If we are not to sit on our butts after a BBL, why are we placed on our backs and then put to sit in a wheelchair after?

Dear tassita1,
I instruct my patients not to sit for 2 solid weeks. We provide them a specialized pillow that our patients can sit on during that time. They can sleep on their stomachs or sides. Fat viability depends a lot of surgeon technique. The fat has to be placed back into the buttocks as soon as possible so that it has a greater chance of survival. It has to be placed carefully so that not too much fat is placed in only one area.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Following surgery, the patient is placed on his/her side propped up by pillows in the recovery room (RR).  My LVN helps all my patients matriculate from the RR to their mode of transportation (less than 20 feet away) to ensure that they are comfortable and safe.  He reclines the seat at a 45 degree angle and places a folded pillow under their thighs. My patient coordinator recommends a plastic inflatable with a hole in it (called a lilo), where instead of your tummy, you place your butt, so you can sleep on your back with pillows propping up your neck and head.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

After surgery, patients recover on their back (or side) with prop pillows used to keep pressure off of their bottom. They are then pushed to their vehicle in a wheelchair (also with pillows or padding) to help them get home. Then, once home, it is very important to keep weight off of the newly placed fat cells so that these cells can grow a new blood supply to help them stay alive. The more weight on these cells, the more the cells will die off and minimize the results of surgery. Does this make sense?

every plastic surgeon will have a different protocol. I personally do not let my patients lay on their back or sit in wheelchairs unless they're sitting on a BBL pillow after the procedure. I also do these procedures with my patients awake so this process is a little easier in comparison to recovery after General Anastasia.  Waking up from a general anesthetic require most patients to lay on their back in order to maintain a safe airway.  While this may not be ideal for a BBL patient safety comes first. Immediately after the procedure there's also no issue with disrupting the new blood supply  that will eventually support the grafted fat. The ingrowth of new blood vessels typically happens starting 48 hours after the graft has been placed.