Sculptra or fat transfer for hip dips and to achieve a more hourglass shape? (Photos)

Question

I want to fix my hip dips and even out my hip in one side to achieve a more hourglass shape. I have scoliosis so one side noticeably sticks out. I do not want implants and I’m told I don’t have enough fat to do a fat transfer. What would you recommend and if so, how many vials of Sculptra?

Ryan A. Stanton, MD · Answer

I have unfortunately had many patients come to me after having their high hopes for buttock/hip augmentation crushed by measly Sculptra results or other "fillers" such as Renuva and Juvederm, etc. Other than the fact that these are not FDA approved for buttock injections, here are some critical points of awareness: 1) they all are temporary, lasting 1.5 - 2 years at very most, 2) if done correctly dermal fillers like Sculptra ir Renuva are cost prohibitive for 99% of potential buttock augmentation patients. In order to create a significant/noticeable result with a dermal filler, at least 200 mls of product must be injected into each buttock cheek for a total of 400 mls. At $1000 per ml, this equates to a minimum price of $400,000.00. Thus if your doctor is recommending to put in ONLY 20 or 40 mls of these fillers you will pay $20,000-$40,000 and get an insignificant miniscule result! (eg. like a “drop in the ocean” effect), 3) Do not let anybody tell you that the product is so special that it's going to magically grow over the following months or years...this just doesnt happen to any noticeable degree!, 4) dermal fillers, when injected in large quantities, have a relatively high infection rate, guaranteed tendency to migrate away from the original area they were injected into, and almost always stimulate a lot of inflammation with a subsequent and disastrous amount of scar tissue/hardening, and 5) the one very serious complication that can rarely happen is "embolism" in which some of the filler gets into the blood stream and travels up into the lungs, heart, and/or brain causing serious problems, including death.

As well, fat transfer to the hip dips, especially on lean patients, has a poor survival rate and thus often slighted results.

The only relatively safe, reliable, and permanent option for buttock and hip dip augmentation is with implants. Please note, an extremely few number of board-certified plastic surgeons specialize in buttock or hip implants so you may have to travel far and away from home to find this particular surgeon. Glad to be of help.

As well, fat transfer to the hip dips, especially on lean patients, has a poor survival rate and thus often slighted results.

The only relatively safe, reliable, and permanent option for buttock and hip dip augmentation is with implants. Please note, an extremely few number of board-certified plastic surgeons specialize in buttock or hip implants so you may have to travel far and away from home to find this particular surgeon. Glad to be of help.

Stanley Okoro, MD · Answer

Thanks for your question and the photos you provided. Sculptra is an option as well as Revunva. It is really difficult to tell exactly how many vials you need without examining you in person. I would start off with 10 cc of product and then consider adding more in 3 months if you desire a more full look. Make sure you consult with a board certified plastic surgeon.

Kenneth Hughes, MD · Answer

The Sculptra buttlift has been popularized by some practitioners as a less invasive method that can benefit even thin patients. Sculptra is a filler that has been approved for facial augmentation and has been used off label for butt augmentation. The question of utility of Sculptra in butt augmentation really just comes down to volume of improvement and the safety of the substance injected. Consult with a board certified PS via email or Skype to learn more about the cost and amount of Sculptra required to reach your goals.

Daniel Barrett, MD · Answer

Dear Generous571634,
based on your photos, you look like a good candidate for a BBL. Liposuction of your abdomen, back and flanks should give you more curves and hourglass shape and fat transfer to buttocks should give you more projection. I would suggest you to consult a board-certified plastic surgeon because 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

Adolfo Sesto, MD · Answer

Hello. Sculptra or any other method with laser or ultrasound is good for fat tranfer since all of them destroys the fat cell making their survival in tha receptor area impossible. I thin you have enough fat for a tranfers to your hip dips, but not a huge amount. 29 year experience, American Society of Plastic Surgeons.

Mats Hagstrom, MD (license on probation) · Answer

When it comes to making an assessment in regards to how much fat someone has for an ideal fat transfer procedure they answer is rarely yes or no but instead patients are on some point of a spectrum.

There are of course extreme examples where someone is so thin that virtually no fat can be harvested or are so overweight that Liposuction and fat transfer procedures don’t make sense.

I know BMI patients the project is typically to add more areas in the treatment plan for Liposuction to gain sufficient amounts of fat for the procedure. This may include the entire torso, arms, inner thighs, internist and occasionally circumferential thighs. Liposuction of the entire body may still not get enough fat for an ideal outcome but it will give enough fat to deliver some improvements. Whether this is justified as a discussion that needs to be done after a thorough in person consultation.

Temporary fillers or products like sculptra are generally never sufficient unless someone is willing to spend a lot of money.

To put things in context a typical hip flip or fat grafting of the hip dip area on a conservative level requires at least 1000 mL of fat total.  Grafting  volumes around 200 mL/per side exclusively in the hip dip may be insufficient to give a complete correction but enough to have a nice visible improvement.

To put this in context of for example standard HA fillers even at a higher volume discounted rate 100 mL would cost (100ml x $500/ml = $50,000) $50,000.  Another way to put this in context is 1 mL of volume with fillers is about equivalent to the size of one candy skittle.

In your case your options are full body liposuction with fat transfer, implants or leaving your body the way it is.

A fourth option is to do just liposuction of the love handles just above the hip dips to dampen these  a little bit.

I would recommend any contemplation of any of these treatment options being made exclusively during in person consultations with highly skilled and experienced providers only.

Sometimes not having procedures is the best option.

Best,

Mats Hagstrom MD

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