A BBL is basically liposuction of unwanted fat and removal of fat in the waist, flanks, hips and upper thighs as needed to frame the buttock. Then the fat is washed, concentrated and re-injected back into areas of the buttocks that are deficient in volume. Fat is living tissue and not all of it is expected to survive. If it is injected such that too much is put in one spot and it does not get blood vessel in-growth to keep it alive, it dies. Then the fat just dissolves into fatty oil. This is resorbed, but there can be firmness or lumpiness or oil cyst formation or calcification. As a natural consequence of liposuction, there is a reaction in the tissues from the trauma of surgery, and this shows as a firmness which lasts for 2-3 months. Sometimes there is some lumpiness or irregularity as well in the liposuctioned tissues. This normally also goes away in 2-3 months.Seroma is the unwanted accumulation of fluid under the skin. It is most common after tummy tuck where a large space has been opened up. Fluid accumulates for about three weeks, and for some varying period after surgery, drains are placed to remove the fluid. It is not common after liposuction alone. I have never seen it in my practice, but it could be more likely when laser-based liposuction is done. First generation ultrasonic liposuction was prone to seroma, but with the Vaser ultrasonic technology, it has become very uncommon. While toning up is good for muscles, skin does not change. Fat grafting helps loose skin in the buttock if it is not too severe, because the skin envelope is put under tension by increasing the volume of the buttock.
