After 4 years, you would be a great candidate for a BBL revision. The optimal BBL outcomes are achieved with: 1) use of VASER liposuction to harvest the fat, 2) a closed looped system such as Puregraft to process the fat, and 3) strategic micro-packet transplant technique. These three processes have demonstrated over 95% fat graft take. This means that your results will be stable as long as you maintain your weight. As an official VASER trainer, I am routinely referred unhappy BBL patients. One of the most common reasons for disgruntled BBL patients is that patients are not able to accurately communicate their desired buttocks goals to their surgeons. A buttocks assessment tool ban be an invaluable tool to communicate to your surgeon the exact buttocks size and shape you are desiring. A Skype or Facetime consultation with a BBL specialist can help you get an accurate recommendation and pricing.
It's possible to liposuction the buttocks to a certain degree. Sometimes fat is grafted into the gluteus muscle and fat grafted into muscle cannot be removed. This is a very individual case by case basis scenario. I suggest an in person consultation to get an accurate assessment. Best, Mats Hagstrom M.D.