BBL revision left my butt severely saggy and droopy. What can I do?

Dear myamoore1992,
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

You are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, 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 indeed provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock, a bit of a lift, and often also smoothing out lumpiness. Occasionally 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.

Appears the BBL Reduction in round 2 was only slightly successful. I think a round 3 BBL REDUCTION with taping & more trunk lipo with specific fat grafting to areas of butt could improve the results. Fee from $6,000.

Hello!
I'm sorry to hear about your experience. Revision BBLs and liposuction are tough. There are a couple of options that may improve your symmetry and buttock shape.
To decrease the droopiness (more so on the left buttock), a butt lift/lower body lift procedure is sometimes performed. It has a similar name to the Brazilian butt lift, but a butt lift without fat transfer is meant to remove extra laxity from the buttock to lift it rather than volumize it. It is typically performed in patients who have lost a lot of weight or thin patients with poor skin strength/elasticity and minimal butt volume and is dependent on having extra tissue to remove. Essentially, the procedure would entail removing skin and tissue at the point where the buttock meets the lower back. In order to try to raise the left buttock to match the right, more tissue would likely need to be excised from the left side. This would leave a scar along the top of the buttocks in a gullwing shape so it is important to be okay with that length of scar if you decide to consider this procedure and again it's hard to say that you would be a candidate for this if there is not too much extra tissue allowing the buttock to droop (i.e. you would need to be examined by a plastic surgeon in person to know). Even if you are a candidate, I would likely recommend a revision with liposuction and fat transfer first to try to achieve your desired shape before recommending this procedure (due to the size of the associated scar and the uncertainty of whether it would help you achieve your aesthetic goal).
In terms of the asymmetry in buttock size, it is a somewhat difficult situation to fix because it sounds like you prefer the size of the right buttock more so you are interested in removing some volume from the left to better match the right. In general, it is difficult to remove volume in areas that have more fullness and curvature rather than remove volume. Some very care careful liposuction along the lower left buttock and the outer left hip may help to even this out. The risk is that it is hard to remove fat from these areas without causing a contour deformity (i.e. an indentation) and for this reason many plastic surgeons may recommend adding more volume to the right side instead (although I understand larger is not your goal at this point).
The volume/fat placed in your hips could also be smoothed out somewhat with careful liposuction of the most protruding area, additional fat grafting above and below this area and fat equalization. This would give the appearance of a more gentle slope from the lower back along the hip and down the outer thigh, which is a more natural curviness. This is probably the most straight forward option of the ones listed here. However, it would not affect buttock projection or asymmetry.
Lastly, I understand that you did not specifically ask about this, but I do think it is worth mentioning, considering tummy tuck does help give the appearance of more buttock projection and shape because the tummy area is flatter. If this is not an area that bothers you and you do not want the appearance of more buttock projection, then there is no need to worry about it. Just wanted to give you a comprehensive answer.
It may be worth getting consultations with other plastic surgeons in your area that specialize body contouring to see what ideas they have after examining you in person.
Wish you all the best,
Dr. Victoria Aimé

In order for us to make an assessment we need to see quality before and after pictures. For patients who had revision surgery we need to see before and after pictures from each of the previous procedures.If you don’t have proper before and after pictures then ask your surgeon or surgeons to forward the ones they took.
I believe part of your problem is that someone did inappropriate liposuction of your upper thigh collapsing the part that supports your buttocks.
Patients who have had multiple operations become more and more difficult to improve upon.
Delivering consistent quality liposuction and fat transfer results is more difficult than most people believe and this includes plastic surgeons.
The number of plastic surgeons who can deliver consistent quality results on a regular basis including giving correct and accurate assessments steering patients towards the right decisions whether they should have surgical intervention or not are fewer than most people believe.
The importance of selecting a sufficiently talented and experienced provider cannot be overstated.
I question if you were even a good candidate for a BBL in the first place.
If you’re going to have a third procedure you better choose someone with a better set of skills.
Sometimes inappropriately done primary procedures make revisions extremely difficult and some outcomes are simply difficult to improve upon.
Liposuction and to some degree fat transfers.
With limited information we can’t give you a quality assessment or recommendations of specific intervention.
At this point you need to be very selective of your providers and ask yourself if you’re willing to go through more surgery considering that each prior procedure makes obtaining an ideal outcome more difficult.Best, Mats Hagstrom MD