37, BBL revision & possible tummy tuck to improve shape & projection? (Photos)

Dear Fabulous31627,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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

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.


You are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, unevenness, lack of projection in the central and/or lower buttock, insignificant hip augmentation, 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. Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation.

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

Buttock/hip implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the hips and central buttock, and often help 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.

To make an assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures. If you don’t have before, and after pictures and ask your surgeon to forward the pictures they took.
Gluteal, subcutaneous fat, has a significant amount of connective tissue that will inherently limit the amount of projection possible with fat transfer. If someone has a flat buttocks before the procedure, then they may still have a flat buttocks afterwards.
The connective tissue in the buttocks anchors the skin to the underlying muscle fascia. You can use the analogy on the skin of the palm of the hand in comparison to the skin on the back of the hand. It’s easy to pinch and lift the skin on the back of the hand. If you try that in the middle of your palm do you realize that the skin is stuck and you can’t lift it. that is because of connective tissue that holds the skin in place. The buttocks has the same connective tissue, and this will inherently limit projection with fat transfer.
BBL results are based on the patient’s candidacy compared to how well the procedure was performed. Patients who are excellent candidates have the potential for having excellent outcomes. If the procedure is done well. Patients who are not ideal candidate do not have the potential for ideal outcomes, regardless of who does the procedure.
Without seeing your before pictures, we can’t assess your candidacy for the procedure.
Based on the pictures you’ve included, I would say your results are above average.
Consider reposting with a proper set of before and after pictures. If you have concerns regarding your outcome, then I suggest you follow up with your provider. If you’re not getting the help you need from your plastic surgeon then I suggest you schedule a few in person second opinion consultations. For a second opinion, consultations patients should come prepared bringing with them a complete set a before and after pictures, and a copy of your operative report. These are all available from your providers office if you request them.
Best,
Mats Hagstrom, MD

The photos suggest that you are lacking adequate projection in the central portion of your buttocks. You would need to be examined by a Board Certifie plastic surgeon with lota of exerience performing BBL surgeyr and see if you have sufficient donor fat to transfer to the central buttocks.