Lipo 360/arms/thighs/J Plasma. What should I get done? Should I get a BBL? Or is this foundation just bad already? (Photo)

Dear Ms. Superdupercool,

Thank you for your story, photos and questions. Unfortunately with out a exam of your tissues I can can only make general comments. I hope find the following helpful.

It appears you have asymmetry of buttock size and shape.
To obtain a more sharply buttock You will require both liposculpture and precise lipoinjection. Yes you will benefit from liposuction of arms and thighs.

Secondary/revisional surgery is always more difficult and less predictable because of previous surgery and scar tissue.

The amount of fat that takes depends:
1) the gentle technique of harvest providing the least amount of damage/trauma to the fat cells
2) how the fat is injected
3) the receipent area (good blood supply, lack of previous scars, etc.)
4) postoperative care
5) genetics of the individual 

The process for performing a fat injections the same regardless of the patients weight or fat location:
1) harvest the fat 
2) purify the fat
3) sculpting the buttock:
   a) with precise liposculpting 
   b) with precise fat injection

The final shape of the area of fat injection depends on:
1) your underlying boney pelvic frame 
2) the shape of your muscular anatomy
3) the elasticity (stretchability) of the skin 
4) the patients desired shape (where fat is injected)

The bottom line: 
1) fat survival as a graft is multifactoral but usually varies between 70-80%.
2) the fat that doesn't survive is broken down, dissolves and is excreted by our body
3) the amount injected fat depends on how much fat there is available to harvgest.
4) the individuals genetic anatomy and elastic properties of the skin will dictate 
and limit attaining certain desired shapes
5) Just importantly the liposuction should be done to "sculpt" other parts of the body to attain a body that is in proportion and attractive. Thus a small amount of fat can go along way or in contrast a large amount may not give you the desird appearance.
I suggest you collect multiple model photos of your desired abdominal shape and schedule several appointments with experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

My best wishes,

R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
Awardee: RealSelf Top 100
wwwimagineplasticsurgery.com
4646 Brockton Ave
Riverside, Ca 92506

(951) 686-7600

You can get a revision BBL with 360 lipo including your arms and thighs as well as J plasma. It is best to have an in-office evaluation to determine how much fat you still have. Some of the bulk that you still have may be residual scar tissue from your initial surgery so it does not necessarily mean you have a lot of fat to use. You can still improve your shape though with a second round. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon