6 weeks post-op. My butt went from round and perky to flat and droopy. Can this be fixed? (photo)

Question

I had a BBL done 6 weeks ago. I just now started sitting. I made sure to follow all directions. I have wore pajamas for 6 weeks. My butt since the swelling has left looks horrible. It is back flat and my fat has slid down into the bottom right corner of my butt forming a teardrop. It droops! I’m so depressed. I contacted the surgery center and they said wait 6 months and then contact them if I’m still not happy. My butt went from round and perky to flat and droopy? Can this be fixed?

Daniel Barrett, MD · Answer

Dear ccoulter0006,
I understand your concern and it is quite normal to be concerned about the outcome following a BBL surgery. However, you are still in the very early stages of the healing process.Your will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.At the early stage of the healing process, the tissues are still swollen. Once the swelling subsides  you will be able to see the final result of your surgery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

Wait at least six months for round two as the resolution of swelling over the liposuctioned areas may take that period of time. The revision implies that there is less fat than the first time, and scar tissue will make the surgery much more difficult on the surgeon.
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.
Please, follow up close with your plastic surgeon.
Good luck :)

Michael L. Spann, MD · Answer

Six weeks is a little early to be too concerned (unless the area is warm, draining, or painful). The areas treated will continue to evolve as the grafted fat establishes blood supply and the swelling resolves. I typically recommend holding on revisions until a minimum of 3 months. Stay in contact with your surgeon and best wishes on your recovery.

Stephen M. Davis, MD, FACS · Answer

Thanks for writng,The waiting period is to allow a couple of things. First to let as much fat that is going to survive show itself, second this will allow for the previous areas liposuctioned to soften and mature so more fat, if necessary, can be harvested .Stephen M. Davis, MD, FACSCertified: American Board of Plastic SurgeryMember: American Society for Aesthetic Plastic SurgeryMember: American Society of Plastic SurgeonsMember: RealSelf Hall of Fame

Mats Hagstrom, MD (license on probation) · Answer

There are inherent limitations of this procedure. As well, some people are better candidates than others.  It starts with making an accurate assessment which can then be used to predict with accuracy based on experience the type of results each unique individual can expect.  The flats but some people have after a BBL on the inner lower part of the buttocks happens for a reason.  This is also predictable before the procedure and if doctors are aware it's something that should be discussed during an in person consultation.  This area has to tolerate your entire body weight for long periods of time when you're sitting. That's a unique challenge that only happens on a few areas on the body.  The areas on our bodies that can tolerate great amounts of pressure and force are the palms of the hands, the soles of the feet and the flat spot on the buttocks.  These areas have much more connective tissue securing the skin to the underlying muscle fascia.  This connective tissue is not very pliable. It doesn't stretch very well.  The best example I can give is the palm of your hand. Try pinching the skin in the palm of your hand and lifting it up. It's virtually impossible.  I do it on the back of your hand and you will see how very different the skin behaves in these adjacent areas.  If you were to graft fat into the palm of the hand the skin would not raise up very much.  The connective tissue bands simply won't stretch allowing the contour to form.  The same thing happens to peoples buttocks.  People are different. Some people have short intense connective tissue bands on the buttocks that severely limit the projection in this area.   The area is adjacent to this flat spot tend to have much less connective tissue with more stretching us. This means that regardless of how the fat is grafted the flat spot stays flat but the other areas expand.  This creates an image of the flats but looking even worse.  You're fat did not move.  It didn't shift from one area to another. These are the inherent limitations of the BBL procedure in your body.  Granted, I was not present for the procedure so I am making a great deal of assumptions.  Next topic at hand is the boxiness. The shape of the buttocks is typically not changed very much from a BBL procedure when it comes to Square versus round.  I think Dr. Mendieta has described this the best both in his books and many videos available to the public.  People with fullness or droopiness of the inner lower part of their buttocks need a different procedure to get the desired round contour. Dr. Mendietta refers to this as the dirty diaper look. While perhaps not the most flattering terminology it is fairly descriptive.  His treatment for this is called the Miami thong lift.  It is not correctable by fat manipulation.  To make an accurate assessment requires accurate information, complete information  and is a complex task.  It's really far beyond what can be accomplished on forums like real self.  On top of this, patients have lots and lots of questions especially when trying to explain why results look that way they do or why there are inherent limitations.  This makes in person consultations and follow up care  important.  If you want more accuracy in our assessments then you should consider posting proper before and after pictures so we have some reference of what was actually done.  Best, Mats Hagstrom MD

John E. Nees, MD - Account Suspended · Answer

Hi andwelcome to our forum!Congratulationson your recent procedure...The procedure of BBL is an"insult" to the soft tissues, resulting in swelling which willinitially totally obscure the operative result. Thepurpose of a compression garment is to prevent bleeding and to controlswelling. We usually recommend its use for the first 4-6 weeks after theprocedure. 60-80%of the swelling should subside within the first 6 weeks, with the remainderslowly subsiding over 6-12 months. In addition, the skin envelope will readjust to accommodate the additional volume over a number of months.It is a bit early to consider revision as the final result is not yet apparent.Continuefollowup care with your plastic surgeon. We usually recommend waiting 6 months before considering revisional surgery to allow subsidence of swelling and the hypervascularity of healing. 15% of cosmetic surgeries require a secondary touchup.Best wishes...

6 weeks post-op. My butt went from round and perky to flat and droopy. Can this be fixed? (photo)

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