How much volume can be added?
Fat transfers, such as a Brazilian butt lifts, rely on the same principles as other forms of tissue grafting. In order to remove tissue from one area and graft it into a new area, it must be handled gently, be made up of small particles and be grafted into or surrounded by vascular live tissue.
Once the tissue has been transferred or grafted, it needs to stay immobilized for a minimum of 10 to 12 days.In order for tissue transfer to be successful, each grafted particle needs to develop a new blood supply. This is referred to as neovascularization and happens between the 5th and 10th days after tissue transfer.
In determining how much tissue can be transferred during any single session, all of these factors need to be taken into consideration.If too much fat is attempted to be transferred in a single session, then each small particle of fat will not be surrounded by living vascularized tissue but rather by other grafted fat particles. When this happens, the total percentage of fat that survives is decreased.
This then leads to more fat necrosis, scar tissue and dead tissue that needs to be absorbed by the body. Our general rule of thumb is to never attempt to transfer more tissue than would double the initial volume of the area treated. For example, if the buttocks before treatment has a volume of 1500 mL, then no more than 1500 mL should ever be attempted to be grafted in a single session.
Of the tissue transferred, only a certain percentage will survive. The percentage of tissue that survives varies greatly both in opinion and in research.If all the above described principles are perfectly adhered to, then the percentage of graft survival can be very high. The reverse is also true.
There have certainly been many patients who have undergone fat transfer and a year later are disappointed to see little to no change at all. Some patients are better candidates than others. Overall young, healthy, non-obese and nonsmokers tend to do the best.
The expertise and skill of the surgeon is of paramount importance.Any provider performing these procedures who are not properly trained or have a grasp of the fundamentals of tissue transfer will not have consistent high quality results. I suggest you consult in person with an experienced board-certified plastic surgeon who specializes in these type of procedures. (Mats Hagstrom, MD, San Francisco Plastic Surgeon)
Brazilian Buttock Lift Volume
In the majority of cases where fat is going to be grafted into the buttock it is safe to graft 500 mL to 1500 mL into each buttock. In my experience, most women need at least 750 mL into each buttock to achieve satisfaction.
The majority of the fat should be grafted into the gluteus maximus musculature because of the profuse blood supply as compared to this subcutaneous tissue of the buttock. It is also important to place fat into the subcutaneous tissue to feather and sculpt for precision and smooth contour.
The grafted fat also has an effect on the skin and makes the skin smooth with improved texture. We see this effect went fat is grafted into the face. I have grafted up to 1500 mL into each buttock and in my personal opinion this should be the upper limit. I believe you reach a point of diminishing returns when too much fat is grafted because there is just not enough blood supply for enormous amounts of fat to be placed into a confined area. Too much grafting can lead to hard lumps, fat necrosis and death and eventual severe infection and even necrosis and death of the overlying skin. This procedure should be safe. The consensus among the majority of fat grafting specialists who attend our symposiums suggest a range of 500 mL to 1500 mL as I have outlined above. Personally, I have performed over 1000 of these procedures and have never had a complication or an infection. I think the biggest complaint is women want to be too big and they don’t understand the necessary precautions which need to be taken to make the procedure safe. It is much better to come back in a year and have more fat placed than to put too much in the first session. (James Fernau, MD, FACS, Pittsburgh Plastic Surgeon)
A fat transfer to the buttocks is also referred to as a Brazilian Butt Lift or BBL. The end result is totally dependent on the amount of fat that can be safely transferred from other areas of the body to the buttocks. (David Finkle, MD, Omaha Plastic Surgeon)