A BBL revision can address a variety of concerns, including issues with healing, size, asymmetry, and irregular contours or dents, lumps, rippling, and skin trenches.
Your surgical plan will depend on your concerns, anatomy, and desired results. Revisions may involve transferring more fat, to correct problems or add volume, or using liposuction to selectively remove fat.
Sometimes we do a combination of butt implants and more fat grafting, depending on the individual patient needs, for instance, if a patient is too thin and doesn’t have enough excess fat to be harvested and then transferred to the buttocks, silicone butt implants can be used to round out the area and create more projection.
Most doctors suggest that patients wait at least six months (possibly a year) before any revision gluteal fat augmentation. It can also take a year to see the final results from the grafting, since it takes time for the fat to be revascularized and survive on its own. This also allows time for swelling to resolve. At this point, both you and your surgeon will know exactly what your initial results are, so they can give you options to improve them.
Doing surgery before this point is typically like trying to hit a moving target, since your body is still changing from surgery. Also, giving your body time to heal will allow the scar tissue from liposuction to soften and give the fat transfer a chance to heal so that the next surgery can be as precise as possible.
Some issues may work themselves out during this waiting period. For instance, fat necrosis, which occurs when transplanted fat dies and becomes nodular (which feels like a firm, round lump), usually softens with time and resolves within 6 to 12 months. If it persists or causes pain, it can be removed with fine cannula liposuction.
Revision surgery is always more difficult, and revision BBL is no exception. If you undergo liposuction in the same area as in the first surgery and have scarring, you’ll likely have more bleeding—and it may be more painful for the patient.
This makes it all the more crucial that the surgeon performing your revision BBL has extensive experience in the procedure as well as in fat transfer, scar release, and BBL surgery in general.
Brazilian butt lift surgery has a high incidence of post-op complications—more so than nearly any other cosmetic procedure. It also has the distinction of having the highest mortality rate. Not all surgeons who offer gluteal fat augmentation have the training necessary to perform this complex procedure or know the safest and most up-to-date techniques, so doing your homework before choosing a board-certified plastic surgeon is essential.
The key recommendation is that fat injections to the buttocks are safe, if they’re delivered into the subcutaneous space just beneath the skin—never below the fascia and into the gluteal muscle. The gluteal area is very vascular, which means there are a lot of blood vessels in and below the gluteal muscle. Fat that enters a vein can be carried into the heart or lungs, creating a fat embolus that blocks those critical vessels—which can lead to death very quickly. Before signing up for more surgery, be sure your plastic surgeon uses only the recommended above-the-muscle technique to inject fat.
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Before Brazilian Butt Lift Revision Surgery
Brazilian Butt Lift Revision Surgery Advantages and Disadvantages
. Revision BBL can address areas of concern and help you reach your goal of creating a fuller, rounder, shapelier backside.
. The surgery can often be performed through the existing scars. If new scars need to be made (for instance, if a different donor site is going to be used), they’re often very small (less than half an inch long) and can be well-concealed.
. Reinjected fat should survive at the same rate or possibly better than it does during an initial BBL.
. Secondary procedures usually cost significantly less than primary procedures.
. You need to wait at least six months to have a revision. The reason to wait longer when performing liposculpture on the same previously treated areas is for any scar tissue to soften and resolve. You can’t see it or feel it, but areas previously treated with liposculpture can be very firm with scar tissue, making the procedure of viable fat harvesting very difficult.
. It may require multiple sessions to correct what you don’t like.
. You may not have enough fat to achieve the result that you want. Depending on the goal of the surgery, the recovery—which includes not sitting directly on your butt for at least two weeks—may be as lengthy as the first time around. If you need more of a touch-up, the downtime will be shorter.
. The risks of a revision BBL include all the risks associated with the primary surgery as well as the increased risk of contour deformity and/or skin damage. The risks increase if liposuction is performed in areas where you’ve previously had liposuction.
. Though results can usually be improved, surgeons can’t guarantee it. It’s possible that you won’t like your result after a secondary BBL.
During Brazilian Butt Lift Revision Surgery
During the procedure
Depending on what’s being done, a revision BBL often takes longer to perform than a primary BBL—anywhere from 30 minutes to two hours or more. Additional liposuction to areas of the body that have already had liposuction is more difficult and tedious, and additional time and care must be taken to avoid injury to the overlying skin or other structures. If new parts of the body are being treated with liposuction, they’re often smaller, with less overall fat, and require frequent position and equipment changes—all of which can increase the time needed to perform a redo BBL.
If the problem being corrected is minimal, it’s possible to do the touch-up under local anesthesia. Otherwise, a BBL revision will be performed under general anesthesia. In either case, the surgery is performed on an outpatient basis, which means you’ll go home the same day.
Pre-operatively, the areas that will be liposuctioned to collect the fat used to augment the buttocks are marked. The outline of the new augmented buttock will also be marked prior to the surgery.
Once the fat has been liposuctioned from the predetermined areas, it’s then purified so that only the most viable fat cells are transplanted. The fat is then reinjected into the buttocks as needed to reach your goals. The surgeon will use precise layering and massaging so that the fat settles correctly and offers a smooth result. Only small incisions are made for both the liposuction and fat injections. Drains may be inserted to prevent fluid buildup (seroma) that can lead to infection. When the procedure is completed, you’ll wake up wearing a compression garment.
After Brazilian Butt Lift Revision Surgery
Recovery from a BBL is similar to that of the original procedure. It takes two to six weeks, but you should plan to take 10 to 14 days off work and avoid sitting directly on your buttocks for at least two weeks (though some doctors allow patients to sit for 30 minutes or less, every two hours). Too much pressure on the area can compromise the blood supply to the new fat and cause it not to take. Your surgeon may suggest you sit on a special donut-shaped booty pillow—or even two or three of them—to avoid putting pressure on the areas of the fat grafting.
You’ll need to wear a compression garment for up to six weeks, to decrease bruising and swelling and help any loose skin retract, as well as avoid strenuous exercise for six weeks.
Pain, swelling, and bruising should begin to decrease after about a week. Be sure to follow your doctor’s instructions for pain management, to avoid complications: for instance, because the skin will be numb, using ice or a heating pad can burn the skin. Surgical drains will usually be removed after a week or two.
You’ll see results immediately, but it can take up to four months or more to get your final results as the swelling from the surgery and liposuction goes down.
Around 60–80% of fat typically survives during a BBL, and the percentage of fat survival in a revision should be about the same, if not more. Secondary BBLs usually have better graft take and quicker healing time because your body has already been primed for healing.
To maintain your results, it’s best to stay within 10 to 20 pounds of your operative weight. As you lose weight, your buttock is likely to lose volume.