Help! Can this horrible BBL be fixed? (Photo)

Question

I had a BBL several months ago and I'm devastated by the results. My butt looks worse than before and I don't understand all the dents. I found my surgeon on RealSelf based on his perfect results and seeing patients with the same body type. How did this happen and what can I do to fix it? The only thing I noticed (different from other patients post op pictures) is that I had major bruising on my butt on the spots that ended up being dents.

Ryan A. Stanton, MD · Answer

When you say “perfect results“, how far out from surgery were the after pictures you were viewing? They may have been either on the surgery table results are within only 2-3 months or so postop, in which case there is still a lot of swelling masking problems such as yours.

That being said, you are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, dents, 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.

Fillers, such as Sculptra and hyaluronic acids,  for augmentation of the buttock/hips are a rip-off, period!

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 loveyoucrystal,
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

Camille Cash, MD · Answer

I'm sorry you are unhappy with your BBL.  You can consider Aveli for the cellulite.  This is nonsurgical one time treatment that is FDA approved for cellulite of the buttocks.  To improve contours you can consider further sculpting with liposuction and/or fat grafting.

Darryl J. Blinski, MD · Answer

Though your posted photos are helpful ONLY in person or virtual consult with ... can I offer a better explanation to the poor outcome. I think the "major bruising" lead to superficial fat necrosis because thid went un noted and treatment was not started quickly. As for the chicken butt deformities I need to see before photos.

Kenneth R. Francis, MD, FACS · Answer

Dear Crystal,
It is difficult for us to assess a result of a BBL without preoperative photos.  So some, much, or all of the cellulite dimpling that is present may already have been present.  I inform all of my BBL patients that have cellulite dimpling in their buttocks before surgery that BBL is NOT considered to be a treatment for cellulite (at least in my hands).  Despite that, even the best surgeon in the world can have the worst result on any given case as the human body is sometimes unpredictable in the healing process.  Return to your plastic surgeon for a discussion of your possible options for improvement.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

There are two variables determine cosmetic surgery outcomes. The first is patient candidacy, and the second is the skill of the surgeon.
To make an accurate assessment on the outcome of a procedure, we need to see complete sets of before and after pictures. If you don’t have before, and after pictures, then ask your surgeon to forward the ones they tookBased on your pictures, you were not a good candidate for a BBL because you have severe cellulitis. Cellulite is made worse by fat transfer, and this should’ve been pointed out to you.
Delivering consistent quality, liposuction and fat transfer results is far more difficult than most people believe. If not done correctly, patients can be left permanently disfigured.
To find the best provider, I recommend patients have multiple in person consultations. For a complicated and difficult to do procedure like it’s a BBL I recommend patient start by having at least five in person consultations. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of patients who look like you. Being shown a handful of sample pictures which are preselected and representing the providers best results is insufficient to get a clear understanding of what average results look like. You should also have a very good understanding of your own candidacy for the procedure. Not everybody seeking Liposuction for fat transfer a good candidates for the procedure.Somebody who is an excellent candidate, has the potential for getting excellent results if they choose the right providers. Somebody who’s not a good candidate does not have the potential of getting quality outcomes, regardless of who does the procedure.
Ask providers to show you samples of patience, wet, excellent outcomes, average outcomes, and outcomes that did not turn out as well as they had hoped for. Providers may be reluctant to do this, but patients need to take responsibility and an active role during the consultation realizing that they need to vent the provider in regards to the skill and competency.
An experienced provider Should have hundreds or even thousands of before, and after pictures to choose from it. An experience provider should have no difficulty show me a minimum of 50 sets of before, and after pictures of commonly performed procedures.
It’s not possible to make an assessment on your end, because he did not include the proper before, and after pictures. Your pictures show a severe cellulite, which makes you a poor candidate for the procedure, or at least limits your ability to have a good outcome.
Each provider has the wrong set of moral standards, but patients should never assume the doctors served as patient advocates. Unfortunately, those in the cosmetic surgery field are often highly driven by financial gain.
Patients need to take ownership of provider selection and providers are ultimately responsible for the outcome of the procedures.
Consider writing some reviews about your experience to tell others what it was like for you. I’m sure you would’ve appreciated reading other patients experiences who had similar results.
I cannot emphasize enough the importance of patients ,focusing on having a clear understanding of their candidacy for the procedure and putting significant effort into this provider selection process.
Liposuction and fat transfer. I was probably not the best procedure for you and there may be other procedures that would serve your needs much better.
With limited pictures, we can’t make an assessment. I suggest having an honest conversation with your provider. Let them know you are disgruntled with the outcome and see if they can do anything for you. You can ask for a partial refund, which they may or may not agree to. If you were shown before, and after pictures, they were substantially different in your outcome then ask the provider to bring out those before and after pictures and show them side-by-side with your pictures.
Revision surgery probably isn’t going to do much since secondary procedures typically don’t do much if the primary procedure didn’t fix the problem.
Your outcome is unfortunate and was preventable by being more thorough in provider selection and your provider be more truthful about your candidacy.
I’m making certain assumptions here because without before, and after pictures, we really cannot know what the surgery outcome was.
Best,
Mats Hagstrom, MD

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