How to get rid of these lumps from BBL 9 years ago (photo)

Question

I had a BBL in 2016 and ever since I had the procedure done. I have these hard lumps in my left butt cheek. The last 3 to 4 weeks one of the lumps has swelled up and feels like it’s filled with liquid and is very sore and painful. It feels like a blister. What are my options to get this removed without having to go through an entire surgery?

Daniel Barrett, MD · Answer

Dear kayblack92,
it is hard to tell for sure without an examination. If you are considering a procedure, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

Augmentation of buttocks with fat grafts usually requires massive amount of fat grafts. About 50-60% of transferred fat would survive and the rest is either resorbed by the body or will stay within the tissue in the form of scars and oily cysts. Those lesions that are close to surface may in time become more visible (palpable) and occasionally need removal. In person evaluation with a plastic surgeon familiar with fat transfer is recommended. Good luck.

Mustafa Aydinol, MD · Answer

I’m sorry you’re going through this – it sounds uncomfortable and frustrating. What you’re describing could be fat necrosis, fluid collection (seroma), or even an infection. Sometimes, areas of transferred fat can harden or develop cyst-like pockets over time.
Non-surgical options might include: • Aspiration or drainage – If it feels fluid-filled, a provider may be able to drain it with a needle. • Steroid injections – These can help reduce inflammation and soften the lump. • Ultrasound or radiofrequency treatments – These can break down hardened fat or scar tissue.
If infection is suspected, antibiotics may be needed. If the lump persists or worsens, a minor surgical procedure to remove the area may be the best long-term solution. I’d recommend seeing a surgeon experienced in BBL revisions to evaluate it further. You deserve to feel comfortable and confident in your results!

Kenneth R. Francis, MD, FACS · Answer

Dear kayblack92,
You are most likely experiencing either an infected fat necrosis or oil cyst.  This can occur even years after a BBL, and may progress if not addressed.  Fortunately, most of the time it can be effectively managed without surgery.  You may need an aspiration if it is fluid filled, and possibly a course of  antibiotics.  Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon that does a number of BBLs and is familiar with managing this complication.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

The lumps you describe are most likely fat necrosis which represents large amounts of fat that did not survive after the procedure. Necrosis is avoided by using careful technique, flying all grafted fat carefully, and not injecting too much in any single area. Once fat necrosis has formed, it can either be removed with the direct surgical incision or if the fat has become liquid, it may be able to be drained.
Sometimes when grafted fat dies, it becomes an oil cyst that can be drained.
Draining fluid it’s probably best done by an interventional radiologist.
If you think it’s a fluid collection, then you can ask your primary care doctor to refer you to an interventional radiologist.
 if the lumps are causing pain, this may be covered by medical insurance.
Best,
Mats Hagstrom MD

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