Dr. Saber’s Blog
The Brazilian butt lift (BBL), which combines abdominal liposuction and a fat transfer around the glutes, is one of the most iconic plastic surgery procedures of the past decade. And yet, in the last couple of years, I’ve seen a noticeable uptick in consultations for the opposite procedure – the BBL reduction or even BBL reversal.
These requests did not happen in a vacuum. A quick look at the latest social media trends reveals that many designers and influencers are once again opting for slimmer figures. Online news sites spent weeks speculating about Kim Kardashian’s BBL reduction and collecting before-and-after pics of other celebrities’ changing figures.
But this doesn’t mean BBLs are out! I continue to see patients who are interested in butt augmentation surgery. Some may find themselves requesting a reversal in a few years – or may ask for more radical body contouring procedures instead. Ultimately, desired body shapes are as unique as bodies themselves, so it’s important to have a frank conversation regarding the effects of realistic expectations, capricious trends, and even natural aging on our mutual surgical goals.
It would be far too easy to dismiss the latest requests on BBL reversals as people “following the fashions.” This diminishes the value of cosmetic surgery itself and infantilizes the patients (who are primarily women) who request the procedure.
In reality, most patients who want to go back on their buttock augmentation do so for a combination of reasons. These include:
A frequent statement I’ve noticed during consultations for this procedure is, “I didn’t think this through.” Sometimes, this goes back to the patient’s unrealistic expectations about their body. More often than not, it comes back to issues that would not have been obvious for a patient but should’ve been brought up by the surgeon. Unfortunately, the effects of butt augmentation on posture or the realities of aging are not always discussed as clearly as they should be.
As a plastic surgeon, I want my patients to feel more confident and secure after the final bandages come off. We can’t always ensure this satisfaction will last long term – but I always try.
When I design a body sculpting plan, many factors come into play. But before we can discuss which parts to remove or which areas of the body to enhance, I need to make sure my patient is clear on five basic things.
Reversing a previous BBL procedure usually involves combining surgical techniques to remove the old fat grafting and reshape the buttocks into a smaller, symmetrical form.
Most of the work is done via liposuction: through tiny incisions, we insert thin cannulas into the problem areas to “suction” away the excess fat. Next, we lift the buttocks, followed by skin tightening or “tucking.” The task of reshaping the buttocks requires a custom-made strategy for each patient: I will need to consider the original grafts’ location, the post-BBL size of the buttocks, and the patient’s skin elasticity. The result should look like a natural, smaller version of the butt with no saggy skin, dimples, or cellulite.
That said, a BBL reversal is always a bit more complicated than a first-time liposuction procedure, as I will need to work around the existing scar tissue. Most surgeons strive to perform BBLs using small incisions in hard-to-spot places, but even if they’re not visible from the outside, fat grafting leaves behind a lot of scars that can make traditional liposuction tricky.
All cosmetic procedures carry risks, although an experienced surgeon can minimize most of them. Reversing a BBL carries most of the same risks as a regular liposuction. Risks may include numbness in the affected areas, infection, or temporary pockets of fluid under the skin. BBL reversals are usually done under general anesthesia, which also carries its own risks, especially for patients who are overweight or have pre-existing cardiovascular conditions.
One specifically serious but thankfully rare complication of liposuctions is pulmonary fat embolisms or PFE. This occurs when a small “bubble” of fat makes its way into the lungs immediately after surgery. A PFE can be fatal if untreated, which is why I like to keep a close eye on my patients immediately after any fat removal procedure.
Compared to first-time liposuctions, a BBL reversal also carries a higher risk of bleeding or of leaving behind contour irregularities. If the original BBL involved a large amount of fat grafting, we will also have a higher risk of seeing stretch marks or saggy skin in the buttocks – but these are treatable, and we can plan and perform a mini-tuck to counteract them.
The recovery times after a BBL reduction vary widely and depend on how large the original BBL was and how much fat we removed during the second procedure. Other factors, such as a patient’s general health condition, their age, and whether they smoke, can all lengthen the recovery process.
At the very least, most patients can expect:
We won’t be able to see the final results of the procedure until the swelling goes away completely, which may take six weeks or more.
Yes, but this is easier said than done.
The path to preventing a BBL reversal starts when we first plan for the original butt enhancement. For less experienced surgeons, the discussion around long-term expectations is a thorny one, so they avoid it or skim through it. But those awkward 10 minutes now could save us so much pain in the future!
After the procedure, the story changes. Sometimes, weight loss alone can be enough to “shrink” the buttocks after a BBL. This is generally safer and often cheaper than a second cosmetic surgery. But once again, there are a lot of factors that will affect this. Here, patients who are on the fence should consider a few things:
The popularity of BBLs has also increased the amount of surgeons offering them – and of patients who are left unsatisfied with the results. Following an overambitious BBL, some may want it gone right away.
Unfortunately, this is far from safe and may not even be necessary. It is not uncommon for BBLs to “shrink” within the first six months after the surgery, as not all the implanted fat cells will “take.” Until that happens, we won’t be able to see the full extent of any asymmetry or determine what needs to be done.
The body needs time to heal properly after a BBL surgery, and I need to see the final results to design an efficient surgical plan. As a result, most board-certified plastic surgeons will not perform a BBL reduction until at least six months after the original surgical procedure.
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Dr. Sepideh Saber, MD, FACS, is an American Board of Plastic Surgery-certified plastic surgeon practicing in the greater Los Angeles area. After completing medical school at Stanford University, she trained at the University of Southern California and at New York University in plastic surgery, hand surgery, and microsurgery. This experience allows her to provide safe and predictable results for BBL reversals, tummy tucks, reverse tummy tucks, or breast augmentation procedures.
Her philosophy of care is built equally on expertise and empathy. At her practice, any surgery is carefully planned to ensure patients from all walks of life can receive compassionate care that addresses their physical and mental concerns.
To request a consultation, call (877) 205-4100 or schedule a consultation online.
The practice of Dr. Saber is located in Encino, CA for patients throughout the Los Angeles area. We are also convenient to Encino, Woodland Hills, Sherman Oaks, Calabasas, Burbank, Glendale, Hidden Hills, Agoura Hills, Northridge, North Hollywood, Malibu, Topanga, Canoga Park, Reseda, Valley Glen, Chatsworth, West Hills, Winnetka, Universal City, Bel Air, Beverly Hills, Downtown Los Angeles, Silverlake, and Echo Park.