The great advantage of the VASER Liposuction with fat transfer to the buttocks (Brazilian Butt Lift (BBL) surgery is that this technique uses your own body fat (autologous fat) and avoids the need for implants or harmful buttock injections. This fat, as an autologous tissue, can be considered an ideal filler because of its biocompatibility. Fat resorption may occur after BBL because some of the fat cells do not survive when they are transferred to its new environment, due to limited blood supply. Several factors affect fat resorption after Brazilian Butt Lift such as patients’ anatomy, history of smoking, non-compliance with post-op protocols, among others. However, BBL successful results can be permanent. Usually, a highly skilled and experienced plastic surgeon will achieve around 65% to 85% survival rate of the fat cells.
4D VASER Liposuction with fat transfer to the buttocks (BBL) performed by Dr. De La Cruz.
Recent developments have minimized fat resorption, allowing plastic surgeons to deliver near permanent results. Long-term results after Brazilian Butt Lift are achieved with the following critical factors: 1) Gentle liposuction techniques; 2) purification of fat prior to re-injection; and 3) meticulous fact injection into the buttocks and hips, 4) patients compliance with pre and post-operative protocols. It’s important noticing that fat cells treated and removed during VASER Liposuction procedures are typically of high quality (in contrast with the ones extracted via Smart Lipo) and are viable to re-introduce into the body (1). Fat that is removed in laser liposuction cannot be re-used as the fat cells are destroyed by the heat from the laser. Certain donor or liposuction sites such as the lower back and flanks also boast high survival rate of fat grafts due to their proximity to the buttocks and hips.
The method of processing (purification of the fat) is the second key factor that surgeons can use to maximize fat survival. The preparation process clears the donor fat of blood, pain killers and other unwanted elements that could cause infections or other undesirable complications. Separation from excess fluid ensures that the plastic surgeon is injecting only purified and stable fat cells will be re-injected into the buttock area. After the fat selection process is completed, only 500cc to 1500cc of the fat will be injected into each buttock (2).
Third, high success rates of fat survival can be achieved by choosing a proper method of placement. During BBL surgery, fat grafts should be placed in a way that simulates naturally-occurring fats. Micro-droplets of fat (a mere 0.01cc) are disperse through meticulous fat injections. By all means, fat placement requires slow injection techniques and is time consuming (3). The use of micro-droplet technique ensures smooth skin surface and natural buttock contour. It creates small compartments of fat in which blood vessels can grow. It is important noticing that blood supply is essential for the long-term survival of fat grafts, the same way it is crucial in skin grafts and organ transplants.
Lastly, patients can actively contribute on the success of BBL surgery and the longevity of the results by closely following their surgeon’s recovery recommendations. Plastic surgeons typically suggest their patients avoiding cigarettes and heavy drinking because these habits reduce circulation throughout the body, leading to the degradation of new cells. Smoking causes vasoconstriction, which limits the blood flow to the newly transplanted fat cells. The fat needs that blood supply to survive and give you the best BBL outcome possible. Another fundamental measure is wearing specialized compression garments around the clock (except for showering) for six months, to reduce swelling and help their skin contract smoothly to your new body’s contours. Additionally, at least ten lymphatic drainage massage sessions are required, starting 24 hours after the procedure, to eliminate excess lymph fluid, alleviate swelling and discomfort, and also prevent complications such as seromas (fluid collection) and contour irregularities (indentations, and/or fibrosis).
Patients who successfully avoid sitting or putting pressure on their buttocks or stretching for the first 8 weeks after BBL surgery are much more likely to have long-lasting results than patients who fail to follow this advice. In the case you can’t absolutely elude sitting, it is recommended doing it in a modified position, placing a bolster or rolled-up towel under the back of the thighs while sitting down, as to avoid significant pressure. Also, there is a variety of post BBL surgery support cushions available on the market. Moreover, it is not advisable to do squats and lunges during the first 8 weeks following BBL surgery because it can cause the resorption of the newly transferred fat cells. Additionally, stomach sleeping, having different pillows at hand and changing your neck’s position from time to time, are helpful measures to feel more comfortable in bed and guarantee beautiful results. Side sleeping can also be an option after BBL, but only if you feel certain you won’t end up on your back. Most of your weight will be on the front of one of your hips. Your legs will be sprawled out, and you can place a pillow in between them to make it more comfortable.
(1) Schafer, M.E., et al. “Acute Adipocyte Viability After Third-Generation Ultrasound-Assisted Liposuction”. Aesthetic Surgery Journal. 2013 Jul; 33(5):698-704.
(2) “What do you expect out of Brazilian Butt Lift”. The Bioplasty International Center. https://www.internationalsurgery.com/what-do-you-expect-out-of-brazilian-butt-lift/
(3) Strong, Amy L. “The Current State of Fat Grafting: A Review of Harvesting, Processing, and Injection Techniques”. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov