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!
