Any way to fix dent following revision to treat it & it came back? (Photos)

Question

Had a bbl that resulted in dent Has a revision and one year later the dent is back. Any way to fix this?

Justin Yovino, MD, FACS · Answer

I find that these situations are difficult to completely resolve. There are natural connections between the skin and the buttock muscles that pull tissue in. There are differences in expansion properties of zones of the buttocks. Typically the superior buttocks expand easier than the mid and inferior buttocks when enhanced with volume. With that said, I think your options are volume enhancement of the depressed area and / or volume removal from the adjacent superior and lateral zones. Gold standard volume enhancement would be additional fat transfer. Other more subtle options would be sculptra and / or renuva. Volume removal of the adjacent relatively fuller zones would be with liposuction. All of these mentioned option would be performed with the patient awake and comfortable in our office.

Daniel Barrett, MD · Answer

Dear Mm83,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment on the outcome of a plastic surgery procedure proper before and after pictures. If you’ve had more than one operation that we need to see before and after pictures of each of the procedures. Without understanding your candidacy for the procedure in the first place it becomes difficult to give you a good answer because we can’t make a quality assessment. If you don’t have proper before and after pictures, then ask your previous surgeon or surgeons to forward the before, and after pictures they took. 
The indentation most likely represents cellulite, and this may be seen on your before picture. If it is then it should have been discussed during your consultation. Cellulite is generally made worse from fat transfer, and it’s not well corrected by adding more volume.
Cellulite is caused by connective tissue pulling on the skin. The connective tissue has a set length and lacks pliability. The more volume to the area, the more the indentation becomes. To treat cellulite the connective tissue bands, pulling on the skin need to be released. Cellulite may or may not be the underlying cause, but it is a very common outcome after BBL, and patients who have baseline cellulite to start with. Consider reposting with a complete set of proper before, and after pictures, follow up with your provider, or scheduled in person second opinion consultations.
Individuals who have cellulite should have a discussion with their provider during in person consultations, so they have a clear understanding of the implication of moving forward and fat transfer, and how cellulite can affect the final outcome.
Best,
Mats Hagstrom, MD

Any way to fix dent following revision to treat it & it came back? (Photos)

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