When a BBL is done should the fat be put in through both the upper and lower butt?

Question

I had a bbl done two years ago and I am just now noticing that I only have incision scars on my lower butt cheeks. Most bbls I see they inject fat in both the upper and lower. My surgeon only put fat in through the bottom. Is this bad? I feel as though this could be why my butt is starting to sag now.

Daniel Barrett, MD · Answer

Dear Xoxo333,every plastic surgeon has his own technique. Fat viability depends a lot of surgeon technique. The fat has to be placed back into the buttocks as soon as possible so that it has a greater chance of survival. It has to be placed carefully so that not too much fat is placed in only one area.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Kenneth Hughes, MD · Answer

It is less about where the incision is made and more about where the fat is delivered.Kenneth Hughes, MD

Larry S. Nichter, MD, MS, FACS · Answer

Ideal candidates are at a stable weight,  in good health , and have excess fat in some parts of the body and too little in other regions.  Gaining weight before the procedure is to no advantage and when you lose weight again the fat cells will shrink just like the donor site fat cells.  Typically, the transferred fat results in a significant increase in volume of the body site being treated.

Massiel Guzmán Reyes, MD · Answer

Hello!

Thank you for the information provided. Every surgeon has their own way of doing this procedure. It depends a lot on the patient, the shape, and what will give you a better result. If you have any concerns always remember to consult with a board certified plastic surgeon. 
Best of luck!

Kelvin Eusebio, MD · Answer

Dear xoxo333,The BBL fat is transferred everywhere in the buttocks area. This means upper-lower and specially around the hip area. I usually use the same incision in the middle of the cheeks for the buttocks and an incision the lower cheek for the hips and sides. Best wishes.

Adolfo Sesto, MD · Answer

For sure you have another scar maybe between both cheeks, upper inside, that you are not able to see. Surgeons usually inject fat in both upper and lower butt, but scars remain unvisible. Nevertheless, sagging problems are not related to where the fat was injected but mostly if the patient had  received massages or any therapy directly over the buttocks.

Steven Wallach, MD · Answer

Everyone does it differently so there is no standard incision for the procedure.  If you are unhappy with the results, then you can be seen for revision. Best of luck.

Brian Kubiak, MD, FACS · Answer

Thank you for your question.  Every surgeon has their own preferred technique which usually relates to the equipment they have.  I assume that your surgeon placed fat throughout your buttocks.  Your surgeon may have had long injection cannulas which allowed him/her to reach all areas of your buttocks only using lower buttock incisions.  They may have also hidden an upper buttock incision in a location that you have not noticed such as in your intergluteal cleft (butt crack).  It is difficult to say whether your fat injections are contributing to the sagging you are seeing in your butt.  If you are dissatisfied with your result, you should discuss this with the operating surgeon.  They should be able to answer questions about the technique and can do any revisions if necessary.

When a BBL is done should the fat be put in through both the upper and lower butt?

Answers (8)

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