When the Hype Exceeds Reality in BBL

I have been a Board Certified Plastic Surgeon for quite some time, being in private practice for more than 20 years. I have been doing fat transfers to the buttocks since before it was called a Brazilian Butt Lift, and continue to perform this procedure more than 150 times a year. I think I get great results, yet I hear some disappointment from patients more than with all other surgeries. Am I just not good at the surgery, or is it something else?

When I compare my results to those seen in the Plastic Surgery journals, I feel they exceed nearly all in effectiveness and fat take. That makes me confident I am doing it well. So why are some people not thrilled? I blame social media.

People watch reality tv, look at photoshopped pictures and posts, and feel that it doesn’t matter what they start with, that a good plastic surgeon can do anything. This is unfortunately not true. The amount of fat you have, the bone and muscular structure, and metabolism are all factors beyond our control. I have miraculous changes walking around who are upset that with white lycra tights, there is a slight difference from side to side, even if they started out horribly asymmetrical.

My choices are to either stop offering the procedure, or to continue to try and educate each patient as to what is possible and what is not. I am not ready to stop. Be realistic and accept a great result. Perfection is sometimes the enemy of happiness.


Half Year Report

It is now July, which means half of 2016 is gone.  The older you get, the faster the time slips away from you.  As you know, I always do a year end review of my results so I can keep my quality at its best.  I thought I would reflect on a few trends I have found in the first half of 2016.

Surgical demand remains high, and I continue to see an increase in Brazilian Butt Lifts.  I have done as many as four in a single day, and this year should do more than 200.  I have a long experience and have honed my technique to get the best results, but there are still limits to how much fat will stay, and it is very patient dependent.

I continue to be the tummy tuck guy, approaching 200 a year as well.  I have changed my suturing technique for the muscle, and have been even more pleased.  I continue to do “retucks”, abdominoplasties after others have done them in the past.  Challenging, but very rewarding.

I have assembled a great staff, and continue to strive for the best patient experience.  We are more automated, trying to go fully paperless this year.  I pads are in increasing use, and the tech continues to help us give a better experience.

As I am now officially in my 20th year of private practice, I want to thank the tens of thousands of you who have come to Yager Esthetics.  We are the Latino beauty experts, in the community for the community.


Brazilian Butt Lift Experience

I have been doing Brazilian Butt Lifts (BBL) or fat transfer to the buttocks for over 15 years.  I do more than 150 of them every year, so I have learned a few things that may help you if it is a procedure you are considering.  I will start by saying that the great majority of my patients are very happy with the results, and that every single one has an improvement in the size and shape of the buttocks.

I am confident that the surgery works.  Technique of fat removal, the cannulas used to both remove and inject the fat and how you treat the fat are all important.  Without getting technical, the less you do to the fat cells, and the quicker they are replaced in the body, the better the results in my hands.

How you take care of yourself for the first few weeks, including sleeping position and the avoidance of sitting, are major factors in fat survival.  If any doctor tells you you can do a BBL with a Tummy Tuck or Breast or Face procedure, do not do the operation.  Sitting or lying on your back, even if you use a donut pillow, will not give the best results.  You can do other surgery, as long as you can lie on your stomach after.

Laser or Ultrasound liposuction fat should not be used in fat transfer.  This fat is damaged and unsuitable for transfer.  Make sure tumescent technique is used for removal of the fat.

There are some areas in certain patients where fat will not survive as well.  Even if the surgeon does everything right, fat can disappear or take more on one side versus the other.  Also, there is a limit to the amount of fat that will survive, which is determined by the circulation and oxygen availability of the area being treated.

People who do not have enough fat for transfer will not get a good result with temporary weight gain to have more fat.  When you lose weight, you lose fat.  They are also poor candidates for buttock implants, which I do not feel are good for virtually anyone.

Choose your BBL surgeon carefully.  Go to www.plasticsurgery.org to make sure they are a Board Certified Plastic Surgeon, and ask how many they do a year, and see lots of before and after pictures.  You are in charge, so be selective.