I have severe fat necrosis as a result of a BBL. I am almost a year post op. Can I get a BBL revision to rectify this? (Photo)

You are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, unevenness, lack of projection in the central and/or lower buttock, etc.). It is not as much the quality of the doctor but rather the quality of the procedure that is a large part of the problem. Thus, going back for round 2 BBL most often produces the same disappointing results but at another financial loss. Buttock implants indeed provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often smoothing out lumpiness. Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in buttock implants so be sure to consult with one that is reputable and experienced. Unfortunately you may have to travel long and far away from home to find this particular surgeon. Glad to help.

Hello, thank you for your question. Dead fat, unlike living fat, cannot be removed by liposuction, or removal of fat through a cannula by pressure extraction. The dead fat hardened by calcium must be removed in total through an incision in the skin, much like a cyst or a tumor is removed. If the removal is extensive, reconstruction with additional fat grafting may be necessary as well. Thus, the issue of fat necrosis requires an expert skill set to create the optimal result. The goal is both optimal removal of the dead fat while sparing any living adjacent tissue to minimize the overall defect and allow for the best possible reconstruction. A board certified PS should be able to perform both the fat necrosis removal and about three months later perform the BBL.

Dear Kind958521,
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

This is a bad problem as there will be a lot of hard areas/scar tissue in your buttocks. The "bruising" is actually PIH (post inflammatory hyper pigmentation and is likely permanent. You would need the fat necrosis removed which may leave you with a completely flat buttocks. You would then need enough fat to fill out the buttocks from that starting point. There is also a chance that this same thing could happen again as fat necrosis is a known entity. We know that on average 50% of the fat injected dies or is lost. The definition of fat necrosis is "dead fat", so this is actually expected. Most patients bodies absorb this fat with no issues while others scar it off (what your body did). I am not sure another surgery would give you what you are hoping for. Do a lot of research when picking your next PS.

It’s important to know how many months apart the before and after pictures were taken.

Your after picture still looks like you’re bruised. Typically bruising has completely resolved by three or at the most for a weeks.

I recognize your procedure was close to a year ago so your results at this point our final but are they represented by the after picture you have shown?

It looks like there was liposuction done at least on the periphery of your buttocks.

I suggest you follow up with your provider. Your situation is complicated and there is no easy solution. You will for sure need in person consultations.

You will not get the comprehensive answer you’re looking for by posting on real self at this point.

There are multiple variables that need to be reviewed. A proper consultation for where you are at the moment should take at least an hour if not longer.

Start by following up with your provider.

Best,

Mats Hagstrom MD