A Brazilian Butt Lift (BBL) is a cosmetic procedure that reshapes the buttocks and surrounding areas by using a patient’s own fat, which is harvested through liposuction and then strategically injected. While the procedure is highly effective for enhancing contour, patients commonly experience contour irregularities, often described as “dents,” depressions, or uneven texture, during the recovery process. Understanding their origin and the available corrective measures can provide a clear path toward achieving the desired smooth results.
Understanding the Appearance of Dents
These uneven contours arise from biological and mechanical processes following the fat transfer and liposuction components of the BBL. One common cause is fat necrosis, where a portion of the transferred fat cells does not establish a blood supply and subsequently dies. This non-viable fat can form firm nodules or oil cysts beneath the skin, which then create a visible indentation or lump on the surface.
Another factor relates to the distribution of the fat itself, which may be unevenly placed during the grafting phase of the surgery. If the injected fat is not spread in smooth, thin layers throughout the tissue, it can result in a lumpy texture or distinct depressions. The initial liposuction performed to harvest the fat can also contribute to irregularities if it is overly aggressive or unevenly executed, creating divots in the donor areas.
The body’s natural healing response involves the formation of internal scar tissue, known as fibrosis. These fibrous bands can form beneath the skin and contract over time, tethering the skin’s surface to the underlying tissue. This tethering effect pulls the skin inward, causing the characteristic dimple or indentation that patients often notice. Addressing these underlying causes requires targeted interventions.
Non-Invasive Corrective Methods
The first line of defense against post-BBL irregularities focuses on supporting the body’s natural healing processes and is primarily non-surgical. Manual Lymphatic Drainage (MLD) is a specialized, gentle massage technique that stimulates the lymphatic system, which often becomes overwhelmed after surgery. MLD is effective at reducing post-operative swelling and helps to prevent the buildup of fluid that can contribute to contour problems.
Deep tissue massage, once cleared by a surgeon, helps break up developing scar tissue and fibrosis. By applying focused pressure to hardened areas, a trained therapist can soften the fibrous bands pulling the skin inward. This mechanical action smooths contour irregularities caused by internal scarring.
The consistent use of compression garments is a powerful tool in managing and correcting minor irregularities. These garments apply steady, even pressure across the treated areas, which helps the newly sculpted tissue adhere smoothly to the underlying structures. Wearing the correct size and type of garment, often including specialized foam inserts, reduces swelling and prevents the formation of fluid pockets. Compression should be maintained for several weeks post-surgery, with the specific duration often progressing through different stages as recovery advances.
Surgical Revision Options
When irregularities persist beyond the initial healing period and non-invasive methods have been exhausted, surgical revision offers definitive solutions. The most common approach is targeted fat grafting, which involves transferring small, precise amounts of fat to fill specific depressions or divots. This procedure requires meticulous technique to blend the new fat seamlessly with the existing tissue and restore a smooth contour.
Revision liposuction is often performed concurrently, especially when the irregularity is caused by a ridge or bulge adjacent to the depression. This technique involves carefully feathering the edges of surrounding fat deposits to create a smoother, more gradual transition. Advanced tools, such as ultrasound-assisted liposuction, are helpful in areas with existing scar tissue, allowing for more precise fat removal.
For smaller, localized indentations, injectable dermal fillers, such as hyaluronic acid or poly-L-lactic acid (Sculptra), are an alternative option. While these fillers offer a non-surgical solution for minor corrections, they are temporary. The long-term durability and volume correction of fat grafting make it the preferred option for more significant contour deficits.
When to Consult a Specialist
The final results of a Brazilian Butt Lift are not immediately apparent, and minor irregularities are a normal part of the healing process. Swelling and the settling of the transferred fat can mask the final contour for several months. Patients are advised to wait until the initial results have fully stabilized before considering any form of revision.
Most surgeons recommend a waiting period of at least six months to a year after the initial procedure before a revision is seriously considered. This time frame allows the transferred fat to either integrate and survive or be reabsorbed by the body, providing a clearer picture of the final contour. Attempting a revision too early can be counterproductive, as the tissues are still healing and the extent of the irregularity is not yet fully defined.
When seeking correction, consult with a board-certified plastic surgeon who has specific experience in BBL revision procedures. Revision surgery is often more complex than the initial operation due to the presence of scar tissue and altered anatomy. A specialist can accurately diagnose the cause of the irregularity and recommend the most appropriate and effective treatment plan.