Butt dent: Subcision only or would i need a BBL? (Photo)

Hello @Terrific344245, thank you for your question. One possible treatment option for this is subcision. The procedure involves cutting the fibrous bands that cause the dent, allowing the skin to lift and the dent to become less visible. Subcision, however, does not fully correct volume loss resulting from fat atrophy, as it primarily treats indentations caused by scar tissue. Due to this, some patients choose to undergo fat grafting or a Brazilian Butt Lift (BBL), which can add volume to the affected area, and this may be a more appropriate treatment based on the severity and depth of the dent. A combination of these techniques might be used for optimal results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Hi, injection of a steroid has the known side effect of fat atrophy or loss of fat in the area injected. This may or may not be associated with some scar that is tethering the skin down. If the principal of this scenario was fat loss it is best to replace the fat through a fat injection. When done in larger volumes in the buttock, it's referred to as a BBL. If the scar is mobile and it does not appear to be tethered on a physical exam , injection of the fat might be enough. If it does appear to be tethered or "stuck down" then subcision would be done at the same time as the fat injection to help improve the final result. Good luck.

Hello, thank you for your question. I would speak to your plastic surgeon about your options and a better assessment. Breaking the fibrotic band would be ideal along with placed a small amount of fat there to help keep it from healing indented .

What you could do is fat transfer to your indent. You will only need 5 days to recover, it can be done under local anesthesia. Procedure takes about 40 minutes.

Dear Terrific344245,
it is hard to tell for sure without an examination. Based on your photo, it looks like you would need some kind of grafting to fill the dent. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Interesting question1 Subcision will definitely help. But I’m afraid it might not be enough. I will help release the tissue but it would be best combined with fat grafting. This does not have to be a full blown BBL if you van only take a few days off. Subcision plus a little bit if lipo and then grating that fat to the on the affected areas is very possible to do with zero downtime.

Best of luck,
Dr. Miguel Mota

Hello, thanks for your question.The best procedure for you really depends on you overall goals and having a good understanding of what each procedure has to offer. A subcision only serve to break up the fibrous bands and scar tissue with the hope that the skin will release and improve the indentation. On the other hand, a BBL, in my hands, is a patient centered, customized procedure to shape the waist through liposuction and enhance the butt and hip with fat transfer to correct any concerns with size, projection, balance and asymmetry.It is also important to note that indentations like yours often have element of small volume loss that needs to be replace in addition to the scar to be released. Again the best procedure for you will be based on your goals after a proper examination. If the indentation is your only concern, I would consider an incision-less release of the scar and localized fat grafting to the area to treat the volume loss. Hope that was helpful.

Subsicion is indicated if there is connective tissue or scar tissue that’s contracted and pulling down on the skin on the underlying deep tissues.Fat atrophy from steroid injections should not have created a significant amount of scar tissue, so volume restoration alone may be sufficient. There are different ways of assessing if substation is needed in order to create a better contour. One technique is just simply inject saline (salt solution used in intravenous fluid )as if it were filler or a fat grafts.
If injection with saline solution, restores and natural ideal contour, then you’ll know that connective tissue or scar tissue is not creating a significant problem. If however, injecting saline does not restore a good contour, and you see evidence of indentations, or cellulite type appearance then you’ll know some type of separation of scar tissue will be needed. Far transfer most likely take a few sessions, and it’s better to build up the volume gradually then trying to do it all in a single session to avoid fat necrosis.
A suggest having multiple in person consultations with plastic surgeons who have experience with fat transfer.
Best,
Mats Hagstrom, MD