Is there any reason related to anatomy, why a surgeon creates a squared buttock in a BBL? (Photo)

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, 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 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. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging. 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.

Dear DollyVy,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

There isn’t much we can do with your post other than bring up important points that were probably better discussed before your procedure.

First and foremost, to assess the outcome of a surgical procedure we need to see before and after pictures. If you don’t have those then you should ask your surgeon to forward the ones they took.

Your surgeon is obligated to see you after surgery especially if you have concerns. Not doing so it’s called abandonment and is considered a violation of professional behavior.

Contact your plastic surgeons office and request an in person postop visit. If they refuse to see you then contact the state medical board.

If you traveled for surgery then you are now living with the consequences of not staying local for a surgical procedure.

People who have a lack of projection on the backside of your buttocks or a flat spot, typically have connective tissue anchoring the skin to the underlying muscle fascia. This connective tissue limits projection in the flat spot and this is predictable before the procedure. This connective tissue prevents projection and can be made worse from procedures like fat grafting.

The best analogy I can give you to demonstrate how much restriction connective tissue place try pinching and lifting the skin on the back of your hand.

Now do the same in your mid palm.

You’ll recognize that the skin on your mid palm cannot project or be separated from the underlying deep tissues because connective tissue is anchoring the skin in place.

Areas on the body that can tolerate a lot of pressure like the soles of the feet, palms of the hand back of the thigh and lower buttocks have a lot of connective tissue. when plastic surgeons see this during an in person consultation they should if talented and experienced be able to predict exactly what the results will look like on that individual person. The results from these procedures are highly predictable in the hands of experienced talented providers. it’s up to each individual surgeon to communicate the best they can ideally using before and after pictures to show accurate representation of what each person can expect from the procedure.

A thorough in person consultation should include reviewing lots and lots and lots of before and after pictures and this should be part of the decision making patients use to choose the most talented and experienced provider.

Providers should show examples of patients who have similar body characteristics to your own to show what can or cannot be accomplished.

I recommend patients ask their providers during the consultation to show examples of excellent results, average results and less than results. More than anything they should ask providers to show before and after pictures of patients who have very similar characteristics to your own. highly experienced surgeons should have hundreds of before and after pictures to choose from so doing so should not be difficult. seeing the best results of someone with career does not give a potential patient a clear understanding of what average results look like in the hands of that provider or what someone with their individual body characteristics can expect.

You may or may not have been a good candidate for the BBL. The procedure may or may not have been performed well. There is substantial difference personal philosophy in what these procedures should look like as ideals not to mention skill or experience.

It takes three months before your results are final and results should not be judged until at least six weeks after the procedure. Your pictures appear to be taken sooner after the procedure. if your procedure was done a year ago then showing current results which at this point would be final would be a lot more helpful. in the end what we need to make an assessment on the outcome of a procedure is proper before and after pictures with the after pictures taken at least three months from the date of surgery.

If you don’t have before and after pictures then ask your surgeon to forward the ones they took.

Follow up with your provider and insist on having an in person consultation.

In the end your surgeon is responsible for your outcome and you are responsible for choosing that surgeon.



Best,

Mats Hagstrom MD

Based on your pictures, I agree that your buttocks are square and lacking in the projection that give a rounded appearance. You are an excellent candidate for a Brazilian Butt Lift (BBL) revision. The optimal BBL revision outcomes are achieved with: 1) use of VASER liposuction to harvest the fat since your fat has already been harvested 2) a closed looped system to process the fat in order to optimize transfer time and avoid your fat from becoming contaminated and 3) strategic micro-packet transplant technique that maximizes graft take. 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. Finally, attention must be given to providing you the buttock shape that YOU desire. This means using our proprietary BBL assessment tool. 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. Our buttock assessment tool can 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.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee