Why is my butt like this after BBL? Can it be smoothed out?

Question

Im embarrassed to show my butt when sitting and won't wear a bathing suit or any thin clothes. My buttocks is indented in the middle and dimply. Should i have another BBL or try cellulase or injectibles? Please help.

Gregory A. Wiener, MD, FACS · Answer

Hello, and thanks for the very good question. Unfortunately, this is a common problem after BBL (Brazilian Butt Lift), and the issue usually is that there was some degree of cellulite and dimpling naturally before the surgery. The problem is, as fat is added, the dimpling and cellulite can look more pronounced. Areas of dimpling won't expand and round out as well because the shorter septae (vertically oriented fibers that connect the skin to the underlying fascia covering the muscle) don't stretch in that area, while longer septae in the surrounding areas fill out more completely, giving you low and high areas no matter how much fat is placed into the lower/tighter dimples.One partial solution is called "subcision", which means cutting the short septae by running a small forked blade on the end of a cannula beneath the skin. This is usually done after fat has been placed in that area and essentially releases the skin so that it can expand to the same level as the surrounding, undimpled skin. I say "partial" solution because subcision must be done very carefully and in small amounts, because if the overlying skin is completely released this may create a pocket under the skin that can fill with fat that ultimately won't survive and there could be a large fluid filled cyst that forms in the area. Even worse, if aggressive subcision is done to the entire buttock the whole buttock can droop because the skin is no longer connected to the underlying muscle. I perform subcision in areas of dimpling during fat transfer to the buttock, but very carefully, and in small amounts, so the correction is not always complete, but it is done safely. In cases of severe cellulite and dimpling I often recommend a second, or even third, smaller procedure months later to partially release (subcise) and add additional fat to uneven spots, achieving a little more correction each time without creating big problems.The other key to this whole issue is to diagnose this prior to your fat transfer. Pressing on and moving the soft tissues of the buttock will show areas of dimpling (just like the pictures you took while sitting then partially standing). Then you can make plans and decisions beforehand, and you will not be surprised by some accentuation of dimples and flattening. In your case, some limited subcision and fat transfer may help. It is unlikely that cellulaze or other injectables will help. Discuss this with your surgeon. I hope this helps!

Dhaval M. Patel, MD · Answer

Thank you for your question and photo! I suggest going to your initial plastic surgeon and discussing your concerns and your options.  Best of luck!
Dhaval Patel
Double Board Certified 
Plastic Surgeon
Chicago
Hoffman Estates
Oakbrook
Orland

Johnny Franco, MD, FACS · Answer

This is a great question at multiple levels. First of all, it addresses the fact that the Brazilian Butt Lift (BBL) will not treat the cellulite in the butt and thighs.  The BBL is a great treatment to enhance your buttock and overall shape, however it does not treat the superficial cellulite. 
There are several ways to address the cellulite for your butt and thighs.  The options are surgeon specific and should be discussed with your Board-Certified Plastic Surgeon performing your Brazilian Butt Lift.  
  
The first option is to have the Cellfina done at the time of your Brazilian Butt Lift if your surgeon has that option available for you.  This is easier logistically as your two procedures are combined in one. 
  
When choosing between doing the procedure before or after the BBL I would recommend doing the Cellfina prior to the Brazilian Butt Lift as it will release the bands and in my patients, it seems to allow for more fat transfer.  However, if you do it prior, it needs to be several weeks prior to your Brazilian Butt Lift.  
  
With all of this said you are still a candidate for Cellfina after your Brazilian Butt Lift.  I typically have patients wait at least six weeks after their BBL to undergo a Cellfina treatment.  
  
The versatility of being able to do the Cellfina in the office under local or in the operating room as part of your Brazilian Butt Lift gives patients a lot of options. 
  
I hope this helps.  Please consult with your Board-Certified Plastic Surgeon about your Cellfina treatment as every surgeon has a specific time-line for having a Cellfina treatment before and after a Brazilian Butt Lift.

Larry S. Nichter, MD, MS, FACS · Answer

Ideal candidates are at a stable weight,  in good health , and have excess fat in some parts of the body and too little in other regions.  Gaining weight before the procedure is to no advantage and when you lose weight again the fat cells will shrink just like the donor site fat cells.  Typically, the transferred fat results in a significant increase in volume of the body site being treated.

Ron Hazani, MD, FACS · Answer

It is common to have pre existing cellulite that is made worse or more apparent after fat transfer.

Why is my butt like this after BBL? Can it be smoothed out?

Answers (8)

Answer: BBL revision candidate

Answer: BBL revision candidate

Answer: Why is my butt like this after BBL? Can it be smoothed out?

Answer: Why is my butt like this after BBL? Can it be smoothed out?

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Everything you need to know about Brazilian Butt Lift Revision

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Why is my butt like this after BBL? Can it be smoothed out?

Answers (8)

Answer: BBL revision candidate

Answer: BBL revision candidate

Answer: Why is my butt like this after BBL? Can it be smoothed out?

Answer: Why is my butt like this after BBL? Can it be smoothed out?

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Recommended reading

Everything you need to know about Brazilian Butt Lift Revision

Our mission is to create a world where every investment in modern beauty is Worth It.