Dr. Kenneth Hughes, Harvard-trained, board-certified plastic surgeon, sees many patients who want more than just a larger butt or a more shapely butt with more projection.  In addition, patients may have dents from previous trauma or from some congenital event or previous surgery.  Revision surgery from previous fat transfer attempts by other surgeons make up about 80% of Dr. Kenneth Hughes’s practice in Los Angeles.

These dents can be the result of a portion of fat dying after a transfer procedure.  The dents can also result from restrictive areas of the butt not expanding to the extent that the rest of the butt expanded in response to the fat transfer procedure.  The ability to improve these dents can be extremely difficult to acquire.  Dr. Kenneth Hughes employs a variety of measures to treat these sometimes unique postoperative sequellae of Brazilian buttlifts or BBLs performed elsewhere.

Some plastic surgeons or other doctors may recommend saline injections to help improve these areas.  This technique, in general, results in no real improvement as the saline is rapidly absorbed by the body.  Fat that survives transfer is thus much more effective for this purpose.  However, patients must realize that fat by itself has almost no structure and cannot be expected to dramatically expand a constricted area.  Thus, various methods of scar release have been employed to lend more mobility to the skin envelope.  Complete release of an area may allow for some alteration, but the fat injected must be confined to a distinct area and thus the best result occurs when the release is confined to a small area that encapsulates the dent in question.  This process can be repeated for multiple dents at the same procedure.  However, large amounts of fat should not be grafted at this time as the percentage for development of fat necrosis will likely be much higher given the stripping of an area of tissue and blood supply.

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