A Brazilian Butt Lift (BBL) is a cosmetic procedure that reshapes the buttocks using a patient’s own fat. The process involves harvesting fat via liposuction from areas like the abdomen or thighs, purifying it, and then strategically injecting it into the buttocks for enhancement. The permanence of the BBL is nuanced: fat cells that successfully integrate will remain permanently. However, not all transferred fat survives the initial process, meaning the final, stable result is typically a percentage of the volume initially injected.
The Science of Fat Survival
The core principle determining permanence in a BBL is the viability of the transferred fat cells, known as “graft viability.” After harvesting through gentle liposuction, the fat must be carefully processed, often via centrifugation, to separate viable cells from damaged cells, fluid, and oil before re-injection. This careful handling is important because fat cells are delicate and easily damaged.
For the transferred fat cells to survive, they must establish a new blood supply, a process called neovascularization. The cells initially rely on surrounding tissue for nutrients. Over three to six months, survivors integrate by connecting to the host’s vascular network. Once this connection is established, the fat cell is a permanent part of the body’s natural fat stores.
During this initial healing phase, a portion of the injected fat will not survive and is naturally reabsorbed. Patients typically expect a survival rate of 60% to 80% of the transferred fat, though figures vary. The volume remaining after three to six months is the stable, long-term result of the BBL. This surviving fat behaves like any other fat in the body, responding to weight changes and aging.
Factors Influencing Initial Graft Retention
The percentage of transferred fat that successfully survives and integrates depends on several variables. The surgeon’s technique is a significant factor, particularly the methods used for fat harvesting and injection. Gentle liposuction techniques use lower suction pressure, minimizing trauma to the fat cells and increasing their viability before transfer.
The injection method is also influential. Surgeons use a micro-droplet technique to place small amounts of fat throughout the tissue. This prevents large fat clusters, allowing each injected cell to establish a new blood supply. Poor technique can lead to fat necrosis, where cells die and form hard lumps or cause contour irregularities.
Post-operative care is critical during the first few months after the procedure.
Post-Operative Care
- Avoiding direct, sustained pressure on the treated area, as compression can crush new fat cells.
- Avoiding smoking, as nicotine constricts blood vessels and compromises circulation.
- Maintaining a stable, healthy weight.
- Ensuring proper nutrition to support the healing process.
Long-Term Maintenance and Stability
The fat cells that successfully survive integration are permanent, but the stability of the aesthetic result depends on the patient’s lifestyle. Since the transferred fat is living tissue, it responds to systemic changes, particularly weight fluctuations. If a patient gains significant weight, the fat cells in the buttocks will expand and grow, increasing the size and altering the shape of the augmented area.
Conversely, significant weight loss will cause the transferred fat cells to shrink, reducing the size and projection of the buttocks. Maintaining a stable body weight is necessary to preserve the final contour. Changes exceeding 10 to 15 pounds can noticeably impact the results.
The natural process of aging also affects the long-term appearance. Over time, skin elasticity decreases, and gravity can slightly change the shape and firmness of the buttocks. While the fat cells remain, changes in surrounding skin and underlying tissues can subtly alter the overall aesthetic result years after the procedure.
Addressing Potential Revisions
Even with optimal technique, the final volume or shape may necessitate a secondary procedure. Some patients experience higher fat reabsorption, resulting in a smaller final volume. This may be corrected with a “touch-up” BBL, which involves harvesting and injecting additional fat to achieve the desired volume or correct subtle asymmetries.
Revision surgery is also required to address contour irregularities, such as dimpling or unevenness, which occur if the initial fat grafting was inconsistent. During a revision, the surgeon strategically injects fat into depressed areas or performs minor liposuction on areas with excess volume to smooth the contour. Patients must wait at least six months after the initial BBL before undergoing a revision to allow swelling to subside and fat retention to stabilize. These secondary procedures aim to refine the results but can be more complex due to scar tissue from the initial surgery.