Brazilian Butt Lift

Buttock augmentation in the form of fat injection or the Brazilian butt lift is a fat surgery. Fat is the storage compartment. When you take in calories that you do not burn that very second they are stored as fat. What you do with the Brazilian butt lift is to liposuction fat away from places we do not want to fat and move it to the buttocks, to lift shape and shade the buttocks.

What is Brazilian Butt Lift?

What you are physically doing is liposuction in the abdomen, back and flank, collecting this fat, removing the blood, fluid and ruptured fat cells and then re-injecting the fat into the buttocks using multiple small volume injections in multiple planes. If you remove 3000 mL of fat with liposuction all of this is not available for injection approximately 1/3 of which liposuction is good enough to be used for injection. This would leave about 1000 mL from the injection. 65% of the fat you inject should survive to give a permanent change in the buttocks.

Brazilian Butt Lift Recovery

The hardest part of the Brazilian butt lift is preserving the injected fat. This requires 10 days of not sitting and sleeping on the stomach. Sitting and putting pressure on the buttocks will kill the fat cells and cause an suboptimal result. The pain of the procedure is essentially the pain from liposuction. The patient will have a hard night the first night but then much better by the second of the night. Most patients require pain medicine for only 4 to 5 days. There is no exercise for two weeks, after that, light treadmill level of exercise can be done. Four weeks must pass before heavy exercise can be done. It takes 2 to 3 months before all the swelling resolves and you get the final look. Lymphatic massage is the best way to speed up the resolution of the swelling and ensure the best results.

The complications associated with fat injection include pulmonary embolism, deep vein thrombosis, fat embolism, drug toxicity, and the complications associated with anesthesia.

Liposuction with fat injection is one of the procedures in plastic surgery that probably makes the most profound change in the patient’s appearance. A flat stomach is nothing without a curve.

Brazilian Butt Lift Explained

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Hello! This is Dr. Perry. Today we’re going to be doing the Brazilian Butt Lift consultation.
The Brazilian Butt Lift is a liposuction and fat transfer. What we’re doing with the Brazilian Butt Lift is changing storage locations for calories.
Fat is a storage compartment. If you take in any calories, and you do not burn the very second you take them they are stored as fat. Everyone is born with a certain number of fat cells, in certain concentrations and certain locations.
The areas that have the highest number of fat cells store the most calories. These areas are called the problem areas. These are areas where we gain weight first and lose weight last.
What we’re doing with liposuction is trying to get an even concentration of fat cells. The absolute, perfect liposuction we leave an equal amount of fat cells head to toe. So if you gain a pound, you gain it evenly.
Liposuction works because fat cells don’t replicate. We’re all born with a certain number of fat cells at certain locations. If we gain weight, each cell gets bigger. And if we lose weight, each cell gets smaller but the number stays the same.
If fat cells replicate, liposuction would never work. If you took one cell away and another one grew right back in its place, your back to square one.
Perfection in liposuction is in equal concentration head to toe. It is not perfect to take all the fat cells from one place because if you take all fat cells from one place, you’re condemning someplace else to gain weight. Theoretically, if you take all the fat cells from the shoulders down, from the body, legs, arms, if someone gained weight, they gain all the weight in their neck or their head. That would be a disaster.
So perfect is not taking all the fat cells from a place. Perfect is getting an even distribution. If I can get that same concentration of fat cells in the back, waist and hips, then we will have a smooth curve. If you gain weight, you will get wider but the curve will be intact because the concentration is the same. If you lose weight, you will get smaller but the curve will stay.
Now, when we do a fat transfer, what we’re doing is we’re increasing concentration of fat cells in the buttocks. So we’re making it the problem area. We’re going to make it the place that gains weight first and loses weight last.
What we’re doing physically when we do this transfer of the buttocks is a non vascularized tissue graft. Like a skin graft. We’re taking the fat cells away from the body where they have a blood supply. We’re putting them in the buttocks where they have no blood supply.
The fat cells that get blood supply will live and give a permanent result. The fat cells that don’t, die. Best case scenario 70% of what we put in will live and give permanent result. We’re going to lose 30% no matter what you do. If you float in the sky, if you stand on your head, you’re still going to lose 30%.
Now, in my patients, I see that loss of 30% in the first three weeks. I think whatever is there in three weeks, is there. I think after three weeks sitting, moving will not affect the cells. I think they’re either alive or dead.
Now, what we ask after surgery is not to sit for 10 days. Ten days is really an arbitrary number, just greater than four or five days. Blood vessels start to grown at day 4 so the first four or five days is when the fats are weakest. After that, it’s getting stronger and stronger.
There is no difference between Day 9 and Day 11. There is no magic day where the cells live. It’s just Day 11, the cells are slightly stronger than Day 9. I think the time that it doesn’t make any difference is three weeks. From 10 days to three weeks, we just start to sit but we don’t sit for hours. We sit for 30 minutes, stand up for 10 seconds, move left, move right. Don’t keep pressure on that same area or one area for the entire time.
That’s the idea of what’s happening, what we’re doing with the surgery so far as the liposuction and the transfer. Physically what are we doing? Physically we’re coring out fat cells. We make it solid and make it into a Swiss cheese or sponge. If you did a cross section, it will look like sea sponge. All the holes where we took the fat cells away will fill up with water, these holes fill with water and that’s what the swelling is. The swelling physically is fluid in the holes where the fat cells were. The swelling goes away by all those holes healing and scarring closed. Each of those holes will scar close. When its scar close, there’s no place for the water to go and that’s when the swelling goes away. I always think of our post-operate regime as collapsing the sponge. I’m going to put on a tape garment or a tape cast. I’m going to make a cast out of a tape to squeeze you and collapse the sponge. We’re going to put a garment on and squeeze it and collapse the sponge.
We’re going to have you do massage. I’m going to teach you how to do your own massage because my results are better when people do their own massage as opposed to when they go out and get a lymphatic massage. All I’m trying to think about is collapsing the sponge. If I have a tissue separated by water, it cannot scar together so we have to push that water out and get it to scar together. The swelling will be like an accordion. It’s going to go up and down throughout the recovery. What’s going to happen is maybe the first day 1% will scar closed and the swelling come back 99%. The next day 98%, the next day 97%, then 96%. Three months later, it will be 100% scarred.
If we start off with something 4 inches thick, after the liposuction is something this thick will scar and collapse into a pancake. So we might start off with something like 4 inches thick, it will collapse into something 1/2 inch thick. That’s what’s making the skin contract. It’s that collapse that helps the skin to contract. You can see, if you look at the muscle, the skin is very far away. Now, the skin is very closed. When you do superficial liposuction correctly the skin will always contract. It’s not a question of if the skin will contract it’s a question of how much the skin will contract. The scarring of the liposuction is what’s doing this. That’s part of the reason why the skins contracting. Physically, that’s what we’re doing decreasing the concentration of fat cells were we don’t want them. Again, when we do the fat transfer, we’re adding those fat cells where we do want to. There getting a blood supply, they’re living. And we are storing more calories in the buttocks where we want them.
Now so far as recovery goes. First day hurts. On the first night you’ll be wondering why you did it. It really hurts. It’s throbbing, achy, bruising kind of pain.
The second day it starts to get better, maybe 20% better. Day 4, Day 5 you start to turn the corner. Maybe the pain is down by 30%, maybe it’s down by 40%. But then you get better and better. The key to getting better faster is eating, drinking and moving. This surgery is an injury. In order to heal from an injury, in order to make scar tissue you will need protein. Your metabolism will increase in order to heal. So you have to eat more than normal. Instead of 40 grams of protein, now you got to eat 50 because you need that scar tissue to heal. If you don’t eat, if you don’t have protein, you cannot make scar tissue. You cannot heal the swelling will stay.

The only place in your body that stores water is your vascular system. That’s IN your blood vessels. So whenever you have swelling, the water is coming out of your vascular system. Swelling makes you dehydrated. So, if you don’t drink and you’re swollen, you’re going to be dehydrated. If you swell one gallon of water into your tissue, you got to drink one gallon of water. The people who get better faster, eat, drink, move and don’t take a lot of pain medicine. If you take a lot of pain medicine and you feel worse Day 4 than Day 2, it’s the pain medicine. Nothing wrong with after surgery taking Motrin or Aleve for pain. The people who use these get better faster then the ones who take a lot of narcotics.
If you stretch from Day 1, you’ll never get stiff and you will avoid pain of stiffness. If you pull into a ball, then you just have pain and you keep pain. So far as the recovery these are the things we should do to try to get better. no sitting for 10 days. Two weeks without exercise. Mild exercise for two weeks, heavier exercise at four weeks. Garment day and night for 24 hours for one month, then you can start to back off. After a month your activity and the garment are based on trial and error. You can do anything that doesn’t make you have additional swelling. You can take garment off. When you take it off, you don’t have additional swelling, it’s fine to be off. Everything is a trial and error. If you take off the garment and you get swollen afterwards, put it back on. If you do some treadmill and you get swollen afterwards, stop doing the treadmill. Come back and try it week later, two weeks later. It’s kind of trial and error.
The only thing we’re judging by is that you don’t have additional swelling with that activities or when taking the garment off.

It will take three months for you to have your best look. Nobody looks their best at one month. Everybody looks better at two months than one month. So you just have to let those areas heal.
Again, we’re going to have you doing self-massage that we’ll teach you. We’ll use body weight. We’ll use yoga rollers and we’re just going to collapse your swelling like a sponge using these things. The people that do the self massage have best results. That is essentially the recovery.

The complications, we have to be concerned about is the next topic. This is general anesthesia procedure. Whenever you have general anesthesia, the chance for blood clot, and for pulmonary embolism. While you’re in surgery, you’ll have a machine on your leg called a Sequential Compression Device that squeezes your leg. That keeps the blood moving and prevents clots. After surgery, it’s moving and drinking prevents clots. The setup for a clot is a person who’s dehydrated and doesn’t move. If you’re dehydrated the blood’s thick, it clots. If you don’t move, the blood sits still and clots. The night after surgery, you got to get up and move. Moving prevents clots, even just flexing your feet, tapping your toes, or moving your legs makes the muscles contract and prevent clot formation. Clots usually start in your legs. What you will see one leg swollen and painful, the other one normal. The dangerous thing is called the pulmonary embolism. The clot breaks from the leg and goes to lung. That will cause chest pain and shortness of breath. Chest pain and shortness of breath is the 911 of this whole thing. If you have chest pain and shortness of breath, you don’t call me, you don’t call mom. You call 911. That is the emergancy of the whole situation. Fat embolism. Fat embolism is fat getting into the blood stream when you do the fat injection. There’s nothing you can do about this. It’s how I inject the fat that decreases the chance of that happening.

I inject with my hand so it’s low pressure. I inject small amount at a time. When I inject small amounts the chance of getting fat into the blood stream is less. I might inject 1 cc, 2 cc per injection. If I have 1,000 cc that means I make 500 injections to put it in. That is how I get better result and that is how I get safer results. When I put small amounts in many places, I have a greater surface area. Greater surface area mean a better blood supply and better fat survival. If I just put one big glob of fat the chance of me getting 70% fat take is non-existence. All the fat inside of that glob will die, because it has not blood supply. Also by putting small amounts the chance of me forcing fat into a vessel is very unlikely. The last thing that prevents fat embolism is I inject the fat while withdrawing the cannula. If I’m near a blood vessel, I do not stand still and inject. I’m always going to be backing away when I inject so I’ll never be in the same place for any period of time and this makes it less likely to force fat into a blood vessel and retrograde back to the lungs.
Infection can happen within the operation. Fever, pain, chills is a sign of infection.

The last thing so far as complications have to do with anesthesia. This is general anesthesia. You might have an allergy to anesthesia. You might have atelectasis , lung collapse after anesthesia. You might have pneumonia after anesthesia. You’ll could get laryngeal spasm after anesthesia. These are the complications of anesthesia.