposed to a BBL. Wishing you the best as you move forward with your decision.
Sincerely,
Dr. Katzen

Wess Cohen, MD · Answer

Thank you for the question. I think a BBL would be a good procedure for you. The advantage of a BBL is that all will help to recontour your abdomen waist and back with the liposuction portion of the procedure while also adding volume to your buttock. This will help to enhance a feminine figure. Beware of the complication profile of a BBL - Complications can be limited by injecting a thought into the subcutaneous space only and avoiding high-volume. Good luck

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.

That being said, it appears as though your skin quality is good enough such that liposuction alone will help carve out and sculpt your hips and love handle areas without the need for a “butt lift.  As far as enhancing your buttock, although there are two FDA approved options - BBL and  buttock implants, implants are a much more reliable, relatively safe, and permanent option for providing perk and projection. Please note there are an extremely few number of board-certified plastic surgeons specializing in buttock implants, so you may have to travel far away from home to seek consultation and treatment by one of these particular types of surgeons. Glad to be of help.

Zoran Potparic, MD · Answer

Based on your photos, it looks that you are good candidate for liposuction of torso and fat transfer for augmentation and shaping of buttock and hips. In person consultation with a board certified plastic surgeon, with expertise in BBL, is recommended.

Daniel Barrett, MD · Answer

Dear Angela4281,
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

Omer Sagir, MD · Answer

Hello dear, 
The answer depends on your medical status & skin quality also. But from what I see, you might be a good candidate for a BBL. Because you can get rid of your side and belly fats also since we will need to gather the extra fat from your body. This would create a better outcome for you. I think you would be happier with some liposuction on your abdominal area and BBL for your buttocks.

Mats Hagstrom, MD (license on probation) · Answer

Typically whenever someone mentions weight loss than the answer to the question is almost always more skin surgery.
It’s not uncommon for plastic surgeons to not take the tummy tuck skin excision far enough back during a tummy tuck because doing so is difficult and requires turning the patient in the operating room. With the history of weight loss and skin lac city I suggest you Address that first because as long as you have a loose skin Liposuction will not work well.
Blue skin will contribute to body contour far more than most people think and it significantly hampers results from Liposuction.
To help differentiate skin laxity versus subcutaneous fat I typically put the skin under tension by lifting up on the skin above the area of concern to see if it improves by putting the skin under tension. Doing so also gave us to a good chance at seeing what the true subcutaneous fat layer really looks like without the skin bulging.
 It’s very difficult to tell from the picture alone and I could see how plastic surgeons would be tempted to think they could contour that with Liposuction. The problem is that if much of the contour is coming from skin laxity then the skin will still bulge even if you remove the fat and the result will not be very good. 
Ideal candidates for liposuction and fat transfer should not have skin laxity.
It may be that you need to both procedures and it’s conceivable that both skin excision and liposuction be done at the same time.
I suppose you could do liposuction and the BBL and see what that looks like and then come back and address the skin laxity if you’re not happy with the outcome.
I generally like the deal with the primary problem first and then weight-loss patients that is almost always skin redundancy and patients need more extended skin operations.
Plastic surgeons doing assessments for tummy tucks and patients with significant skin laxity that continues to the side and the back should recommend extended tummy tucks in the first place to deal with the skin laxity not only on the front but on the sides and back as well.
Like I mentioned earlier doing that requires turning the patient on their side or face down during surgery and this can be quite a to do in the operating room that some surgeons don’t feel like dealing with.
I feel like your tummy tuck left you with a partial result because they did a partial procedure. You were probably a better candidate for an extended or three-quarter wrap around tummy tuck.
You may also benefit from Liposuction and a BBL.
I simply like to deal with the biggest problem first and like I mentioned earlier when someone mentions weight loss the answer is almost always more skin surgery.
I would like to point out that from 25 years of doing plastic surgery of which the last 10 years were devoted exclusively to doing only liposuction and fat transfer procedures. Delivering consistent high-quality liposuction and fat transfer results is more difficult than most people believe in this is true for both patients and plastic surgeons. Most plastic surgeons think they are better at liposuction than they actually are. Liposuction and fat transfer has more variance or difference in outcome purely based on who does the procedure than any other surgical procedure I’ve ever seen. Being board-certified in plastic surgery with an overall good reputation is not sufficient to guarantee that somebody has mastered body contouring. Personally I view the torso as a single anatomic unit and either treated the entire torso or don’t do Liposuction. There are of course exceptions but for the most part I believe in treating the entire torso. A full torso includes upper abdomen, lower abdomen, love handles all the way down to the hip dips, waist, the entire back and under arm area all the way to the side of the breast. this leaves people with a natural thin fat distribution without transition zones between treated and entrteded areas. I’ve viewed the BBL as an enhancement to body contouring creating an ideal feminine S-curve that goes from the armpit to the knee. I did not emphasize a large buttocks with liposuction of the outer thigh creating a big round butt on the small leg which I sometimes called the “lollipop look”. Instead I emphasize long smooth harmonious curves creating a slightly hyper feminized balanced figure. To find the most talented and experienced provider in your community I suggest having multiple in person consultations. I do not recommend patients travel for elective surgical procedures and I recommend patients whenever possible avoid virtual consultations. During in person consultations ask each provider to show their entire collection of before and after pictures of BBL results. Always confirm that after pictures were taken at least three months from the time of surgery. anybody who shows early postoperative pictures such as pictures with patients still showing surgical drawings on them, being in the operating room or any evidence of recently having had surgery should be immediately discounted as showing “.fake news”. Early fat transfer results can look very impressive but do not at all represent final results. Ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. Specifically ask each provider to show as many pictures as possible‘s of patients who have similar body characteristics to your own. An experienced provider should have no difficulty showing you a minimum of 50+ sets of before and after pictures. Simply seeing a handful of pre-selected sample pictures which in reality most likely represent the best results of that providers career is insufficient to get a clear understanding of what average results look like for that provider. Highly experienced providers will have hundreds or even thousands of before and after pictures and should be willing to give you access during the consultation to see as many pictures as possible. If somebody claims to of done a lot of surgery but doesn’t have a lot of before and after pictures then you should ask yourself why? Do not commit to surgery or pay a down payment during the time of consultation until you’ve finished all your consultations and have given yourself plenty of time to think about your decision. The results from these procedures are permanent and irreversible. When in doubt slow down and schedule more consultations. Finally I recommend patients read all reviews on all various physician review websites avoiding providers for any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling and having an abundance of positive reviews. Plastic surgeons with the biggest social media profiles are not necessarily any more talented than those who have no websites at all. Famous or likable does not equal talented. Find the right plastic surgeon and everything falls into place. 
Good luck, 
Mats Hagstrom MD

George Lefkovits, MD - Account Suspended · Answer

Due to your weight loss you really need to have an in-office consultation with a Board Certified plastic surgeon with lots of experience performing BBL surgery. A preliminary viewing of your photos suggests that you may be a candidate for a BBL. But again you do need an actual examination. Good luck!

Would I be a good candidate for butt lift or BBL? (Photo)

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