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