8 years post BBL - Should i get implants or fat transfer? (Photos)

Question

Hello im 42 yrs old. 5'3 160lbs. I had a bbl about 8 years ago and it was a total fiasco. But i want to give it another try. Should i get implants or fat transfer? I wanted to try sculptra and ultherapy/emusculp but i think it wont be enough. Thankyou for your response.

Geuris Cruz Quiroz, MD · Answer

Thank you for your question dear @Bright129308
Based on your pictures I will be recommend to have another BBL procedure done, over the years the technique and the technology used in this procedure has been change to give the patients better results and you are a very good candidate for a conventional 360 Liposculpture and BBL procedure. Please search for a certified plastic surgeon who had worked in body frame as yours that will guarantee you good and safe results. 
Good luck!

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

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, post-deflation sagging, fatty necrotic cyst or scar tissue, etc.) as most of the fat melts away. It is not quite as much the quality of the doctor nor liposuction technique but rather the quality of the procedure that is a large part of the problem.  Thus, going back for additional rounds of BBL most often produces the same disappointing results but at another financial loss.

Fillers, such as Sculptra and hyaluronic acids,  for augmentation of the buttock/hips are a rip-off, period!

Buttock implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often smoothing out lumpiness. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging.  When considering buttock implants make sure that the surgeon is going to be placing the implants within gluteus muscles , (a.k.a. “intramuscular pocket”), and that they are using anatomically correct, oval-shaped implants, such as Stanton Anatomic ®️ implants. 
Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in these 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.

Zoran Potparic, MD · Answer

In the past few years we see a lot of patients needeng improements after BBL. There is no doubt, based on these photos, that you will need additional shaping of bottocks, hips and waist. Liposuction and fat transfer, would make quite a change. In person or teleconference consultation is recommended. Good luck.

Daniel Barrett, MD · Answer

Dear Bright129308,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
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 accurate assessment on someone who’s had previous cosmetic surgery we always need to see proper before and after pictures. Even though it’s been eight years, you may want to consider asking your provider to forward the pictures they took, because they are an important part of making an assessment for a future surgeries.
Most plastic surgeons in the United States, do not offer gluteal implants. There’s a good reason for this.
There may be room for improvement with secondary liposuction and fat transfer and making an assessment for secondary procedures is not always straightforward. Delivering consistent quality Liposuction and fat transfer results is more difficult than most people realize. The number of plastic surgeons who master did these procedures are in a small minority.
Quality plastic surgery outcomes are based on the patient’s candidacy combined with the scale of the surgeon. Understanding your old candidacy, for the procedure is critical, and having a clear understanding of what the procedure can, or cannot accomplish. Likewise, finding the right provider, it is paramount, regardless of your candidacy.
I generally recommend patients having multiple in person consultations. This is the best way to vet plastic surgeons to find the right provider.
It appears you had a tummy tuck in the past. Was that done in conjunction with the BBL?
I don’t think you’re going to get a quality assessment and therefore a lack of quality recommendations without any in person consultation.
Best,
Mats Hagstrom, MD

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