2.5 weeks post-op. Why is there not a lot of projection on my BBL? What went wrong? Advice? (photos)

Question

Im only 2 1/2 weeks post up n i know it only gets smaller from here . I asked for more projection and I don’t see a big difference than before n my measurements are only 2 inches bigger than I previously was . He put 710 cc in one cheek and 790 cc in the other . What went wrong?

Kenneth Hughes, MD · Answer

Pre operative photos showing frontal, side, and back views would be helpful in making a recommendation.   I would give yourself at least 3 months to make a determination about the result. 
Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Tania Medina de Garcia, MD · Answer

Hello dear!!
Thanks for the question and provided information as well.
You are still early on the healing process, it can take up to six months to see your final results, so please be patient.After a BBL, only about 70% of the transferred fat cells will survive, so it is normal to see a minor reduction in your buttocks. If you have any concerns, I suggest you to follow up close with your plastic surgeon.
Good luck :)

Mats Hagstrom, MD (license on probation) · Answer

Setting realistic expectations is important. Your reference of what you think is an obtainable good result determines if you're happy with moderate results or not.  Some of the pictures floating around online simply aren't even close to realistic.  I'm not saying the pictures are manipulated but I can tell you for sure some are.  Their number of variables to take in the consideration.  Peoples bottoms have connective tissue that sometimes limits the amount of projection that can be obtained no matter how much fat or how the fat is grafted.  The areas immediately adjacent to the butt are generally reduced in size to make the BBL look bigger. To the naked eye it may be difficult for you to perceive which part was achieved by liposuction and which part was achieved from the fat transfer.  I have after pictures of patients who only had liposuction but everyone swears the butt is bigger making it look like they had a BBL.  I have one patient who got liposuction only. The patient's mother wants a written letter from me stating I did not put in gluteal implants.  It's a bit of a crazy story but her butt now looks so big her mom thinks he has implants.  She doesn't have implants and no fat was grafted. Her waist came in giving her incredible proportion's and curves.  So some of the amazing results you see are a combination of two complementary procedures done adjacent to each other giving a final remarkable contour.  Which was most important? The fat transfer or the liposuction or both? Liposuction and fat transfer procedures vary greatly on the candidacy of the patient.  Some people will never have great results while others are a slamdunk and only incompetent persons could not deliver results. There are also safety parameters to take into consideration.  There are just as many people looking for amazing results posting on real self  as there are people scared to death of having a fat embolism from this procedure. There's no way someone is going to give you 2 inches of projection without grafting fat into gluteus muscle.  Were you willing to except a one in 3000 mortality from doing this procedure in a more dangerous way?  If the surgeon wants to keep the procedure safe then results will have to be sacrificed to some degree.  Maybe a plastic surgeon did you a big favor because you're alive  to tell about it. We weren't there for the procedure so none of us can give you any real input on if it was done adequately or correctly.  Lastly you're judging results way to early. Granted your butts only going to shrink from here but so will day results from liposuction.  Be patient, wait three months to review with your results with your surgeon.  This is way too complicated to just say I want 2 inches of projection Dr.  Some people may be able to get that much projection but I would say 2 inches is the max anyone can achieve ever.  Put 375CCs  water  in a plastic bag. That's the total volume for your entire butt cheek when all is said and done long-term. Assuming a 50% fat survival. 700 to 800 mL for cheek are pretty typical volumes. You're not going to get the answers you're looking for from real self because we weren't there for the procedure.  Give it three months and follow up with your plastic surgeon. I'm sure he or she has your best wishes and needs in consideration. Best, Mats Hagstrom MD

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