Scheduled for a BBL, but have Fat Necrosis from a Fall 8 Years Ago. What should I do? (Photo)

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 awesomeatiya,
plastic surgeon should be able to remove fat necrosis, but you can expect the dent to increase in size. And you should fully recover prior to fat transfer. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I suggest consulting with other plastic surgeons.

Simply based on what you’ve posted I don’t think you should choose the surgeon you did. If he or she is not willing to remove the fat necrosis and insist on you doing so then that’s not maybe the person to work with.

It’s a little hard to tell without an examination but most likely unless the fat necrosis is causing symptoms weren’t removing it I would leave it alone. If it’s causing ongoing pain then there may be a good indication for removing it.

Taking it out will most likely leave a visible scar and indentation that will not be corrected with the fat transfer.

I suggest getting second, third, fourth or fifth opinions.

I would also insist on having in person consultations.

The following are some general recommendations I give to patients to help them get the best results.


Avoid traveling long-distance for elective surgical procedures.

Rely on in person consultations.

Schedule multiple consultations with surgeons in your area who have a good reputation for the procedure you’re interested in.

During the in person consultation to ask each surgeon to show all of their before and after pictures of the procedure you’re interested in. The goal is not to see the best results of their career but to see what average results look like and get confirmation of how many of these procedures that surgeon has performed. Ideally the surgeon should be able to find before and after pictures of patients who are very similar body shapes and contours to your own.

An experienced plastic surgeon should have an abundance of before and after pictures. A highly experienced plastic surgeon will have several hundred or even thousands of before and after pictures for each procedure.

Read all the reviews on various physician review websites avoiding providers with any significant number of justified negative reviews.

Organic unmanipulated reviews tend to follow fairly equally among different review websites. Those with an excessive number of positive reviews on a single website may be a telling sign of aggressive marketing.

The presence of justified negative reviews can be more important than an abundance of positive reviews.

Don’t schedule surgery during the consultation.

Give yourself time to think about important decisions like permanently and irreversibly changing your body.

When in doubt slow down and schedule more consultations.

The outcomes of this procedure are all over the place based exclusively on the skill and experience of the surgeon.

Best,

Mats Hagstrom MD