How do you how much fat can be transferred in a BBL?

Question

When does the surgeon know he/she can't fit more in the buttocks? Can skin elasticity be a problem? What methods are used today to be sure you have put in enough fat? If you’re going to do a BBL and you lipo 4 liters of fat. How much of that fat is good to go back in your buttocks after washing it?

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. To provide a valid medical opinion I will need to see pictures of you body from different angles. I would suggest to be treated by board certified plastic surgeon with experience in this procedure, to get the best desired results.

Respectfully,
Dr. Emmanuel Mallol Cotes.-

Respectfully,
Dr. Emmanuel Mallol Cotes.-

John L. Burns Jr., MD · Answer

A BBL is designed with both shape and size in mind.  Overfilling is never a good idea this compromises fat viability and shape.

Mats Hagstrom, MD (license on probation) · Answer

How much fat can be appropriately grafted is to some degree a subjective measure, and each provider will have their own way of determining this. There is no objective criteria. Ideally fat grafting should be done maintaining a reasonably healthy, grafted fat to host the tissue volume ratio. Someone has seven layers of soft tissue, representing host of tissue in the area to be augmented. Then smaller amounts of fat can only be grafted in order to prevent and avoid symptomatic fat necrosis, including oil, cysts, and other complications. Overgrafting increases the chances of negative Side effects complications, and eventually reduces the percentage of fat survival.
The technique used for grafting fat is also very important. Grafted fat needs to be stratified into many different layers coming in from many different angles.
The best providers will have experience from doing thousands of cases. For those with less experience, it’s better to stay on the conservative side and avoid complications potentially leading to disfigurement, needs for revision and secondary surgeries. 
Provider selection and understanding your candidacy for the procedure are the two most important variables.
Not everybody is seeking a BBL is a good candidate for this procedure.
Likewise, delivering consistent Liposuction, and fat transfer results is more difficult than most people realize. The number of plastic surgeons who have truly mastered this procedure, or in a small minority.
The following are some general guidelines and recommendations for provider selection.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. 
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. 
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. 
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD

Layth Gurgia, MD - Account Suspended · Answer

Determining the maximum amount of fat that can be safely transferred to the buttocks during a Brazilian Butt Lift (BBL) involves various factors and considerations, including the patient's anatomy, skin elasticity, desired outcome, and the surgeon's expertise. Here are some key points to address your questions:

1. Assessment of Available Space: Surgeons evaluate the available space in the buttocks region to determine how much fat can be safely injected. This assessment considers factors such as the patient's body proportions, existing buttock volume, and skin elasticity.

2.Skin Elasticity: Skin elasticity plays a crucial role in the success of a BBL. Patients with good skin elasticity are more likely to achieve favorable outcomes as the skin can better accommodate the increased volume resulting from fat transfer. However, individuals with poor skin elasticity may not be suitable candidates for extensive fat grafting as they may be at higher risk of sagging or other complications.

3. Limiting Factors: Surgeons must adhere to safe guidelines regarding the volume of fat that can be injected during a BBL to minimize the risk of complications such as fat embolism or necrosis. Additionally, there may be practical limitations based on the patient's anatomy and aesthetic goals.

4. Modern Techniques and Technology: Surgeons use various modern techniques and technology to optimize fat transfer during a BBL. This may include specialized liposuction methods to harvest fat with minimal trauma, as well as advanced purification and processing techniques to ensure the viability of the fat cells before re-injection.

5. Fat Viability: After harvesting the fat via liposuction, it undergoes a purification process to remove excess fluids, blood, and damaged cells. The purified fat is then carefully injected into the buttocks in small aliquots or droplets to ensure proper blood supply and survival of the transferred fat cells. The amount of fat that can be successfully re-implanted depends on factors such as the quality of the harvested fat, the technique used for purification, and the patient's specific anatomy.

6. Optimal Fat Volume: While the amount of fat that can be re-injected varies from patient to patient, a general guideline is to aim for a volume that enhances the buttock contours without overfilling or creating an unnatural appearance. Surgeons typically aim for a balance between achieving the desired aesthetic outcome and ensuring the safety and integrity of the procedure. When fat is forced into the buttock then the number of cells surviving will be less and the volume of fat that remains after a few months is also less.

It's important for patients to have realistic expectations and to discuss their goals and concerns with a board-certified plastic surgeon who specializes in BBL procedures. The surgeon can assess the patient's candidacy, provide personalized recommendations, and outline the expected outcomes based on their unique anatomy and aesthetic preferences.

Best regards
Dr Layth Gurgia 
Consultant plastic surgeon
Sweden.

George Lefkovits, MD - Account Suspended · Answer

When ready to undergo a BBL you should consult with a Board Certified plastic surgeon with lots of experience performing BBL surgery. The experienced PS will know approximately how much fat can be transferred upon examining. The exact amount will, of course, be determined at the time of surgery. Variables include donor fat availability,  skin elasticity and tautness of the buttocks upon buttock expansion with fat. You need to be careful and not to overfill if the becomes to taut. Good luck.

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