Painful lump after BBL

Question

I had a bbl two years ago. About two months ago I started getting a pea sized lump in my left middle butt. I have to push in about an inch to feel it. It's not on the surface, so you can't see it. My previous surgeon is in Mexico. I can't travel back for him to assess it. I have another surgery coming up, in May, for a bbl. Can I still get my surgery?! Can you get a bbl with fibrosis, fat necrosis, or a cyst? My surgeon say yes. Do I need a second opinion?

Daniel Barrett, MD · Answer

Dear BeautifulMexico,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jon S. Wilensky, MD · Answer

Experiencing a painful lump after a Brazilian Butt Lift (BBL) can be concerning, and it's essential to address this with your plastic surgeon promptly. Here are some possible causes and steps you can take:1. Seroma or Hematoma:• Seroma: A collection of fluid that can accumulate under the skin, leading to a painful lump.• Hematoma: A collection of blood that can occur following surgery, causing swelling and discomfort.What to Do:• Contact your plastic surgeon immediately to have the lump evaluated.• Your plastic surgeon may drain the seroma or hematoma to alleviate pain and prevent complications.2. Fat Necrosis:• Fat necrosis occurs when the transferred fat cells do not receive enough blood supply, leading to cell death.• This can result in the formation of firm, painful lumps under the skin.What to Do:• Inform your plastic surgeon about the lump and any associated symptoms.• Your plastic surgeon may recommend observation or additional treatment depending on the severity of the fat necrosis.3. Infection:• In rare cases, an infection may develop in the surgical site, causing pain, swelling, and the formation of a lump.What to Do:• Seek medical attention promptly if you suspect an infection.• Your plastic surgeon will assess the lump and may prescribe antibiotics or perform additional interventions as needed.4. Fibrosis:• Fibrosis refers to the formation of scar tissue, which can sometimes feel like a lump under the skin.• It can occur as part of the normal healing process following surgery.What to Do:• Notify your plastic surgeon about the lump and any associated discomfort.• Your plastic surgeon may recommend massage or other techniques to help soften the scar tissue and improve comfort.General Recommendations:• Follow all post-operative instructions provided by your plastic surgeon, including medication use, activity restrictions, and follow-up appointments.• Avoid applying excessive pressure or massaging the area without your plastic surgeon's guidance, as this could exacerbate the issue.• Stay in close communication with your plastic surgeon and report any changes in symptoms or concerns promptly.It's essential to have any post-operative concerns evaluated by your plastic surgeon to ensure appropriate management and optimal recovery. By addressing the painful lump promptly, you can help prevent complications and achieve the best possible outcome from your Brazilian Butt Lift surgery.

Mats Hagstrom, MD (license on probation) · Answer

First and foremost, I do not recommend people travel long distances for elective surgical procedures.
Secondly, I recommend patients have multiple in person, consultations before selecting providers and considering scheduling surgery.
Mastering liposuction, and fat transfer is far more difficult than most people realize and the number of providers who truly have mastered this procedure is quite small.
There is a wide discrepancy in skill and experience among board-certified plastic surgeons with years of experience, and overall good reputation.
 I cannot emphasize enough the importance of vetting providers, thoroughly and carefully through in person consultations.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who have similar body characteristics to your own.
 An experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients.
Being shown a handful of pre-selected images, representing only the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider, what your results are likely to look like or how many of these procedures they’ve actually done.
 It is also very difficult to get an accurate assessment regarding your own candidacy for the procedure without allowing the provider to examine you.
Patient candidacy is equally as important as provider selection.
Without understanding your own candidates for the procedure patients have no idea what kind of results are even possible.
I generally do not recommend patients have virtual consultations whenever possible.
I simply don’t think you can vet providers accurately or thoroughly without meeting them in person.
Fat necrosis is related to using poor technique.
It should not prevent you from having a second procedure, but the second procedure certainly has all the risks involved with having liposuction and fat transfer.
 Secondary procedures are technically more difficult than primary procedures.
In my opinion few people should need a second BBL.
It’s a free world, and people are welcome to do as they please.
People do not seem to appreciate how many patients have real issues and concerns after surgery, the importance of in person, follow-up visits, the number of patients who will need revision surgery or that complications actually do happen.
Best,
Mats Hagstrom, MD

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