BBL with lipo 360 candidate? 26 year old, female, 5’4”, 225lbs (Photos)

Question

l have scheduled a bbl with lipo360 next month. I was just curious about my BMI being on the higher side. I’m bottom heavy meaning my Thighs are larger. My BMI is 39 but I’m athletic. I’ve always been on the thicker side. Am I still a good candidate or what options do I have?

Morad Askari, MD, MBA · Answer

Thank you for your question and for uploading pictures.Each surgeon has their own requirement in terms ofBMI. Based on your pictures, you are a great candidatefor a BBL. I would recommend adding skin tighteningto your liposuction to make sure you have goodlong-lasting results.

Moises Salama, MD · Answer

Thanks for your question. At my practice, the max Body Mass Index (BMI) limit for a Brazilian butt lift (BBL) is 35. The BMI is based on your height and weight. Going by the height and weight you provided, you are at 38.6 and do not meet our BMI requirement. Since you are over the BMI limit, I would recommend consulting with your primary care physician on a proper diet for you to bring down your BMI in order to be able to undergo the procedure. Please always consult with a board certified plastic surgeon. Take Care, Moises Salama MD, board certified plastic surgeon

Emmanuel Mallol Cotes, MD · Answer

Thanks for the question. I recommend you waist and back Liposculpture, getting better curves especially in the waist, improving your body contour also, I suggested take the fat we get and transfer to the buttocks and hips, to mold them and get better volume, contour and butt projection, is that we know as "Brazilian Butt Lift" (BBL).

Kind regards

Kind regards

Daniel Barrett, MD · Answer

Dear Cute446915,
generally speaking, you want to reach your goal weight before you consider a surgery, otherwise your results will be suboptimal if you continue to lose weight after the surgeryIf 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Darryl J. Blinski, MD · Answer

Thanks for tying to post photos but the shadows greatly reduce your natural appearances.  With your very high BMI (39+) you will be cancelled if using a CLINIC in Miami! You must virtual with the surgeon to ask if you are cleared for surgery!!! Otherwise if arriving from out of town you will be cancelled and lose $$$S. I want you to fully understand the lipo limits in Florida are 4 liters (8.8 pounds!), you are so very much over the 4 liters you will need 2-3 surgery rounds. So I can offer you surgery with this understanding of the need for future rounds. Fee I charge is $6,000. Best to virtual with....

Douglas Taranow, DO, FACOS · Answer

You are big all over and at the highest end of my cut off for a cosmetic procedure.  The maximum volume of fat aspirated is 5000cc's (5 liters).  You certainly have this amount and the areas suctioned must be adjusted to max out at this volume.  The BBL is a no brainer.  
Issues I see are how the lower abdominal skin will look post liposuction-flat, folded or wrinkled (no one can guarantee)

Mats Hagstrom, MD (license on probation) · Answer

Candidacy is a complex topic that encompasses numerous different individual sub categories.
You are in many ways not an ideal candidate but quality work should make some improvements.
First and foremost I’d like to point out the importance of approaching this procedure correctly.
In my opinion having been doing this type of work for well over 20 years I believe the best way to maximize hi patient satisfaction and to minimize disappointment or regret including disfigurement patients should consider the following.
The first step in the process is to get a quality assessment.
To get an assessment will require multiple in person consultations with board-certified plastic surgeons who have sufficient skill and experience to not only do the procedure correctly but I’ll also ask you early assess the patient to the point of being able to predictably show exactly what results will look like for each individual by demonstrating previous before and after pictures of previous patients with similar body characteristics so there should be a little discrepancy with what your final results are and what’s presented during the consultation.
A BBL is in fact two procedures done simultaneously.
Patients need to be assessed for their candidacy for both operations.
Candidacy for liposuction includes assessing the thickness of subcutaneous fat another code variables that are not treated by liposuction such as skin laxity, muscle separation from previous pregnancies and excess visceral or intra-abdominal fat.
Assessment likewise needs to be also done for the Fed to transfer parts. For example individuals with significant cellulite are not necessarily good candidates because cellulite is made worse by fat transfer. 
Your pictures show that you are bottom happy to start with which does not speak towards needing a BBL.
My personal approach to contouring women’s bodies is generally to create a smooth continuous balanced feminine S-curve that starts at the arm pit and finishes at the knee. To create that curb your love handles and waist as well as your back and under arm area should be reduced as much as possible. Adding volumes to your hip dip region would create a more hyper feminized curve but your lower extremities are already large so an aggressive fat transfer procedure could potentially push towards a cartoon caricatures looking body.
A lot depends on what you’re trying to achieve.
I personally believe that maintaining natural balance and always striving for balanced curves should trump excessive volume as an end goal.
Do you have significant skin laxity on your back and any area with skin laxity will have limited results from Liposuction because skin laxity contribute significantly to contour.
Each individual area treated needs to be discussed so you know exactly what will be treated and what they will look like.
In the end there are only two variables that determine what the results will look like. The two variables are candidacy combined with Skill and experience of the provider.
Delivering consistent quality liposuction and fat transfer results is more difficult than most people believe.
There are a substantial number of board-certified plastic surgeons with good intentions, proper training and all the correct certifications are simply are not very good at either Liposuction or fat transfer.
Delivering consistent quality results with these procedures is more difficult than most people believe and the number of providers who are truly excellent at the BBL procedure is relatively small.
Liposuction has more variability in regards to results relating to skilled than any other plastic surgery procedure.
Results should be considered permanent and irreversible. If done poorly people are left disfigured.
Poor results from Liposuction are virtually impossible to correct.
After getting a good assessment at which point you should have a clear understanding of what can and cannot be achieved for each part of your body the next step is to find the right provider.
To do that you were gonna need to have multiple in person consultations.
Virtual consultations are insufficient to properly vet plastic surgeons.
I highly recommend people avoid traveling long distances for elective surgical procedures.
Instead I recommend patient schedule multiple in person consultations with local board-certified plastic surgeons who show evidence of quality work by having numerous impressive before and after pictures on their website.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
Providers may be apprehensive to do this and will instead prefer to show you preselected results representing the best outcomes of their career.
This is insufficient to get a clear understanding of what average results look like or how many of these procedures anyone provider has actually performed.
To start with you should ask providers to only show you before and after pictures of patients who have similar body characteristics to your own. This means the same overall body shape, same degree of skin laxity, similar BMI and similar overall contour.
Ask the provider to show you examples of average results, excellent results and results that did not turn out as well as stay at home for.
We all have a variety of outcomes and it’s fair game to ask providers to show you different types of results.
They should be able to differentiate and only show your results of patients who have similar body characteristics to your own
There’s no point in seeing what results look like for individuals who are perfect candidates when you are not.
For reference and experience provider should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures like the BBL.
Highly experienced surgeons will have hundreds or even thousands of before and after pictures for this procedure.
You should be familiar with what quality results look like based on selecting only pictures with patients who have similar body characteristics to your own in the before pictures before having consultations.
Create a rating system for both Liposuction and fat transfer to what you believe our quality results.
During each consultation make notes about the quantity and quality of before and after pictures each provider shows you.
It is paramount did you properly vet providers to understand what they are capable and have done on previous patients who have similar body characteristics.You should likewise also take notes about the thoroughness of the consultation and other aspects such as examination, explanation of assessment, review of before and after pictures, review of medical history, preparation for surgery, risks and benefits, alternative procedures and recovery.Continue having consultations until you found a provider with the right skill and experience level to meet your needs.
When in doubt slow down and schedule more consultations,
There’s no correct number of consultations needed to find the right provider but the more consultations you have the better your chance is.
Trying to find the right provider and simply scheduling the surgery is a risky proposition if you have not properly vetted that provider.
I suggest each person to start by having at least five consultations and continue scheduling many more if needed.
Most people have a little experience having plastic surgery consultations or how to vet to plastic surgeons properly.
They have a multiple consultations you’ll get more familiar and better at the process.
Recognize that you are paying for the procedure and you have total right to demand seeing proof of competency and vetting the provider just like you would if you were interviewing someone that you were going to hire.
It’s not possible to just give an assessment because it needs to be done in context to what your expectations and wishes are.
You are not an ideal candidate but the majority of patients seeking this procedure or not.
What is important is to have a clear understanding of your own candidacy, what can and what cannot be accomplished and then choosing a provider who can deliver the best outcome.
Best,
Mats Hagstrom MD

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