Is it better to do a BBL under intravenous sedation or general anesthesia?

Allow me to answer your question as best i can without any photos. However, please keep in mind that, indeed, an in-person consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

There are currently only two FDA approved surgical options for augmenting the buttock/hip area: 1) Buttock and cosmetic Hip Implants (which are soft semi-solid silicone rubber implants that cannot rupture &/or leak) and 2)Brazilian Butt Lift (aka BBL) - which utilizes the patients own fat from liposuction then transfers this fat into the buttock. On the other hand, BBL using Sculptra is a dangerous waste of money and is NOT FDA approved. and/or hips and . So what it comes down to, like any surgery, is proper patient selection and long-term results. Implants provide the only guarantee for a sustained permanent result and tend to be ideal for perking up not only lean or deflated buttocks but also providing substantial projection to any butt, which is what every single patient wants.

Unfortunately, fat typically melts away leaving disappointing results after 12 months, often sooner. Unless your BBL surgeon is injecting only 200 to 300 ccs of fat into each buttock cheek, a large percentage of that fat is going to die. Dead fat leads to dents and dimpling like cellulite, unevenness, loss of projection, and fatty necrotic oil cysts which are hard marbles and can be very tender
Unfortunately, because ~70+ % of the fat transferred will melt away within a year, most patients are not good candidates for BBL because they lack an adequate amount of fat to harvest. 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 fall victim to this recommendation. Even those patients that had adequate amounts of fat pre-operatively, still end up seeking buttock implants after a year or so because most of the fat transferred melted away leaving them with minimal result. Fillers such as Sculptra are cost prohibitive, provided enough volume is injected (i.e. at least 400 cc of active ingredient costing over $300,000) and last only 12 - 18 months. So, if you're looking for a reliable, predictable, and long-term permanent option that also provides projection in the central buttock, buttock and hip implants are your solution. Please note that an extremely few number of board certified plastic surgeons specialize in buttock or hip implants, so you may need to travel far and away from home to find this particular surgeon. I hope this is useful information for everyone. Glad to help.

Gluteal Fat infiltration requires removing the fat from other areas and is a surgery that requires to follow all type safety measures ( Operating room, anesthesia, etc).I will recommend to get a personal consultation with a board certified plastic surgeon to evaluate your case and depending on how much fat is going to be remove and inject he will give you the best recommendation. Good Luck

Dear Genuine1152,
BBL is a major procedure so general anesthesia is probably the best option. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon and anesthesiologist. 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

I do all of my liposuction and fat transfer procedures with patients awake using a local anesthesia with mild sedation only.

Mild sedation means the patient is alert and oriented during the procedure and is able to have a conversation and knows where they are and what’s happening at all times.

Not all plastic surgeons have learned how to do these procedures competently without general anesthesia and still keep patients comfortable.

The best form of anesthesia is the one recommended by the surgeon you choose.

I would pick the most talented and experienced surgeon and follow their recommendations.

I spent the first 10 years of practice doing these procedures using general anesthesia and midcareer converted to doing them as awake procedures.

There is a very real learning curve to learning how to do these procedures comfortably with patients awake but once mastered it is in my opinion a far better way to do it.

One of the biggest advantages to keeping patients awake is that the patient can hold the different positions allowing the surgeon to contour the body in the most efficient way possible.

There are numerous other advantages for keeping patients awake during the procedure but the biggest one has to do with allowing the surgeon to get better results.

This is my opinion and I’m quite certain that those who use general anesthesia will differ.

I have the perspective of having spent 10 years doing these with general anesthesia and without so I feel like I have some position of authority on the subject.

Good luck with your upcoming procedure.

If it was me and I had a choice of IV sedation or general anesthesia I think I would probably simply ask to be put to sleep. When patients are put face down it’s better to have a controlled airway which is required for general anesthesia but not IV sedation.

It can get a little technical but the bottom line is find the right plastic surgeon and follow their recommendations.

Best,

Mats Hagstrom MD