Dark spots & hard lumps after BBL? (Photos)

Question

I had lipo 360 and a BBL in July 2020. The results were horrible so the doctor did a revision April 2021. It's still uneven, however my main concern now is the dark spots and hard lumps and it's been 18 months since last surgery. A few months after the second surgery, my butt was really painful to touch and then the lumps and dark spots came. Are there any recommendations to fix this?

Ryan A. Stanton, MD · Answer

You are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, fatty necrotic oil cysts, unevenness, lack of projection in the central and/or lower buttock, post-deflation sagging, etc.) as most of the fat melts away. It is not quite as much the quality of the doctor nor liposuction technique but rather the quality of the procedure that is a large part of the problem.  Thus, going back for round 2 BBL most often produces the same disappointing results but at another financial loss.   Buttock implants provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often smoothing out lumpiness.  Occasionally the fatty necrotic oil cysts have to be removed by direct excision, or a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging.  Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in buttock implants so be sure to consult with one that is reputable and experienced. Unfortunately you may have to travel long and far away from home to find this particular surgeon. Glad to help.

Daniel Barrett, MD · Answer

Dear Brave888964,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

Some people have skin that hyper pigments are very easily including from minor trauma.
I’m guessing that the impact of the cannulas touching the back of your dermis cost an inflammatory response that resulted in hyper pigmentation.
Are these situations typically continue to fade slowly over time in.
The problem with individuals whose skin is very sensitive to hyper pigmentation is that treatment options for skin color changes like laser treatments can often induce pigment changes on their own sometimes making things worse.
Probably nothing done incorrectly just your skin is very sensitive to forming hyper pigmentation.
Hard lumps most likely represent fat necrosis. I suggest you follow up with your provider.
Best,
Mats Hagstrom MD

Dark spots & hard lumps after BBL? (Photos)

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Dark spots & hard lumps after BBL? (Photos)

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