Would a standard BBL with fat grafting likely correct my asymmetry and dents? (Photos)

Question

I’m 5’1, 126lbs. Would a standard BBL with fat grafting likely correct my asymmetry and dents, or would I need scar release (subcision) or another reconstructive technique because of my previous gluteal implant removal. I previously had gluteal implants removed after only a few months because my right implant was being rejected. It has now been several years since the implants were removed. Since then, I have noticed asymmetry, contour irregularities, and dents, especially on my right side. I would like to improve the shape of my buttocks and add moderate, natural-looking volume Based on my photos, do you think a standard BBL with fat grafting would likely fix this, or does it appear that I would benefit from another revision technique because of the scar tissue from my previous implant removal? If you recommend something beyond a standard BBL, what approach you would recommend?

George Marosan, MD · Answer

Thank you for your question and photos. Based on your anatomy, I would not recommend an immediate fat transfer to the buttocks as your initial procedure. Because you have limited donor sites, you truly have one chance to get this right. I recommend a staged approach. Your first step should be releasing the deep fibrous bands causing the dents (subcision) combined with subdermal biostimulators, such as Radiesse, to build a smooth foundation. This is the basis of the Goldincision procedure originated in Brazil. I trained with the inventor of the technique. It is performed awake under local anesthesia and typically requires two treatments spaced about 3 months apart. Once we achieve an even, smooth shape, you can then proceed with a refined 'skinny BBL' fat transfer to perfect the final contours. I highly recommend consulting with a board-certified plastic surgeon who is experienced in Goldincision—or advanced gluteal subcision and biostimulator treatments—to safely correct the asymmetry first. Good luck.

Yasemin Aydinli, MD · Answer

After gluteal implant removal, dents and contour irregularities are usually tethered by internal scar tissue, and fat grafting alone often cannot fully correct them because the scar holds the tissue down. Releasing the bands with subcision does create small vessel injury, so it must be performed carefully in the superficial plane, and the fat should be placed only in the subcutaneous layer with a blunt cannula to keep the risk of fat embolism low. For extra safety some surgeons stage the scar release and the grafting in separate sessions. Whether your case needs this combination can only be determined by physical examination of the tissue quality.

Would a standard BBL with fat grafting likely correct my asymmetry and dents? (Photos)

Answers (2)

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