Methods of fat transfer for BBL?

As with any procedure, the technique employed in BBL will vary from one surgeon to the next. In spite of this fact the general principles remain the same: harvest fat from an area of excess to an area of relative paucity (i.e. take the fat from where you have it and don't want it and move it to where you want it and don't have it).Technically speaking there will be variations in how the fat is processed (washing, spinning, filtering) and in how the fat is grafted (submuscular vs. subglandular). There is no standard and every surgeon will swear by their technique.We,
as surgeons, tend to describe things in regards to framing and esthetic zones
(as defined by Dr. Mendieta). Beginning with frame, patients are subdivided
into "A" frame, "V" frame based on the relationship of the
A point to the B point. The A point is the most prominent bony point on the
upper hip-the iliac crest. The B point is the prominent bony point on the lower
hip- the greater trochanter. When the A point is wider than the B point you
have the "V" frame which is generally considered less aesthetically
desirable. When the ratio is flipped with the B point being wider than the A
point you have an "A" frame which is more desirable. When the two
points are equal you have a "square" frame.
The
goal of most BBL procedures is to convert "V" or "Square"
frames into "A" frames by understanding the 11 aesthetic units from
which we either harvest or transfer fat. These units are:
1.
Sacrum or "V" zone at the top of the gluteal cleft
2.
Flank
3.
Upper buttock-lower flank
4.
Lower back-just above the "V" zone
5.
Outer leg-below the "B" point
6.
Gluteus-the "apple of the buttock"
7.
Inner gluteal-"Diamond Zone" crucial for emptying the "thong
zone"
8.
Mid-lateral buttock-"C" point between "A" and "B"
9.
Inferior Gluteal/Posterior leg
10.
Upper back
While
this is all very technical, the goal is to achieve an "A" frame by
emptying zones 1-4, 7, 10 and building up area 6 and 8. The goal being to cinch
the waistline and fill out the frame.
With
regards to your specific question, the best way to approach a consultation is
to decide on your frame and then discuss what areas need to be emptied and what
areas need to be augmented. You can discuss the technical aspects unique to your surgeon at the time of consultation.
As
always, discuss your concerns with a surgeon certified by the American Board of
Plastic Surgeons.

I use a system from Wells Johnson where the liposuctioned fat is captured and then transferred using an airtight system where the fat is never exposed to the environment.  This system has dramatically improved fat graft take in my practice

I begin the surgery by removing excess fat from another part of the patient’s body (usually a “trouble area” like the stomach, thighs or hips, where excess fat resides) and carefully processes and purifies this fat before using small syringes to inject it into the buttocks, layering the fat starting from the deepest muscular layer. The fat is injected in several small well-hidden entry sites around the buttocks so that the doctor can shape the fat in the buttocks to create the most attractive shape.Fat cells are very fragile cells and are easily injured during the harvesting process. I use the Revolve system™, an advanced technology that gently harvests and processes the fat while achieving the maximal survival of fat cells for my patients. Good luck!

Upper gluteal area. Upper and lower gluteal area, aforementioned areas and in the trochanteric and subgluteal areas. Complications such as fat necrosis, gluteal erythema, infection, and fat embolism syndrome were more frequent and serious in the first stage, despite the authors having infiltrated smaller volumes.

Hello and thank you for your excellent question. Surgeons will all use different techniques for purifying their fat and transferring it. For instance, we use a combination of fat washing, chemical separation, decanting and filtering. Of course, you will need an in-person consultation to evaluate you for this procedure. Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. Any treatment plan should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck!

Best,
Jon Ver Halen, MD FACS 
Harvard educated plastic surgeon