Dr. Saber’s Blog

Preventing BBL Regret: It’s all in the Surgeon

First, it was the occasional horror story hailing from Ukraine or Turkey. Then, “BBL storytime” became a trending hashtag on social media channels – especially TikTok. Finally, a series of high-profile celebrities, such as Queen Naija or Cardi B, began to warn young girls away from the procedure altogether.

What one influencer can teach us about a BBL gone wrong

In general, my surgical practice prefers to focus on the positive aspects of cosmetic surgery: the success stories, the revamped confidence, and even their role as part of a wider mental health plan. So what prompted me to write about horror stories instead?

It was this very frightening piece about one influencer’s painful experience after a BBL. If you’re not ready to read the full, rather graphic article, here’s a quick rundown: Rachel Velasco, an up-and-coming influencer from Los Angeles, recently saw her post-op experience become “agony” and an emergency stay at Cedars-Sinai hospital.

In April 2021, after facing intense bullying from some of her online followers, Ms. Velasco underwent a Brazilian Butt Lift to “match the popular aesthetic of the Kardashians.” This came after years of insecurities about her behind and from a sincere belief that new curves would give her content the push into stardom she needed.

Unable to book an appointment with any plastic surgeons she already knew, Ms. Velasco went to a medical spa instead. As med spas are mostly in the business of injectables and fillers, they referred her to a “sister facility” next door.

BBL Regret

At this sister facility, she booked an appointment within the same month. The before-and-after photos on their social media looked promising – and here’s where things began to look dodgy.

Velasco received a BBL under local anesthesia (laughing gas), and she was “awake and Snapchatting with friends” during the procedure. She was sent home the same day while still under the effects of the anesthetic, with a medical girdle and some Tylenol. A few hours later, she woke up with “the worst pain of her entire life.”

Scared, she asked her brother to drive her to the emergency room at Cedars-Sinai. After several hours of waiting, she received more painkillers and was told to contact her surgeon – who then rebuked her for going to the hospital instead of calling her.

After four days, the pain finally ceased. However, she ended up with a 4-inch puckered scar on her belly. Her surgeon, Dr. Anna Gevorgyan, is not a board-certified surgeon and was under probation by the California Medical Board at that time. Dr. Gevorgyan recommended (and billed Ms. Velasco for) lymphatic massages to reduce the scar, which did not go away. Six months after the procedure, Ms. Velasco compared her before-and-after pics and saw no noticeable difference.

What is a Brazillian Butt Lift or BBL?

A Brazilian Butt Lift or BBL is a complex cosmetic procedure combining liposuction with live fat grafting. This allows patients to transfer fat cells from undesired areas (such as the abdomen) and plant them somewhere they wish was fuller (often, the thighs or behind the glutes).

BBLs are currently one of the most popular plastic surgery procedures: according to estimates by the International Society of Aesthetic Plastic Surgery, over 390,000 people underwent a BBL in 2020 alone. Most of them are young women who want to pursue the relatively new body ideal that favors curvy figures and wide hips.

How is a BBL done?

There is… a lot wrong with Ms. Velasco’s ordeal – from the mean online comments left on her pictures to her surgeon’s attitudes and business practices. But it’s important to remember that they don’t have to be this way.

So what should a BBL procedure look like when done properly?

Although they don’t usually require an overnight stay at the hospital, BBLs should be done in a fully-equipped operating room and under strict sterile conditions. It is usually done under general anesthesia, but it can be done with local anesthesia and IV sedatives. During the procedure, the surgeon will:

  • Suction fat cells away from the predetermined areas.
  • Quickly purify the extracted fat.
  • Inject the fat in the areas to augment.

Usually, at least 20% of the injected fat cells will not “take” and slide away or burn off. Good technique can keep this to a minimum and provide predictable results – but if most of the fat sags, you can end up with the dreaded “diaper booty.”

After the procedure, you will need pain medication for a couple of weeks. You will also need to sleep on your stomach or side, refrain from sitting or pressing on the buttocks, and avoid strenuous lower-body workouts for up to two months.

Are BBLs dangerous compared to general plastic surgery?

In short, yes. This is not the first time I’ve written about the common complications of a BBL, which can occasionally be life-threatening.

Any surgery carries some risk. However, we shouldn’t forget that BBLs have the highest mortality rate of all cosmetic procedures. This is why due diligence and safety are critical when planning or discussing BBLs.

How can you prevent BBL bad results?

In reality, your chances of being part of the BBL success rate or of being unhappy with the result largely depend on your expectations, the due diligence with which you research your surgeon and clinic, and whether you are willing to respect all safety guidelines.

Keep realistic expectations before a BBL

We must always remember that cosmetic surgery is not a menu of body parts. We can’t order Angelina Jolie’s lips, Kim Kardashian’s thighs, or Dolly Parton’s boobs and expect it all to fit with the rest of our features and bone structure.

BBL Regret

Keep in mind two things: first, the final results of a BBL will not be visible until five or six months after the procedure. During this time, your curves and scars may look underwhelming, and you may need to skip some of your favorite activities.

Second, the “larger” you aim for, the higher the chance that it won’t look the same a few years later. Weight fluctuations, gravity, and changing fashions may change how you see yourself – and while a BBL can be reversed, each subsequent surgery will be harder, as your surgeon will have to work around your scar tissue.

Due diligence can save you a lot of pain

Ms. Velasco did not know Dr. Gevorgyan was under probation, not board-certified, and had originally trained as a gynecologist in Illinois, where the state’s medical board placed her in the “refuse to renew” category. Naturally, the good doctor did not volunteer this information.

And yet, that information — as well as any doctor’s credentials — are all publicly available for those who research. The Federation of State Medical Boards keeps a national registry known as DocInfo, where you can check any doctor’s training, education, and the states where they’re allowed to practice. The American Board of Plastic Surgery’s website also allows the general public to verify whether their prospective surgeon is board-certified.

Safety is an investment

And here we’re not talking about money but about facilities, time, and convenience. For Ms. Velasco, the deciding factor that pushed her towards a medical spa instead of a well-established clinic was the lack of appointments.

For many other patients, “strip mall surgeries” are a matter of saving a few thousand dollars. But equipping and maintaining a safe O.R. costs money – as does hiring extra staff such as nurses, P.A.s, or anesthesiologists. And in many cases, successful surgeries happen without these safeguards – but are you willing to risk your health on that wager?

5 things to ask your plastic surgeon before a BBL surgery to prevent bad results

Your surgeon will be the most decisive factor in your surgery’s eventual success. They must be thoroughly trained, transparent, and able to click with you and your goals.

But how can you tell if a surgeon meets this standard? Here are five questions you should ask during the initial appointment.

How many BBL procedures have you performed?

Practice makes perfect, especially in surgery. Before offering a specific procedure in their private clinic, a surgeon should have performed it extensively at a full-featured hospital or assisted a colleague.

The only exception is for extremely new or experimental procedures. In these cases, your surgeon should be able to tell you whether they attended a special course or seminar for it or have experience with a similar surgery.

What is your facility/clinic like?

Minor procedures such as fillers may be carried out in a comfy chair. However, liposuctions and BBLs require a sterile surgical set up, preferably within a full operating room. These should be separate from their regular office, waiting areas, and recovery rooms. If your surgery requires general anesthesia (going to sleep), then there will most likely be an anesthetist and extra nurses involved – make sure to ask about them too!

How big/small do you think I should go?

Ultimately, the final say on whether a surgery is worth it is up to you – and doctors can get their estimations or advice wrong. A plastic surgeon’s opinion is not final, and you should never accept a stranger’s opinion of your body with blind eyes!

And yet, a surgeon who agrees to any procedure without a proper examination is also not good news. An experienced plastic surgeon should know what’s realistic and what will look graceful. They should prompt you to picture the look of your BBL five years later and mention the possibility of scars. If they treat their craft like a restaurant menu, it’s best to shop around some more.

Dr. Sepideh Saber
Dr. Sepideh Saber

Are you board-certified? Where are you registered to practice?

Don’t take anyone’s word as gospel and check online registries anyway – but you can learn a lot about a doctor from their reaction to that question. Are they defensive? Non-commital? Evasive? Then look extra hard.

Do you have admission privileges anywhere?

A part of Ms. Velasco’s story that I kept returning to was that she spent close to eight hours in an E.R., scared and in intense pain. This is something that no patient should have to deal with after a major surgery.

Even under the safest conditions and with a Nobel Prize winner operating, any surgeon can have an unexpected outcome. But what sets good surgeons apart is that they will have systems in place for when complications happen. By having “admission privileges,” a surgeon can ensure you get a hospital bed and round-the-clock care quickly, should you need it, while significantly shortening or even bypassing a traumatic E.R. experience.

Dr. Saber – The go-to choice for BBLs near Los Angeles

Dr. Sepideh Saber is an American Board of Plastic Surgery-certified plastic surgeon practicing in the greater Los Angeles area. This Stanford University graduate offers a sensitive female perspective to patients of all genders and ages. For her, each plastic surgery is an opportunity to understand a patient’s ideals, values, and priorities. This individualized approach helps her provide her patients with the safest and most satisfactory experience.

To request a consultation, call 818-818-2939 or schedule a consultation online.

The practice of Dr. Saber is located in Encino, CA. We are convenient to patients in the Los Angeles area and Burbank, Pasadena, South Pasadena, San Marino, La Canada Flintridge, La Crescenta, North Hollywood, Altadena, Alhambra, San Gabriel, Rosemead, Monterey Park, East Los Angeles, Commerce, Huntington Park, West Hollywood, and Downtown Los Angeles.

Dr. Saber graduated from Stanford University’s world-renowned medical school and did her plastic and reconstructive surgery residency at the equally lauded University of Southern California. She then completed a fellowship at New York University in the extremely challenging and delicate disciplines of hand surgery and microsurgery.

Dr. Saber offers a more sensitive, female perspective for patients of all ages, genders, and orientations. Former patients from all walks of life have praised not only their treatment outcomes but her caring, thoughtful approach to a wide array of appearance and health-related matters.
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    Dr. Sepideh Saber, MD, FACS

    👩🏻‍⚕️ Board Certified Plastic Surgeon
    🏫 Stanford/USC/NYU Trained
    🏥 Encino, CA | Book a Free Consult
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    ✨ Our patient is 4 weeks post Tummy Tuck and Breast Reduction.

Her scars are a bit fresh. Overtime they will heal and become less visible. ✨

Give us a call to set up a complimentary consultation with #DrSaber who will create a customized plan for you!
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    Cheers to a weekend without rain! 🥳
    ✨ Our patient is 3 months post-op from our Tummy Tuck and Fat Transfer for her Breast Lift procedure. 

She wanted to avoid implants, so we opted in for the subtle augmentation. 
We are absolutely thrilled with her results✨

Give us a call to set up a complimentary consultation with #DrSaber who will create a customized plan for you!

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    ✨ Our beautiful patient came in for our Otoplasty procedure. Her after photo is only 3 weeks Post-Op. We are absolutely thrilled with her results!✨

Give us a call to set up a complimentary consultation with #DrSaber who will create a customized plan for you!

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    Happy Saturday 🫶🏼

  • What patients say about Dr. Saber

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    Over 16 Reviews

    I was fortunate to find Dr. Saber after researching board-certified surgeons who specialize in breast cancer reconstruction revision surgery. I knew I was in good hands from the moment I spoke with the lovely and efficient Marlene, Dr Saber's office manager. Dr Saber patiently listened to my concerns and, after examining me, explained what I could realistically expect the outcome to be from another surgery. She also explained to me that she would need to review my previous surgery notes before we could discuss a possible further surgery, which I found comforting and highly ethical. I also discussed a couple of other procedures that I would like done, including fat removal from my large upper arms that had caused me great embarrassment for several years. Dr. Saber is an excellent surgeon who is incredibly kind and genuine. She truly understands the female body and the emotional aspect of body insecurities yet, she is transparent about what can and cannot be done and takes time to discuss realistic expectations and outcomes. My breast reconstruction revision surgery will take place in the New Year, but in the meantime, I have the most fabulous upper arms that I recently flaunted in a strapless dress (something I have not done in years). Dr Saber is truly one of a kind, and I still cannot believe how fortunate I am to have found her. I highly recommend Dr Saber.

    Linda DeCarlo November 29, 2023

    I don’t have enough wonderful words to describe Dr Saber and Marlene! I had a tummy tuck done this year and from start to finish the entire experience was amazing. Marlene is always so helpful and works so hard to make every detail a breeze for you. When I had my consultation with Dr Saber I was at a point of complete agony with my body. She instantly took that stress and frustration off my shoulders! As a woman not being heard by doctors for years I left that consultation with happy tears knowing I had finally found my Dr. It was a major surgery and I felt completely zen and at peace going in because she really does make you feel that safe. I didn’t think I would ever look the way I do now! She gave me the gift of having the body I kept fighting for. I will never stop recommending her.

    Monica Prusa October 9, 2023

    I saw Dr. Saber when I broke my wrist. I ended up having to have surgery. She did an excellent job and I am healing nicely. She was very professional, but was also very kind and compassionate. I would highly recommend her!!

    Sandy Schaupp September 13, 2022

    I LOVED DR SABER!!! There are a few reasons why I chose her. One was because she’s a female Doctor that was my goal who also did a good job (which I was able to confirm with all her before and after photos) and what sold me was my safety in mind. She made me feel like I was in the best hands ever along with Marlene who coordinated everything THANK YOU LADIES! Dr Saber helped me get back the body I have always desired. I had a lot of stomach fat from weight gain and I lost weight so a lot of my weight was in my front lower and upper abdomen. Now I have a super beautiful curvy body like an hourglass after a tummy tuck and lipo she did. She understood the assignment hahaha . I’m 32 years old no kids just wanted to enjoy my younger body looking and feeling beautiful and she really took good care of me. Even after hours I had an emergency due to my fault but she was there and got back to me very quickly and I’m very grateful. I also think her work says a lot because I stopped taking pain medication on the 3rd day after surgery and was fine with very minimal pain I was able to tolerate the healing process. Highly recommend going with her I just had a wonderful experience and would do it all over again if I had too. Maybe after I have kids. Thanks Dr Saber and team <3

    STEPHANIE d July 15, 2022

    Dr.Saber is by far one of the best plastic surgeons. I love how she takes her time to explain any procedure to the patients understanding. She always makes sure to answers any and all questions.From fillers to body contours she’s the one you want.

    Katherine Melara February 15, 2022

    Dr Saber is amazing! She is caring and very informative. I went in for fillers and she explained procedure step by step. I highly recommend her and look forward to future visits.

    Amanda Vazquez December 18, 2020

    Dr. Saber was friendly, knowledgeable and professional. She took time to listen, answer all my questions and was forthright in her recommendations. Her staff was friendly and helpful. I was very happy with the results and plan on going back. If you are looking for a first rate professional experience look no further she is the doctor for you!

    T R December 18, 2020

    Dr. Saber is one of a kind plastic surgeon with a heart of gold. She is a well verse plastic surgeon that puts her patient's needs before anything else. She genuinely cares about every single patient, and her work speaks for itself. I notice every post-operative result on her Instagram (@saberplasticsurgery) the patients have this glow that radiates through. I have been going to Dr. Saber for my Botox for the past 3 years, and love the results every time. I know who I will be going to for any future plastic surgery needs, and will confidently refer family and friends to Dr. Saber for any Botox, fillers, and plastic surgery consultations.

    Rudy Garcia December 16, 2020

    I have nothing but great things to say about Dr. Saber! I am so pleased with my results from a breast augmentation she performed on me back in late June! She answered all my questions and concerns before and after my surgery. She’s very easy to get in contact with and she’s so nice. She made feel so comfortable throughout the whole process. 100/10 Lover her work!!

    Amanda Villegas October 15, 2020

    Dr Saber is hands down the best surgeon! She took her time answering my questions and explained procedure in detail. After doing liposuction six months ago, I am extremely happy with my results and I appreciate her so much.

    Marlene Cosentino October 15, 2020

    Dr. Saber is so kind and thorough with her patients! She is an amazing doctor and genuinely cars about everyone she comes in contact with. I would recommend her to anyone for any hand surgery or cosmetic procedure.

    Rachel Meach October 15, 2020