Do I have enough fat for another BBL? (Photo)

Question

Hello, I am 24 year old. I weigh about 120 pounds and I am 5'3. I had a BBL 3 years ago, but I am not happy with the results. Do you think I can have another BBL? Thank yoi.

Ryan A. Stanton, MD · Answer

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.

In short, no, you are too lean to even consider a BBL. Additionally, 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, fatty necrotic cyst or scar tissue, 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 additional rounds of BBL most often produces the same disappointing results but at another financial loss.

Fillers, such as Sculptra and hyaluronic acids,  for augmentation of the buttock/hips are a rip-off, period!

Buttock implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often smoothing out lumpiness. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging.  When considering buttock implants make sure that the surgeon is going to be placing the implants within gluteus muscles , (a.k.a. “intramuscular pocket”), and that they are using anatomically correct, oval-shaped implants, such as Stanton Anatomic ®️ implants. 
Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in these 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 jenny1805,
it is hard to tell for sure without an examination. Based on your photos, you look like a good candidate for BBL surgery. 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

George Marosan, MD · Answer

Thank you for your question and photos. Original preop photos would've been helpful. Based on these photos and BMI of 21 you are a good candidate for another buttock augmentation. To create a beautiful shape, one must have an anatomical understanding of the beautiful normal. The back photo shows that you have a very long buttock shape. Your anatomical buttock ends about the level where the shadowing is on your right side (top of the gluteus maximus muscle). Everything above that needs to be removed and sculpted and the fat transferred into the correct location into the buttocks to create a more upside down heart shape. Although your abdomen is flat, looks amorphous without definition. If you were my patient, I would do VASER Hi Def lipo 360 degrees of your torso and transfer the fat into the buttocks for enhancement and shaping.
See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Geuris Cruz Quiroz, MD · Answer

Thank you for your question dear @jenny1805. 
Enough will be depend which results are you looking for, based on your pictures you qualify for a good BBL procedure, means more projection in your buttocks area, but everything depends which results are you looking for we can talk about if your results can be realistic or not. 
Good luck!

Darryl J. Blinski, MD · Answer

Based on the 2 posted photos and you BMI under 22, you need to gain 10+pounds or consider doing a Skinny Composite BBL. That is using both lipo fat of very limited amounts with Injection BBL (Sculptra/Radeisse combo at least 10-20 vials or syringes. Fees either $10,000 or $14,000. But best to do in person consult or virtual consult with.....

Douglas Taranow, DO, FACOS · Answer

I would love to see your before photos to see where you started, as well as where they took the donor fat from (which areas were liposuctioned).  This would allow me to better judge if you have enough donor fat to proceed with another BBL procedure

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. If you don’t have before and after pictures, then ask your surgeon to forward the ones they took. It’s important to know what areas you had treated before, especially in regards to Liposuction. It looks like your torso was treated at least the lower part. There may be fat the harvest by doing Liposuction for a second time on your torso. We usually can harvest 25% of the volume we got from the primary procedure by doing secondary liposuction. That may not be enough to warrant doing a fat transfer, depending on what you’re hoping to achieve. Additional areas to harvest fat from include arms and lower extremities, especially inner and anterior thigh. Secondary Liposuction of your torso with the addition of arm and lower extremity Liposuction may create enough fat for a modest fat transfer procedure.
Delivering consistent quality, liposuction and fat transfer results is more difficult than most people realize. Doing extremity, Liposuction is technically more difficult, and the importance of finding a sufficiently talented experience provider cannot be overstated.
Assessing how much fat can be harvested from liposuction procedures, especially a secondary liposuction procedure is especially difficult.
Surgeons do not want to underestimate how much fat can be harvested because this leads to a disappointment. Both regards to Liposuction and fat transfer results.
In the end individuals, who may not have the ideal amount of fat for a fat transfer, can still have some results. We often quote this in percentages of ideal. For example, a low BMI patient may have an estimate of getting 2/3 of an ideal BBL result, which would still be a nice improvement but not as good as if they had unlimited sources of subcutaneous fat to be harvested. Patient should also ask themselves how much Liposuction they’re willing to have in order to get the benefit of the fat transfer procedure.
Do you have a nice body contours as it is and I see no strong indication of her needing a second BBL. It would be very helpful to see your before and after pictures to know where you started.Best,
Mats Hagstrom, MD

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