BMI 20.1, Should I gain weight before my BBL? Worried I don't have enough fat (Photos)

Dear @Bright813121
based on your pictures and BMI you would be a good candidate for a "Skinny BBL". With the amount of fat that can be grafted it is possible to fill in your Hipdips for a rounder hip. To come closer to your desired result, you need to add weight. The best results we have seen are patients with a BMI from 24-27. A good option for you is a so called "supercharged BBL" , this combines fat grafting plus buttock implants in one surgery. Plus the liposuction of the abdomen and back will already improve your shape and your waist to hip ratio. I recommend you to find a board certified plastic surgeon and talk about your expectations, aftercare etc.
Best regards!Dr. Alexander Hamers , MD Board certified plastic surgeon

Thanks for your question. From your pictures, you seem to be a good candidate for the BBL. The BBL includes 360 lipo, which is lipo of the upper and lower abdomen, the upper and lower back and the flanks. So, you need enough fat in these areas for transfer to the buttocks. That said, depending on your desired results, you may be asked to gain weight between 10 to 20 lbs. I recommend you schedule a consult for a proper evaluation. Make sure the surgeon you choose has extensive experience with Skinny BBLs and clean credentials. Always consult with a board certified plastic surgeon. Take care, Moises Salama MD, Board Certified Plastic

Thank you for your question. Based you appear to be a good candidate for intense liposuction in your belly, chin, arms, upper and lower back, the flanks and the love handles to achieve better body contour. Also, we will take the fat we get and transfer to the buttocks and hips, to mold them and get better volume, contour and butt projection, is that we know as "Brazilian Butt Lift" (BBL).

Kind regards

I would not recommend gaining any weight for a Brazilian butt lift surgery. Any of the transferred fat will shrink if you go back to your current weight, so the weight gain would not make any significant difference on the final result. Based on your photos, you do have some excess fat in the armpit, tummy, and flanks, but it is not enough to achieve the hourglass figure in your goal photographs. I would recommend consultation with a board-certified plastic surgeon to discuss how to best achieve your goals.

Based on these photos, it is very likely that you can expect nice improvement with BBL in experienced hands. Only on the basis of in person cnoultation, a board certified plastic surgeon, with significant experience with body contouring surgery and BBL, can give you better idea of possible outcome with your current body weight. Good luck.

Thank you for your question. You have enough fat for a very good result if Lipo 360 is done. I would not gain weight for any procedure, as your weight will be distributed in different parts of your body that may not be part of the treatment plan, and may leave you with an undesirable appearance after the procedure. Your silhouette will definitely be improved, however, It is unlikely to get those goal results after one treatment. You probably do not have enough fat to have an exaggerated result that you posted. The solution to this would be to do fat grafting as your first stage. Then come back for a second operation which would likely be a buttock implant. You should stage these approximately 3 to 4 months apart in order for the final result for the BBL to be apparent and you’ll better be able to choose the size buttock implant that you desire for your end result. Good luck.

Dear Bright813121,
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

Hi, Bright813121! Thank you for your question and photos.
There is an amount of fat that is needed for a successful BBL, it differs from person to person and according to the patient expectations. 49 kg is a low weight, that looks requiring some weight gain. According to the photos that are your goals, it looks a little out of our reach right now. You might need to combine BBL with a gluteal implant.
Gluteal implants are located inside the muscle, so it provides projection. The sides can not be augmented with implants. So the surgical plan must be this way: A gluteal implant for projection and fat transfer to the sides. So even if you plan to have these operations separately, I would recommend you to use this limited valuable fat tissue on the sides rather than middle buttock (projection). Gaining some weight is a good idea, in an healthy and controlled way.

Dear Bright,
It appears from the photos that you may have some abdominal and flank fat available for harvesting and to contour your waistline. However, your wish photos are far too unrealistic. Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon for an examination and a discussion of realistic results for you. Good luck!

Delivering consistent quality liposuction and fat transfer results is more difficult than most people believe. This definitely includes plastic surgeons. Most plastic surgeons are not as good at these procedures as they think.The learning curve to master both Liposuction and fat transfer requires doing thousands of cases and decades of experience.There is an enormous variance in outcomes of these procedures based on who does the procedure. By far the most important variable is choosing the right provider. I cannot emphasize this point enough!I do not recommend people gain weight for the purpose of fat transfer. Unless someone is underweight and desires to have more body fat for the rest of their life, gaining weight for the procedure is pointless. If you later go back to your normal weight the results will be exactly the same as if you didn’t gain weight. For low BMI patients the correct approach is to include more areas with Liposuction and do the procedure correctly with what you have.There are extreme cases where people simply don’t have enough fat anywhere on their body to justify the procedure and in these cases they are simply not a candidate for fat transfer. The number of people who truly cannot have a quality fat transfer is pretty rare. You should also recognize that slim people require far less volume to augment their body than those who have substantial amounts of fat. A little bit goes a long ways on a slim petite person.The most common area to harvest fat for the BBL is of the torso. It’s very common for plastic surgeons to do upper abdomen, lower abdomen love handles and waist sometimes called abdomen 360. This may or may not include any part of the back and it’s important to understand exactly what’s included and what’s not included in the procedure. I personally view the torso as a single anatomic unit and generally try to treat the entire torso (with the exception of the breast ) when doing Liposuction. A full torso is basically Abdomen 360 with the addition of the entire back, under arm area all the way to the side of the breast and front bra roll. In some individuals there may be fat in the pubic area and lower back that should be removed as well. By treating the torso as a single anatomic unit and treating the entire torso patients are left with an even natural thin fat distribution without transition zone between treated and untreated areas. This is the most attractive and natural outcome without evidence of having had previous Liposuction. It also gives an opportunity to maximize the fat harvest from the torso. If more fat is needed I either add arms or thighs depending on how much fat I need and which one would give the better aesthetic result for the patient. In extremely rare cases I would add both upper and lower extremities. Treating the entire torso and all four extremities should easily give more than enough fat for any patient with the exception of those who are thin to the point of being malnourished.Based on your pictures any talented and experienced provider should have no difficulty giving you a quality BBL without the need to gain weight which as I mentioned earlier is pointless in the first place.You’ll find different providers will vary in their assessment in regards to how much fat you have and how they approach the procedure. Those with the most amount of experience will be the most accurate in anticipating how much fat can be harvested from each area.Anticipating how much fat you can harvest on someone is difficult. I say that after having spent 20 years doing Liposuction of which the last 10 years were devoted to doing only Liposuction and fat transfer procedures having done more than 8000 of them.That’s more liposuction and fat transfer than most providers will ever do in their entire career.It’s extremely rare I end up with less fat than I anticipated but I tend to assess patients slightly conservatively. by simply looking at your pictures my best guess is that your torso would probably produce around 1100 cc. your arms would contribute 200 mL per side. Lower extremities without reducing outer thigh could add an additional 450 mL per side.There are different ways of approaching a patient like you. In the past I’ve had patients consented for multiple areas being treated then made the decision in the operating room depending on if I needed more fat or not. In other words the plan was to do Liposuction of the Torso with BBL but if that didn’t give enough that the patient has given me consent to add arms or thighs if needed in which case I would bill the patient or refund them later. Most of the time the extra areas have not been needed. Surgeons cannot change the surgical plan once surgery is started and the patient is sedated or under anesthesia. Changing the operative plan and working on other areas is considered operating without his consent which is a crime.It’s important to have everything lined up before you start and I have a good understanding of what the plan is. This means you should have an exact understanding of what areas will be treated with Liposuction and exactly where the boundaries are going to be. It’s especially true when providers talk about treating the back. You should have them show you exactly what areas are going to be included and look at before and after pictures of previous patients to know what the results will look like. To find the best provider I recommend patients have multiple in person consultations with local board-certified plastic surgeons. Whenever possible I recommend patients do not travel long distances for elective surgical procedures and I highly recommend avoiding virtual consultations.The point of a consultation is not just to get an assessment but it’s also for you to vet the provider and that is difficult to do unless you meet in personPatients may lack experience how they should be making an assessment or vetting their surgeon.Number one is the schedule in person consultations with the person who’s going to be doing your procedure. Anything other than that is not acceptable.During the in person consultation ask each provider to show their entire collection of before and after pictures for the procedure you’re interested in. An experience provider should have no difficulty showing you a minimum of at least 50 sets of before and after pictures of commonly performed procedures like the BBL. highly experienced surgeons will have hundreds or even thousands of pictures of commonly performed procedures. Being shown a handful of preselected pictures which most likely represent the best results of the providers career is completely insufficient to get a clear understanding of what average results look like in the hands of the provider. some providers may be apprehensive to open their portfolio and simply show you all of the results. you should at least try and ask to get access to see as many pictures as the provider is willing to. Put a little pressure on them and tell them that you’ll be interviewing with lots of plastic surgeons and one of the major variables determining who you choose is going to be based on who has the most number and is most willing to show you a variety of outcomes.I asked the providers to show you as many pictures as possible of patients with similar body characteristics to your own. It’s really helpful if you bring in printed pictures of your body taken similar to how plastic surgeons take before and after pictures. You can have them on your phone or you could have them print it on a piece of paper and hold it side-by-side when comparing so you can find other patients who has similar characteristics. This is the best way to get a good understanding of what your results will look like. You should also ask the provider to show as many pictures as possible of patients who had excellent outcomes, average outcomes and less than outcomes. Ask the provider about what the revision rate is and asked to see pictures of patients who had revisions and what their results look like afterwards. We all have a variety of outcomes and it is absolutely fair game for patients to ask providers to show a variety of outcomes.I think you’ll find that the most experienced and talented providers other ones that are most open for showing you a variety of outcomes including results that didn’t turn out as good as everybody had hoped for.The key is to get a sense of what average results look like and to get an idea of what the worst case scenario would be and what your dream results or best possible outcome is as well.There are far too many manipulated pictures floating around the Internet that the perception of what can be achieved with this procedure and what results actually look like on average are drastically different.Patients need to get real and surgeons need to be honest. Recognize that a BBL it is to procedures done at the same time. You need to view each of the procedures separately both in regards to getting assessed and looking at before and after pictures. When reviewing Liposuction results look at all the areas treated and make absolutely sure you don’t see any evidence of skin contour irregularities on any area treated. As the surgeon to review the pictures with you when I asked him what areas were treated and have them show you transition zone between treated an untreated areas. For example if the entire back was not treated look at the transition between the back in the waist and see if it looks natural.You should also look very carefully at the transition between the buttocks and the waist. This is one of the hallmark areas that differentiate quality work. In my opinion the ideal female figure should be a smooth sweeping S-curve that starts at the armpit and finishes at the knee. This S-curve follows the torso from the spine to a three-quarter angle towards the front. The front of the female body does not have an S curve but the side and back should.Some plastic surgeons leave fat in the upper part of the love handles distorting the S-curve creating a bit of a boxy looking buttocks. Likewise there’s also a tendency for plastic surgeons to do a liposuction of the outer thigh in the hopes that this makes the buttocks look bigger. This grossly distorts the natural S curve leaves people looking unnatural and the outcome is extremely difficult to correct afterwards. I called the “lollipop look” and it is highly undesirable and you should avoid the providers who do this. Anybody who talks about making your thighs small to make your butt look big is the wrong person.I don’t know how many consultations someone needs to find a right provider but I would start with a minimum of five and then continue until you feel very confident you found a ride provider. This may require 10-15 or even 20 consultations. I recognize it’s a big effort and a lot of time but the procedure is going to permanently and irreversibly change your body for the rest of your life and it’s definitely worth taking the time to find a ride provider for this procedure.I have seen too many people disfigured from body contouring to not feel the need to warn people about the importance of selecting providers carefully and correctly.In the end they were only two variables that matter. The candidacy for the procedure and the skillet experience of the surgeon. You appear to be an excellent candidate for the procedure so there is only one variable and that is choosing the right provider. The equipment is irrelevant and anyone who tries to sell you that their equipment is better should just be ignored. If they happen to also deliver a good result and I have a collection of before and after pictures that reads like a telephone book and they’re open to showing you all the pictures described above and there’s nothing wrong with using anyone in particular device but the Equipment has very little to do with what the final results look like.It’s not a bad idea to review lots of before and after pictures you find it on other doctors websites before having the consultations. Or have pictures of yourself and make sure that the before pictures look as similar to your body in proportions amount of fat shape at jet dry as possible. You can print out or bring with you copies of what you think are before and after pictures but please please please make sure that the patients look like you do in the before pictures. You can run this by somebody else because we tend to be pretty biased about how we think our own body looks.In the end when in doubt just slow down and continue to schedule more consultations. Do not be in a hurry for cosmetic surgery.Likewise I would recommend never scheduling surgery on the damn consultation and never make a deposit for surgery on the day of consultation. Always give yourself time to think about it and make sure you finished all consultations before committing to any one particular provider. Find the right provider and everything falls into place. Don’t get fat for an operation it’ll just make you fat and won’t make you look any better and it will not change your outcome.Best,Mats Hagstrom MD