BBL nerve damage/compression - what can I do for pain more than 1 post op?

Question

I had a BBL in Feb 2025 and it still hurts and it’s super uncomfortable to sit only on one side on the top of my butt it hurts and is so uncomfortable I can’t handle it anymore I contacted my Dr and they said it’s normal for up to a year and it’s been longer and have been no help I don’t know what to do

Yily De Los Santos, MD · Answer

Persistent pain after a BBL can sometimes be related to nerve irritation, inflammation, prolonged swelling, compression from scar tissue, or pressure on surrounding structures during healing. In many cases, symptoms improve gradually over time, but ongoing pain should never be ignored, especially if it is severe, worsening, associated with numbness, weakness, burning sensations, or difficulty walking or sitting comfortably.

One of the most important first steps is determining whether this is true nerve injury, temporary nerve compression, muscle inflammation, or another postoperative issue. Symptoms such as tingling, shooting pain, hypersensitivity, numbness, or radiating discomfort may suggest nerve involvement, but a proper physical examination is essential.

Daniel Barrett, MD · Answer

Dear HSLOVEEEEEE,

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

Kadir Berat Oyur, MD · Answer

Regarding your persistent, localized pain 14 months post-BBL, experiencing severe discomfort while sitting falls outside the expected recovery timeline for standard fat graft integration. This presentation strongly suggests non-standard etiologies such as deep scar tissue contracture, localized nerve compression, or a chronic inflammatory response within the deep soft tissue layers. Given the lack of resolution, a secondary clinical evaluation by an independent plastic surgeon is indicated. An objective physical assessment, potentially supplemented by soft-tissue imaging such as an ultrasound or MRI, is necessary to rule out underlying structural pathology and establish a targeted pain management or revisional plan.

Frank Agullo, MD · Answer

Past one year, focal one-sided buttock pain after a BBL is not normal, and your surgeon's wait-it-out answer is not the right one anymore. You need a workup.

The pain pattern you describe (top of the buttock, one side, worse with sitting) points to the superior cluneal nerves. They run over the iliac crest and can be entrapped by scar, by transferred fat sitting in the wrong plane, or by fat necrosis. Less commonly, deeper grafts compress branches of the sciatic.

The next steps I would push for are an MRI of the pelvis and buttocks to look for fat necrosis or fluid collections, and an evaluation with pain medicine or a peripheral nerve specialist. A diagnostic nerve block under ultrasound can both confirm the source and give you real relief.

A revision surgeon can also help if there is a contour abnormality on the painful side that suggests a graft to debulk. Do not let your original surgeon stall this further. A year is a year.

#StayBeautiful,

@RealDrWorldWide

Semih Yildiz, MD, FEPOBRAS · Answer

Persistent one-sided pain more than a year after a BBL is something I would take seriously rather than simply waiting it out. It can come from several causes, including scar tissue, fat necrosis, nerve irritation or compression, a deeper fluid or tissue issue, or even a non-surgical hip/back source, so an exam is important.
I would ask your surgeon for an in-person reassessment, and if you are not getting clear guidance, seek a second opinion from a board-certified plastic surgeon. Depending on the exam, imaging such as ultrasound or MRI and/or referral to a pain or nerve specialist may be appropriate. If you develop fever, redness, drainage, worsening swelling, or rapidly increasing pain, seek urgent care.

BBL nerve damage/compression - what can I do for pain more than 1 post op?

Answers (5)

More Brazilian Butt Lift Questions

BBL 11 years ago - Is this scar tissue ?

Seroma from 11 years ago causing dull ache. What could cause this? (Photos)

4 years post BBL - how can I have this lump removed? (Photo)

Loose skin from pregnancies & weight loss - Is it better to do a lower body lift, or a BBL followed by a tummy tuck? (Photos)

Skinny BBL/ Tummy Tuck - what will give me the best shape and remove loose skin? (Photos)

BBL on rectangle body shape - can I add hips to my frame? (Photos)

WE SEND PRETTY
EMAILS