Is this fat necrosis? What can I do to fix my problem? (photos)

I'm very sorry you experienced these issues. The firm areas may be treated with steroid injections or in extreme cases, surgical excision.
The discoloration may be permanent as it has been well over a year. The flat areas most likely have multiple scar bands holding the skin down. Releasing these bands will allow the skin to become more round, but may also allow too much fat to collect in the 'loose skin". This may cause a lump to form which is a whole other issue to treat. Unfortunately, there is no easy cure for your issue. Another BBL procedure should reduce some of the flatness you are concerned with.
Dr. T

In order for us to make a better assessment you need to post proper before and after pictures.

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

Knowing what your body look like before the procedure allows us to assess how the procedure was performed more accurately.

Fat transfer can only be treated by direct open excision. The indication for removing fat necrosis is based on how much it bothers the patient in comparison to how much they’re willing to put up with the consequences of removing the dead fat.

If you had a flat spot before the procedure then it may be challenging to improve it with a second BBL.

The discoloration maybe due to hemosiderin deposit if the procedure was done with bloody fat or without proper tumescent solution.

Typically hemosiderin stand tissues follow areas that were highly bruised for a long time after the procedure.

Unfortunately the results and out, or a direct reflection of how the procedure was done and that is a reflection of the surgeon you chose.

Your plastic surgeon is ultimately responsible for the outcome of your procedure and you intern are responsible for choosing that provider.

I’m guessing there may be a lack of faith at this time and a second opinion is probably appropriate.

To get accurate thorough detailed assessments including treatment plants you should commit to having in person consultations.

When preparing for a second opinion consultation you shouldn’t have ready your first procedure operative report and before and after pictures taken by your first provider. These are part of your medical records and available to you if you call that doctor or clinic and request all of your medical records including the operative report and all pictures taken.

It will be important for the next surgeon to have this information.

Secondary procedures are far more difficult than primary procedures. It may be difficult to restore your buttocks to what you look like before or together as substantially improved results. Some improvements are probably possible.

I cannot emphasize enough the importance of choosing the most talented and experienced board-certified plastic surgeons for this and all cosmetic surgical procedures.

Best,

Mats Hagstrom MD