Uneven results from BBL 3 years ago and revision 1 year ago. What's next? (photo)

Unfortunately your photo with jeans on is inadequate to appreciate the unevenness you speak of. That being said, here are some general comments and recommendations I have for many post-BBL patients just like yourself.
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, post-deflation sagging, 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 round 2 BBL most often produces the same disappointing results but at another financial loss. Buttock implants indeed 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. Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in 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.

Dear mcdowell17,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You are encouraged to consult a board certified plastic surgeon. Revision cases are more complicated and require good surgical planning. The definitive correction for liposuction deformities requires the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I encounter suboptimal liposuction outcome referrals weekly. VASER liposuction has been the only modality that has consistently corrected liposuction caused deformities. VASER liposuction ensures a smooth contour regardless of severity of contour irregularities by virtue of being able to remove any and all remaining fat comprehensively and uniformly. Finally, when skin redundancy irregularities are observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

The human body is not symmetrical. This is true for the face body and extremities.

The judge the outcome of a surgical procedure we need to see proper before and after pictures. Most likely you had a symmetry in your before pictures.

The primary asymmetry is most likely based on skeletal structure. Subcutaneous fat or soft tissue coverage tends to be more symmetrical and asymmetry when it’s significant is usually not related to subcutaneous fat.

When plastic surgeons attempt to compensate for skeletal asymmetry by adding more or less fat they are in a sense simply creating two asymmetries one is the primary skeletal and the second is the created different amount of fat.

Being asymmetrical is not abnormal and having a symmetry does not ruin results.

People view symmetry as a aesthetic ideal but the human brain is highly accustomed to seeing the human body as asymmetrical.

Computer generated symmetrical faces are found to be less attractive and look odd and strange to the human mind because we’re not used to seeing symmetrical faces because they don’t exist.

Internal organs are all highly asymmetrical and most people are left-handed or right handed.

If you want us to make an assessment on the outcome of your procedure you should consider re-posting with proper before and after pictures. If you don’t have those then ask your surgeon to forward the ones they took.

If you had revision work done then ideally you should include before and Afters for each of the procedures.
Before and after pictures should include all areas treated and for a BBL this means showing the full torso from the neck to the knees from the front, side and back wearing undergarments.

If you want a proper second opinion assessment then I suggest having in person second opinion consultations with local board-certified plastic surgeons. If you opt for that then you should bring a copy of your operative report and all before and after pictures so that surgeon can make the best assessment possible.

Best,

Mats Hagstrom MD