I have found, however, that there are many misconceptions and myths surrounding the procedure- so here's my best attempt to provide a basic education on the technique, what you could expect, what would be expected of you after surgery, how to maximize your chances of achieving the beautiful buttocks you desire, how to minimize the risks to your safety, the alternatives, and the risks associated with Brazilian Butt Lifting.
In the Brazilian Butt Lift technique, fat is removed from areas where it is in excess and contributing to an unfavorable contour, treated to prepare it for replacement into the body (described below), and then carefully grafted into the area to be augmented (in this case the buttock area). This is the key to understanding the enormous transformational power of the procedure- unlike other plastic surgery procedures, this technique really allows the realization of more significant change by altering not just the dimensions and appearance of the buttocks directly, but by also allowing for dramatic change in the relationship of the buttocks to the areas of the body around it, such as the waist, hip, and thighs. The CONTEXT in which the buttocks is viewed changes- which, combined with the changes in the buttock area itself, is very powerful.
Removal of the fat is done by liposuction, and there are several important considerations here.
First of all, it is very important to realize that liposuction IS a surgical procedure- the benefits of liposuction cannot be denied, and under the proper circumstances, and in the appropriate hands, it is among the safest operations performed by Board Certified Plastic Surgeons.... but in the wrong hands, it can, and has been, fatal.
Within the past few months, here in my home state of Florida, a young woman died during liposuction being performed by a rehabilitation medicine doctor.
So while the best methods for choosing a safe and well trained surgeon are beyond the scope of this article (you can read more about that topic here: http://www.realself.com/article/Choosing-a-Plastic-Surgeon-Part-2), please understand that it is very important to your safety and chances of achieving your goal that you choose your provider well.
Secondly, the technique used to harvest the fat needs to be different than you would use if the only goal were to remove the fat (but not replace it into the buttock)- the goal here is not simply to remove the fat, but to also have it SURVIVE, in order to give you the permanently improved shape you desire.
This highlights the importance of finding a surgeon who is not only Board Certified by The American Board of Plastic Surgery, but also very experienced in this technique. The fat harvested is precious- you will never be able to get it back... if poor technique is used, resulting in poor success of the procedure, you will not have a second opportunity. (Here is more to read about liposuction machines, providers, and staying safe: http://www.realself.com/article/liposuction)
Even with the best technique, approximately 20-25% of the fat will be reabsorbed over the first month after surgery, so most surgeons over-graft a bit, meaning that your buttocks may initially seem a bit too large- don't panic.
Some surgeons use drains, some do not- this is a personal preference.
The fat used may come from anywhere it is in excess, including the arms, abdomen, waist, hips, thighs, etc..
Once the fat has been treated and carefully grafted into the buttock area, the operation is completed and you are placed in a support garment for transport to the recovery area.
The average Brazilian Butt Lift takes me between 3 and 4 hours, as good technique is very labor intensive and tedious. Some surgeons may take longer, and some less time- again, it's all about finding a well-trained, Board Certified Plastic Surgeon who can keep you safe and give you the outcome you want.
The volume of fat transferred can vary widely depending on your goals, your examination, and the qualities of your fatty tissue noted at surgery. We have achieved our patient's goals with as little as 300 cc, and with as much as 1000 cc (per buttock cheek).
Achieving success is most appropriately measured individually.
With regard to recovery, the procedure is typically not very painful after the first day, with most of my patients describing a muscle soreness type of pain which is easy to control with medication. We would not want you participating in exercise or heavy labor for several weeks after surgery (3-4), but you may return to your everyday home life and personal care immediately.
The most important postoperative concern is that you NOT SIT ON YOUR BEHIND for at least a month. This is very important to avoid losing the fat or altering the shape of the buttocks achieved by your surgeon in the operation. Your surgeon will teach you ways of sitting that allow avoidance of this pressure (in other words, you can still sit- just not on your butt).
You will look better and notice the improvement immediately, but of course the improvement should be expected to evolve over time. Once the first month to 6 weeks have passed, your buttock volume and shape should have stabilized and your final result evident in this area- but the areas treated by liposuction will continue to improve and evolve for an additional 2 months on average, so your final result in all areas will take between 3 and 4 months.
For most patients with administrative positions, return to work is possible after 1-2 weeks. More significant physical job requirements may necessitate another week off before returning.
The risks of Brazilian Butt Lift surgery include those of any operation, those particular to liposuction, and the risks of fat grafting in volume.
General risks of surgery would include bleeding, infection, unfavorable scarring, changes or loss of sensation, asymmetry (where the two sides of your body don't look the same), hematoma or seroma (fluid collecting under the skin), the risks of anesthesia, and the risk that you don't get exactly what you wanted- in other words, just as with any other aesthetic procedure, no guarantee of the outcome can be responsibly given.
Risks of liposuction include the risk of injury to nerves, blood vessels, and organs, as well as contour irregularities that may or may not need additional treatment.
The risks of fat grafting include the risk that more of the fat than anticipated is absorbed or dies (fat necrosis), becomes infected, or causes other problems. The risk of fat embolism (where some of the fat gets into your blood vessels and travels to your lungs/heart/brain/other organs causing problems) should be understood, but should be extremely rare with good technique (I am not aware of this ever actually happening with a Brazilian Butt Lift).
All of these risks can be minimized and managed quite effectively by choosing a surgeon, facility, and anesthesiologist properly, as outlined above and in the accompanying article, "Choosing a Plastic Surgeon, Part 2".
With a healthy understanding of your goals, the procedure, its recovery, its risks, and most importantly how to choose the right situation for you, the Brazilian Butt Lift technique can safely and permanently improve the way you feel about your body.
Buttock implants are the only safe alternative to Brazilian Butt Lift surgery. They are not ideal, as they are not permanent and can be prone to infection, as well as the fact that they may not ever look or feel as natural as a buttocks created using your own fat- but for women who don't have enough fat for BBL and who don't want to (or cannot) gain weight, they are a reasonable option.
There are many unscrupulous providers out there making promises that cannot be kept safely- one of injuries I see most often in Central Florida results from the injection of liquid silicone or "hydrogel" into the buttock tissues for "safe, permanent" buttock augmentation "without surgery". There have been numerous cases of organ failure and death from this practice, and even those patients who do not experience these devastating problems still have a lifelong problem with pain and disfigurement- as once injected it is almost always impossible to remove the liquid polymer.
So there it is- hopefully this answers most questions about Brazilian Butt Lifting for you- if you have others, please email them to me for posting at drsoto@mac.com
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