Fat necrosis - would working out/building muscle hide dimples? (Photos)

Question

Been post op for over a year now about a year and two month, I have dimples on my behind after my bbl. Some areas where the dimples accrued are darker area and pretty sure are fat necrosis but they don’t feel like a rock, just dimples. Doesn’t look good looking for surgeons that do revision but I can’t find much information about actually fat necrosis and doctors that are willing to remove them. Just wondering would it help of I workout and build muscle on my behind to try to hide the dimples

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/dimples, unevenness, lack of projection in the central and/or lower buttock, post-deflation sagging, etc.). It is not quite as much the quality of the doctor 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 and often smoothing out lumpiness.  For any palpable or tender fatty necrotic oil cysts, those can be directly excised.. 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 Giving977618,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from fat transfer. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
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

It looks like you have cellulite. This condition is my divorce from fat transfer and patients who have mild cellulite should be warned that having the procedure can make their is cellulite worse.

There’s no great treatment for cellulitis. Subsicion it’s probably the best option with or without smaller aliquots of volume augmentation using either fillers or fat.

Subsicion can’t be done using a device called Celfina.

All patients develop some degree of fat necrosis from fat transfer procedures. If done correctly the individual particles are fat that Necrosed  are small enough and spread out enough to not create any noticeable issues.

Fat necrosis typically causes firm lumps that can be felt underneath the skin but it does not create cellulite.

Cellulite is caused by connective tissue bands that anchor the skin to underlying muscle fascia. This type of connective tissue is present in areas that can tolerate more pressure such as the palms of hands, soles of the feet, back of the thigh and lower inner buttocks.  These connective tissue bands do not stretch and create a tufted appearance when the subcutaneous fat layer is increased.  this is why cellulite typically becomes more evident with obesity and fat transfer.

Best,

Mats Hagstrom MD

Fat necrosis - would working out/building muscle hide dimples? (Photos)

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