BBL - Can fat be transferred into dead space after removing silicone?

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

If you are expecting the fat to survive and hoping for any significant improvement and permanent result then the answer is “1”. Any “dead space” after silicone removal is full of scar tissue and devoid of healthy blood flow making fat survival extremely poor. In these scenarios, the only relatively safe, reliable, and permanent option to recreate buttock contours with fullness and projection is with buttock implants. Typically, Stanton Anatomic®️ gluteal implants produce the most natural and realistic buttock contours.

Please note that an extremely few number of board certified plastic surgeons specialize in buttock or hip implants, so you may need to travel far and away from home to find this particular surgeon. Getting it done right the first time around is not only the best chance for success, but also will save you from a lot of headaches and money in the future. Glad to help.

Yes, it is true that if fat grafts are place into the pockets where implants were placed, it would be a minimal contact with surrounding tissue to get proper nourishment and most of injected fat will not survive. However, if implants were removed long time before fat transfer, it is very likely that most of "dead space " is obliterated, non-existent; so fat grafts would be placed into healthy tissue that has good blood supply and will provide nourishment for fat grafts.. Hope this helps.

You cannot inject fat transfers into the space that was previous occupied by silicone as the fat will not survive. Fat has to be in contact with living tissue. Unfortunately, you have not provided photographs. An alternative to consider would be a buttocks lift where the excess skin and fat is used to make a flap and that can be used to fill in the hollow space.

Best Wishes,

Gary Horndeski, M.D.