How can I fix mottled/discoloration after BBL? (photos)

Dear NYCLipoBBL,
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

Skin hyperpigmentation may be attributed to several factors. Hemosiderin deposition by ecchymosis, external pressure from bandages applied, and possible friction from the inlet holes of the cannula have been suspected of increasing the likelihood of hyperpigmentation postoperatively.  The discoloration of hemosiderin can be long-lasting. 

What you are describing is PIH - post inflammatory hyperpigmentation. This is more common in patient's who form pigment easy such as a tan when exposed to sunlight. PIH is something that is fairly common (when you are prone to pigment or "sensitive" to creating pigment) in BBL patients because the liposuction is aggressive. Most patients seeking a BBL ask for  "snatched" waistline or the smallest waist we can create. This means all the excess fat around the waistline is removed with liposuction. Both the repetitive motion of the liposuction cannula on the underside of the skin and also the compression garment rubbing the skin from the outside can lead to PIH. PIH tends to lighten over 1-2 years after the surgery, but can get darker with direct sunlight. There are topical creams that can help to lighten it and also lasers. 

It appears you may have hemosiderin staining. Topical creams/gels and/or laser may be able to help reduce the appearance. It can take several years for hemosiderin staining to resolve. In some cases, staining may be permanent.  

this may represent livedo reticularis which may or may not be related to your procedure.   This condition is somewhat complex, Afton is not related to surgical procedures and can manifest itself midlife more in women than men.  In some individuals it has an auto immune origin.It may be worthwhile seeing a dermatologist about the etiology of this.  For patients who sustain excessive amounts of bruising sometimes hemosiderin deposits can be seen but they typically have a slightly different appearance.  This happens when the iron molecule becomes a pigmented molecule that stains the skin not dissimilar to a tattoo. We typically don’t see much bruising from liposuction and fat transfer procedures when enough time is given and tumescent solution is used properly and given enough time to work effectively.  This solution contains a drug called epinephrine which vasoconstrict blood vessels minimizing bleeding during the procedure.  I cannot speak on behalf of our other providers  or how they do their surgery.  I typically wait 20 minutes until injecting ample amounts of tumescent solution.  I encourage people to not travel for elective surgical procedures for a multitude of reasons.  Best, Mats Hagstrom MD