Brazilian Butt Lift

Q: Dr. Eppley, I have questions about Brazilian Butt Lift surgery. What is the average percentage of the fat transfer that stays on the buttocks? After the surgery are the buttocks firm?  I have not had children yet, when i have children if I would like to go forward with the procedure again if I lose the fat from mybuttocks afterwards will that be dangerous to go through another procedure?

I am very interested in this procedure and would like the best results. Do you have a way to show patients what the body will look like after surgery before the actual procedure?

A: On average the amount of fat that persists in most Brazilian Butt Lifts (BBL) is around 50% to 80% in my experience. But any fat transfer is not completely predictable and every patient will have varying degrees of fat retention. Initially the buttocks are firm from the immediate volume full but that softens quickly in the first month. Fat transfers do not create the firmness that comes with buttock implants. The buttocks will end up bigger but they will still feel soft. There is no harm or danger in the future to having another BBL procedure.

The key question is whether what one wants to achieve with BBL surgery can be done based on one’s goals and what they look like now. To determine whether BBL surgery has a reasonable chance to achieve your goals, I would need to see pictures of your buttocks/body now and what your buttock augmentation goals are.

Dr. Barry Eppley

Indianapolis, Indiana

Brazilian Butt Lift

Q: Dr. Eppley,  I am interested in getting a Brazilian Butt Lift. I am a 24 year old female who is not comfortable and is ashamed of her body. I have been doing research on Drs where I currently live and I haven’t found a Doctor who meets my expectations. And I have seen your woek and I like what you do.I think I am a perfect candidate for a Brazilian Butt Lift since I have some extra fat over my entire body gained after I had my son via c-section three  years ago. I really really want a better body with an “S” shape on the sides. I want my butt and my hips enlarged and I am really hoping you are the one who can make my dream come true. 

A: As you know the Brazilian Butt Lift or BBL procedure is a dual benefit operation where multiple body areas are contoured through the redistribution of fat approach. The liposuction harvest areas create reduction while the fat transfer to the buttocks causes an augmentation. While the Brazilian Butt Lift is a very common operation today, and I have done many of them, the keys to a successful and satisfying outcome are based on realistic patient expectations and an understanding of the natural biology of fat transplantation. Let me highlights these key points:

1) The liposuction harvest is not an overall body liposuction procedure. The goal is to obtain as much fat as possible for the buttock injections for which the vast majority comes from the abdomen, flanks and back areas. The reduction of the waistline above the buttocks plays a major role in helping the buttocks appear bigger.

2) There may be undesired aesthetics from the liposuction harvest in the abdominal region, particularly in women that have had chldren. (loose skin) Ay such loose or irregular skin may require a secondary tummy tuck to create the best abdominal contouring effect.

3) The size limitations of the buttock augmentation increase in BBL surgery is a direct result of how much fat one has to harvest. Thus some buttock enlargement goals are not possible for some women because there is a mismatch between what they want and what they have to give to try and achieve it.

3) The amount of fat that is available to be injected into the buttocks is but a portion of what is harvested. Since the best type of fat to inject is a concentrate of the total liposuction aspirate, not all fat volume that is extracted ends up being injected. It must be concentrated which in women usually means about 40% of what is harvested is useable for injection. (e.g., 1,000 of fat harvested = only 400cc to be injected)

4) The survival of injected fat is not predictable and is never 100%. Thus some of the injected fat will die and some of the initial volume increase will be lost over the first six weeks after surgery. This fat transplantation biology fact seems to confuse many patients as they wonder why their results are ‘disappearing’ over the first month or so after surgery.

5) The final outcome of any BBL surgery takes 6 to 12 weeks after surgery to stabilize and see the final result. But it will not end up as full as one what sees in the first weeks after surgery.

These are the important concepts to understand so that one can have a realistic expectations about what to expect from their BBL surgery results.

Dr. Barry Eppley

Indianapolis, Indiana

Brazilian Butt Lift

Q: Dr. Eppley, I am interested in buttock augmentation. I(Brazilian Butt Lift) What is the cost, how long would I have to be off work. what does it mean by not all of the fat would survive?

A: The cost of Brazilian Butt Lift surgery is variable based on the ‘size’ of the assignment. The more fat that needs to be harvested is going to take more surgical time and costs. But on average the total cost of BBL surgery is in the range of $7500 to $8500. Recovery from BBL surgery is essentially like recovering from a major liposuction surgery. While I suspect you could get back to work in about 2 weeks after the procedure that does not mean you would be fully recovered. That probably takes about a full size weeks. The success of BBL surgery depends on how much fat actually survives the harvest and transfer process. What the amount of fat survival will vary amongst patients, it is far to say that not all of the fat will survive, usually only about 60% to 70% will be retained at the most optimistic estimate. This is why in most Brazilian Butt Lift surgeries it is important to harvest as much fat as possible and place as much as the buttock tissues can tolerate.

Dr. Barry Eppley
Indianapolis, Indiana

Brazilian Butt Lift

Q: Dr. Eppley, I want a Brazilian butt lift and tummy tuck. Can I get a combined surgery package and price for these two procedures.

A: The combination of a Brazilian Butt Lift and a tummy tuck can be done together. But that is a tough combination in terms of recovery and discomfort. I have done it and patients do get through it but it will be a lot tougher than you envision. Ideally it is better to harvest all the fat that one can from the abdomen and flanks for the Brazilian Butt Lift  and deal with the loose skin in a second surgery. (tummy tuck) Whether the combination or staged approach would be better for you depends on what your abdomen looks like now.

While patients understandably would like to combine these procedures to lower costs and have just one big recovery, that approach can be short sighted. In women that have very large abdomens and a lot of excess abdominal skin, it may be more prudent to stage the two procedures. That way the best result may be obtained for both the Brazilian Butt Lift and the tummy tuck with a lower chance of complications.

Dr. Barry Eppley

Indianapolis, Indiana

Mommy Makeover and Brazilian Butt Lift

Q: Dr. Eppley, I’m wanting to do a Brazilian Butt Lift lift. Can that be done at the same time as with a Mommy Makeover?

A: A Mommy Makeover (breast and abdominal reshaping) and a BBL (Brazilian Butt Lift) can be done at the same time but it create a very difficult recovery. It would all depend on what the exact Mommy Makeover procedures need to be and whether such a combination may negatively impact the results of any of the three procedures. For example if the Mommy Makeover needs to include a full tummy tuck there will be less fat that can be harvested for the BBL to avoid compromising the healing of the tummy tuck incision. I would need to make that evaluation during an actual consultation or you can send me pictures of your body type for a preliminary evaluation.

While it is always desirous to maximize the number of operations one can do in a single setting for economy of recovery and economic resources, there are operative combinations that can ‘fight’ against each other and may even compromise their results. This needs to be looked are carefully in these type of body contouring procedures.

Dr. Barry Eppley

Indianapolis, Indiana

Am I A Good Candidate For A Brazilian Butt Lift?

Q: Dr. Eppley, I am a 35 year old woman. I have attached some pictures for your reference. I would like you to give me your opinion on what you could do to make my shape more curvy. (widen hips, increase buttock projection and decrease waist, back and arms size) I think liposuction to the abdomen, flanks and back plus re-distribution to the buttock and hip area is certainly something I would like to consider. 

As you can see in my pictures I also have had a breast augmentation and have been told that these are polyurethane, so they may be hard to remove. I would like your thoughts on what you may do to make my breasts slightly smaller and less projected, but more natural and rounded.

Could you tell me how long I would need to stay in hospital, then in the area before I fly home ( and details of how soon I can fly) Thanks!

A: Thank you for sending your pictures and providing your body contouring objectives. I believe you are correct in the approach to improving your body shape through a combination of aggressive liposuction of the abdomen, waist, back and arms with redistribution of the fat aspirate to your buttocks. That combined procedure has a name and is the well known Brazilian Butt Lift with assured body contouring benefits from the fat harvest and buttock augmentation from the liposuction ‘discard’.

In regards to your breast implants, these are harder to remove than smooth silicone shell implants but let’s not confuse harder with impossible. Most likely they have some degree of encapsulation which makes them look very ‘stuck on’ and firm due to the encapsulation. Removing the implants and their capsule with a slightly smaller volume implant should make them softer and a little less projected. It would ultimately be helpful to know what the implant volume is when planning their replacements and I would probably drop the volume down by about 50cc.

This type of body contouring surgery is done in my private surgery center, not a hospital, where the costs are much lower. Given that you are from afar, I would keep you overnight but you could go back to the hotel the next day. I would anticipate you flying home within 5 to 7 days after the procedure at most.

Dr. Barry Eppley

Indianapolis, Indiana

Can I Have A Brazilian Butt Lift If I Am Overweight?

Q: Dr. Eppley, I am roughly 75 pounds over my ideal weight looking and to have a Buttock Augmentation with Fat Injection.  (Brazilian Butt Lift) My question is do you do what’s considered “Large Volume Liposuction” or do you have an issue with larger patients?

A: . One’s weight per se does really influence the ability to have a successful Brazilian Butt fit surgery…unless one has very little fat to harvest to be able to do the procedure successfully. (have enough fat to inject) Therefore patients that have excessive weight do not represent a limiting factor in being to do the BBL procedure. The only issue with patients with more weight is that they realize the liposuction harvest for the BBL is not going to make them thin nor serve as a weight loss method. Also there is a safe limit of fat harvest which is generally around five liters and that is where it is prudent to stop no matter how much more fat may be able to be harvested. Going about that ceiling and venturing into true large volume liposuction increases the risk of complications such as deep vein thrombosis and pulmonary emboli. Also it really can make the recovery period prolonged and can take weeks until one is fully functional again.

Lastly, using the ratio of about 1/3 fat concentrate results from the unfiltered liposuction fat harvest, the amount of fat that can usually be maximally injected is around 1,500 to 1,800cc or 750cc to 900cc per buttock.

Dr. Barry Eppley

Indianapolis, Indiana

Should I Gain Weight For A Buttock Augmentation?

Q: Dr. Eppley, I am 21 years old, 5 ‘0” and weigh105 pounds. Am I qualified for butt augmentation with fat. (Brazilian Butt Lift) If not what do I need to do to gain more weight or is there anything I can take to gain weight?

A: At your low weight, you are not a candidate for buttocks augmentation by fat injection. And there is no amount of weight that you could reasonably gain to get you to the point where there would be enough fat to make the procedure worthwhile. Even if you did gain a large amount of weight, the fate of the fat that is harvested and placed into the buttocks would be suspect with subsequent weight loss. Only buttock implants would be effective in someone who is so small with very low body fat.

Buttock implants are more reliable in terms of the volume that they provide (fat survives vary variably) but they have a higher rate of potential complications because they are an implant which is not naturally there. I would not say they are any less safe that fat, just that there is more potential complications and recovery than just using you own natural fat as the ‘implant’.

Dr. Barry Eppley

Indianapolis, Indiana

Will The Brazilian Butt Lift Work For Me?

Q: Dr. Eppley, I am interested in the Brazilian Butt Lift and would like to know how many procedures you have performed? I have attached two pictures and would like to know what kind of results you would expect with my body type. I am not wanting a big Kim Kardashian booty just some volume to add some shape. Looking at my attached pictures do you think this is achievable?

A: It is a good thing that your Brazilian Butt Lift (BBL) objectives are not like that of Kim Kardashian as you simply do not have enough fat to harvest to achieve that amount of buttock size increase. The success of BBL surgery depends on two important factors, how much fat does one have to give and how much fat will survive after being processed and injected. When you realize that less than 50% (at best) of what comes out as liposuction harvest ends up as buttock volume addition, the reality of what is achievable by the BBL procedure comes into focus.

What one means by ‘just some volume to add some shape’ is open to interpretation, the question is really whether the procedure is worthwhile. There is only one guarantee with the BBL operation and that is the body contouring that results from the liposuction harvest. When one does not have a lot of fat to harvest and process, a realistic buttock augmentation goal should be ‘just something more than what I have’. As that is the only assurity you can get from the procedure.

Many successful buttock augmentation results occur from the combination of reducing what lies around the buttocks and augmenting what lies within…more so than a real substantial buttock size increase. Such would be the case with your body type.

Dr. Barry Eppley

Indianapolis, Indiana

Can I Get A 1000cc Per Buttock Brazilian Butt Lift?

Q: Dr. Eppley, I am interested in the brazilian butt lift. I originally booked the procedure with another doctor. However, he will not be available for the procedure now and he mentioned you as one of the doctors I should see. I am hoping to get the same service as he was providing, which was liposuction of the arms, back, abdomen, flanks and inner thighs with a minimum 1000cc injected into each buttock.

A: I certainly do a fair number of Brazilian Butt Lifts. The key question, however, is whether you have enough fat to harvest that could be filtered and concentrated to be able to inject 1000ccs per buttock. That would be exceptionally unusual. To be able to get 2000cc of injectable fat, you would have to have close to 6,000cc (6 liters) of fat to harvest. That may be possible in you but since I have never seen your body I could not tell if that was so. What most patients don’t understand is that only concentrated fat should be injected not just the liposuction aspirate. Taking the liposuction aspirate and getting rid of the blood, broken fat cells, free lipids and the tumescent solution usually results in a 60% to 70% shrinkage of volume of ‘fat’ that has been harvested. Thus only about 1/3 to 40% of the lipsuction harvest ends up being useable for injection.

For most Brazilian Butt Lift patients, the maximal amount of fat that can be harvested and injected is done as most patients have an overall deficiency of fat for the procedure (based on their goals) rather than an excess. For this reason, I do not promise any patient that a specific amount of fat will be injected as that is an unpredictable number until the fat is harvested. I would have  a good feel for an approximate amount that could be done in looking at one’s body and thus an estimate could be given before surgery.

Dr. Barry Eppley

Indianapolis, Indiana