Noticed huge dents 7 months postop BBL - should I remove or add more fat? (photos)

Dear Intelligent3587,
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

Seven months post-op you should be able to appreciate your results. This can likely be resolved using high definition vaser liposuction. The definitive correction for liposuction deformities requires the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I encounter suboptimal liposuction outcome referrals weekly. VASER liposuction has been the only modality that has consistently corrected liposuction caused deformities. VASER liposuction ensures a smooth contour regardless of severity of contour irregularities by virtue of being able to remove any and all remaining fat comprehensively and uniformly. Finally, when skin redundancy irregularities are observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

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

To make something that resembles an assessment we need to see proper before and after pictures.

If you don’t have those then call your surgeon and ask them to forward the ones they took.

The lower inner part of the buttocks can be tricky because that area has a lot of connective tissue. People who have a flat spot in this area are not ideal candidate for the BBL procedure and should be told so during an in person consultation.

Areas of the body that can tolerate a lot of pressure typically have a lot of connective tissue that stabilizes or anchors to skin to the underlying muscle fascia.

Examples of this are palms of the feet, soles of the hands, lower inner buttocks and back of the thigh.

These are areas that conform cellulite or contour irregularities because of how the connective tissue pulls on the skin. The connective tissue does not stretch and does not allow the skin to project any significant further distance from the underlying facia.

Adding volume simply causes the flat spot to remain flat while surrounding areas project nicely.

In other words people who have a flat spot on their lower in her buttocks will make this worse by adding Grafted fat because the problem area doesn’t project but the surrounding areas do.

Patients often see this and think the surgeon failed to graft fat in the right area, sitting cost fat necrosis or some other vague explanation.

BBL results are predictable based on each individual patients candidacy and those who have cellulite, contour irregularities or a flat spot on the lower in her buttocks should be told what the outcome is going to look like.

When a BBL is done on the more aggressive side the problem is accentuated worse.

Compression garments do not create complications unless they are absurdly tight.

I’ve done over 8000 liposuction procedures and have never had a patient develop blisters because of compression garments.

In the end your surgeon is responsible for the outcome of the procedure and each patient intern is responsible for choosing their surgeon.

Delivering consistent high-quality Liposuction and fat transfer result is more difficult than people believe. The number of patients who have concerns about the outcome, the need for revisions or are dissatisfied in someway is not insignificant.

Choosing the right plastic surgeon is paramount and minimizing having issues after the procedure. The same is also true for having proper in person consultations and staying local for proper follow up.

To make a quality assessment requires ideally and examination but a minimum of seeing before and after pictures. Based on the pictures you’ve shown I think it’s going to be challenging to create a smooth round contour and adding more fat has a good chance of making things worse.

My approach to the BBL different than how other providers perform the procedure. I generally try to emphasize smooth harmonious S curves along the entire torso and lower extremities rather than creating the “lollipop look”.

The variation and outcome of these procedures among different providers is very real.

I suggest you follow up with your provider and discuss your concerns with him or her.

If you want a proper second opinion then you need to schedule in person consultations at which time you need to bring before and after pictures and a copy of your operative report which you can get from your provider.

Lastly, revision work is many times more difficult than primary procedures. Whether the problem was created by the first procedure or the desired outcome is simply not possible is masked and difficult to assess when doing revision work. for this reason provider selection is even more important when doing revisions then when doing primary procedures.

Best,

Mats Hagstrom MD