Would I benefit from a BBL revision? Almost 1 year post op and would like to get rid of crease lines. (photo)

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, 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 round 2 BBL most often produces the same disappointing results but at another financial loss. Buttock implants indeed 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. Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in 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.

Dear Jennifer6355,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thanks for only 1 posted photo. I think you need 2 procedures. #1. Revision lipo 360 with redo BBL under ultrasound guided fat injections to reshape your buttock "correctly" , (fee $5,000). #2. Injections of Radeisse/Sculptra combination 10 or 20 vials for improvement of inferior creases posterior buttock, (fee either $4,000 or $8,000). Total fees either $9,000 or $13,000. Best to virtual consult with....

To make an assessment on the outcome of a procedure we always need to see before and after pictures. If you don’t have proper before and after pictures then please ask your surgeon to forward the ones they took.
The part of your buttocks that bothers you it’s not really related to fat transfer unless somebody either grafted fat or did liposuction in that area. Individuals who have droopiness in the lower inner part of the buttocks will not have this corrected by fat transfer. it’s not a volume issue but it’s related to droopy skin.
There are however times were some plastic surgeons do a liposuction of the upper thigh in an incorrect attempt at making the buttocks proportionately look bigger. Personally I’m not a fan of this.
When doing body contouring including a BBL my goal is usually to create a smooth harmonious S-curve which your provider did not do for you.
The lower inner buttocks is a bit tricky to fix. It generally requires a tuck which involves cutting out skin and will leave a small scar.
The The condition and treatment options is very well described on a YouTube video produced by Dr. mendieta in Miami.
He calls the condition the dirty diaper bottom lock and the name of the video and his proposed treatment for it is called the Miami thong lift.
There are some improvements that could be made on your BBL especially regarding the transition from your buttocks to your waist which should be a little more smooth and continuous at least in my opinion. The lower inner part of the buttocks is a little tricky and I don’t think Liposuction or fat transfer alone is going to do the job.
Without seeing before pictures and ideally a copy of your operative report it’s a little hard to know exactly what your surgeon did and that would impact how we would approach correcting it.
If you’ve lost faith in your provider who is ultimately responsible for the outcome of your procedure and then schedule second opinion consultations with other plastic surgeons in your community.
For second opinion consultations I would advise exclusively having in person consultations avoiding virtual consultations whenever possible.
I recommend that for all consultations but it is much more important when it comes to revision work.
Generally speaking revision work is much more difficult than primary liposuction and fat transfer.
Come prepared for a second opinion consultations by bringing with you copies of your formal before and after pictures and a copy of your operative report. These are all available from your surgeons office as they are part of your medical record.
It may be challenging to find someone who is familiar with the tuck procedure mentioned in the YouTube video above.
Perhaps other plastic surgeons have some other technique they can offer but based on what I see from the limited single picture I think Liposuction and fat transfer alone will not do the job.
To find the right provider to improve on your current outcome you may need to have multiple consultations and be very selective in picking only the most talented an experienced provider.
To do that I suggest asking each provider to open up their portfolio and show you their entire collection of before and after pictures for the BBL procedure.
Plastic surgeons may be reluctant to do this but you should at least ask and if not then ask them to show you as many pictures as they are willing to. The goal is not to see a handful of pictures which represent the best results of the providers career but instead to see what average results look like and to get some idea of how many of these procedures the provider has performed.
Ask the provider to show as many pictures as possible of patients with similar body characteristics to your own.
An experience provider should have no difficulty showing you at least 50 sets as the before and after pictures. Highly experienced surgeons will have hundreds or even thousands of before and after pictures.
Best,
Mats Hagstrom MD