Hi, Itzzel. There are so many factors that come into play with BBL results. Very import is choosing a surgeon with strong training and experience -- while the technical performance of a BBL may not be particularly difficult, understanding patient anatomy, surgical recovery, and tissue behavior does require excellent training and lots of experience. Equally important is an artistic eye and proficient skills to execute the surgery artfully. Selecting a Board-certified plastic surgeon does not guarantee superior artistry, skill, or sufficient experience, such a selection does ensure the necessary training and increases the likelihood that the surgeon has the other qualifications and that the particular surgeon was dedicated to plastic surgical procedures from the start and not later in his/her career as an alternative (likely purely financial).As mentioned by the earlier physician responding to your question, results with a BBL due vary widely. The amount of available fat and the quality of that fat will play a large role -- some simply do not have enough fat, or their fat may be very fibrous or may be prone to turning into oil with the liposuctioning and not be useful for transfer. Often times, it may appear that there is a reasonable amount of fat when in reality the fullness is due to excess skin and the corresponding superficial layer of fat that must stay with the skin in order to preserve the circulation and lymphatics, as well as to avoid contour irregularities and excess scarring. The performance of other surgical procedures at the same time, such as a Mommy Makeover, may limit the available areas for fat removal, may require a less aggressive fat removal, may contribute to post-operative factors that may have a negative impact on fat graft retention (such as anemia, increased swelling, difficulty keeping pressure off of the fat grafted areas, fluid collections/blood collections, etc.). A patient's tissue quality will also affect the results -- some patients have better quality tissues and/or a better foundation for a BBL, with good expansion and shaping with the addition of the transferred fat; others may have so much deflation that the transferred fat may have little impact on shaping or apparent volume increase or alternatively may have adherent tissues that resist expanding to create a nice, curved contour and rather stay flat and/or square. Post-operative events and complications, such as infection; fat death; compromised circulation; seroma (fluid collection); hematoma (blood clot/collection); excess swelling; pressure on the grafted fat; etc. will have a profound impact on the final results.Very often, patients that have a sleeve gastrectomy, full gastric bypass, gastric band, or just natural weight loss may be sub-optimal candidates for a BBL, despite having the most need for one. By definition, needed fat volume will be limited due to the significant weight loss. Further, the better quality fat that is best for the fat transfer, is usually the fat the is lost first and it is the more fibrous fat (more difficult to remove and more prone to oil conversion) that is persistent and pesky. Further, with the weight loss surgery, nutrition and the ability to absorb vitamins, essential to successful healing, is generally compromised.Even with good quality fat, with sufficient volume, and an uneventful and successful recovery, a 2nd-course or "revision" BBL often results in even more superior results. Best of luck to you, and I hope you achieve the results you desire, should you decide to repeat your BBL.
