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