I want more projection without becoming more wide. What procedure can fix this very specific issue? (photos)

Question

I had a mommy makeover surgery two years ago. He added fat to my hips and also a little to my butt(although I didn't request or pay for a bbl) it seems like he focused more on my upper butt and left my lower butt alone. I now have an indention that is more noticeable at certain angles as per pictures below. I want more projection without becoming more wide. I feel like adding fat or an implant to that specific area would help. What procedure can fix this very specific issue?

Alan Gonzalez, MD, FACS · Answer

Hello @Lookingforcurves22 thank you for your question. I understand your concern, however without a proper assessment an expert opinion is not possible. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD FACS

Yily De Los Santos, MD · Answer

Thank you for your question and pictures. I would recommend you Lipo and  BBL for betters results. If you're willing to travel, Surgeons in the Dominican Republic have experience and very high standard of excellence when it comes to plastic surgery. I'm positive you can get what you're looking for

Dhaval M. Patel, MD · Answer

Thank you for your question and photos. From your photos, are a good candidate for BBL. Liposuction will remove excess fat from unwanted areas with some skin retraction. Fat transfer to your hips & buttocks will accentuate your curves. Your expectations and health will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals. Best of luck!

Dhaval Patel MD
Double Board Certified Plastic Surgeon
Chicago
South Barrington
Oakbrook
Orland Park

Dhaval Patel MD 
Double Board Certified Plastic Surgeon 
Chicago 
South Barrington 
Oakbrook 
Orland Park

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.-

Zoran Potparic, MD · Answer

It is very difficult to asses your condition based on these photos. Only on the basis of in person evaluation, a board certified plastic surgeon, expert in body contouring, could make decision where and how much additional fat grafting may be needed to improve current shape/size. Good luck.

Daniel Barrett, MD · Answer

Dear Lookingforcurves22,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Darryl J. Blinski, MD · Answer

Though the posted in life photos demonstrate your inferior buttock issues, better posting photos in standing front, back, side views. You have the classic "chicken butt" or "diaper butt" deformities. These are a more difficult issue to improve upon. I am one of the few boarded Plastic Surgeons doing these corrections via specific lipo and fat grafting techniques with special taping. Fees from $6,500.

Mats Hagstrom, MD (license on probation) · Answer

I appreciate trying to show pictures that display the problem.

For patients who have had previous procedures it is imperative that patients shower proper before and after pictures.  If you don’t have before and after pictures can ask the surgeon who did your procedure to forward the ones they took.

To me it looks like you had liposuction of your upper thigh and this is the primary reason your BBL looks the way it does.

To me the idea of doing Liposuction of the thigh in order to make the buttocks look larger is a mistake and detract from creating the ideal natural S-curve seen in the ideal female form.

To get a proper assessment you need an in person consultation. To prepare for that you should have copies of your before and after pictures and a copy of the operative report from your previous procedure. These are part of your medical records and available to you if you request them.

Creating volume in areas previously treated with liposuction is complex and may require several procedures.

For people who have drooping lower inner buttocks sometimes called the “dirty diaper bottom” attack is required.

Dr. mendieta has a good YouTube video called the Miami thong lift that describes the procedure well.

For patients who have a flat spot on their lower inner buttocks getting projection in this area can be difficult because connective tissue anchors this skin to the underlying muscle fascia and limits projection with fat transfer.

It’s difficult to tell from the pictures if this is the case with you.

The best analogy for describing this situation is to pull the skin on the back of your hand which generally tense up easily when pinched.

If you’re not try to pinch and lift the skin on the palm of your hand you realize that it does not project or lift up.  Areas in the body that can take great pressure like the soles of the feet, palms of the hands, back of the thighs and lower inner buttocks often have connective tissue that limits the ability for it to project with added volume.

When this is the case and patients have fat transfer procedures the surrounding areas project well but the area  with connective tissue adherence fails to do so leaving the patience to believe the doctor put their fat in the wrong place.

Doing a proper assessment and delivering persistent quality liposuction and fat transfer results it’s far more difficult than most people believe.

Surgeon selection is by far the most important decision and in the end is what determines who gets the best results.

To choose the most talented and experienced provider requires having multiple in person consultations.

During consultations ask each provider to show their entire collection of before and after pictures including ideal results, average results and less than outcomes.  An experienced provider should have no difficulty showing you a minimum of 50 sets of before and after pictures. Truly experienced providers will have hundreds or even thousands of before and after pictures for the procedure of interest.  Seeing a handful of example pictures that in fact represent only the best outcomes of the providers career is in sufficient to get a clear understanding of what average results look like.

Pay close attention to who gets the best most natural looking results.

Ask providers to find before and after pictures that are similar to your body shape and contour as possible.

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

The absence of justified negative reviews is more important and more telling than an abundance of positive reviews.

The most talented and experienced surgeons do not always have a big Internet presence, large social media campaigns or paid advertising.

The ideal provider typically has a collection of before and after pictures that reads like a telephone book and virtually no negative justified reviews on any website.

The combination of having the greatest collection of impressive before and after pictures without having upset patients through their career to the point of needing to retaliate this is only combination of variables I’ve ever found the differentiates the truly great plastic surgeons in our community.

That seems to be the best way to get the “golden ticket”.

Your pictures only allow a limited assessment but based on those getting an exceptional result may be challenging and may require more than one procedure.

Unfortunately there is no shortcut when it comes to finding the best providers.  it simply requires meeting a lot of plastic surgeons and vetting each one carefully and thoroughly.

In the end find the right plastic surgeon and everything falls into place.

Best,

Mats Hagstrom MD

Arian Mowlavi, MD, FACS (license on probation) · Answer

Based on your pictures, you are an excellent candidate for a Brazilian Butt Lift (BBL) revision.  Attention must be given to providing you the buttock shape that YOU desire. This means using our proprietary BBL assessment tool. As an official VASER trainer, I am routinely referred unhappy BBL patients. One of the most common reasons for disgruntled BBL patients is that patients are not able to accurately communicate their desired buttocks goals to their surgeons.  Our  buttock assessment tool can be an invaluable tool to communicate to your surgeon the exact buttocks size and shape you are desiring.

The optimal BBL revision  outcomes are achieved with: 1) use of VASER liposuction to harvest the fat since your fat has already been harvested 2) a closed looped system to process the fat in order to optimize transfer time and  avoid your fat from becoming contaminated and 3) strategic micro-packet transplant technique that maximizes graft take. These three processes have demonstrated over 95% fat graft take. This means that your results will be stable as long as you maintain your weight.A Skype or FaceTime consultation with a BBL specialist can help you get an accurate recommendation and pricing.

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

I want more projection without becoming more wide. What procedure can fix this very specific issue? (photos)

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