6 Essential questions to ask before a Brazilian butt lift

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A lot of surgeons now are beginning to perform Brazilian butt lifts. Fat grafting is a highly technique-dependent procedure, and some surgeons are having more success than others. Unfortunately, most surgeons do not see other surgeons’ work so it is hard for them to compare results. But you can!

The information you can get from asking these questions will help you pick the best surgeon!

1) Are you Board certified, and by who?

The first question you should always ask when consulting with a plastic surgeon prior to any cosmetic surgery procedure is, very specifically, “Are you board certified by the American Board of Plastic Surgery?”.

There are many surgeons who are Board certified in other specialties, or who are certified in cosmetic surgery by boards that are not accredited by the American Board of Medical Specialties. They take advantage of patients’ lack of information to appear like they are Board Certified by the American Board of Plastic Surgery, but they are not. Read more about the difference. If they are not being transparent about this, should you trust them?!

2) How many Brazilian butt lifts have you performed?

Be sure to get an actual answer. Likewise, your surgeon should be able to show you before and after pictures of at least 10 good results, preferably with some different body types in the mix. There should be some slender cases, some mid body types, and some heavy body types. This shows the surgeon has experience with difficult cases and you have a better chance of finding a body type you can identify with.

3) How do you perform the procedure?

You want to have the surgeon explain his technique so that you understand how he performs the procedure. The Brazilian butt lift has 3 distinct parts: Liposuction, Fat Processing, and Fat Reinjection. Each component’s process is critical to the success of the entire surgery:

Liposuction

The fat removal via Liposuction should be done with a fine thin cannula to get smooth even Liposuction results. Typically, a total of three areas of Liposuction are performed. If a large cannula is used, the fat will come out faster, but the Liposuction results may not be smooth. Therefore, the use of a thin cannula will make the procedure longer, but the results should be better!. The Liposuction should be done at low suction pressure to preserve the delicate fat cells.

Fat processing

The fat should be centrifuged at low gravity forces for brief periods of time. If not, debris, and unhealthy or dead cells will be mixed in with good cells used for reinjection into your buttocks, and the fat will not last.

Fat reinjection

The fat should be reinjected using small cannulas in minute quantities, the so called micro droplet technique. This ensures that the result will last long term. If the fat is injected in large bunches (instead of small quantity injections), it will not take permanently.

4) How long will my surgery take?

Because of the meticulous way the fat has to be extracted (liposuction),  processed, and reinjected to get a permanent result, the surgery is time consuming. Typically, a Brazilian butt lift will take 5-8 hours. Overall, it depends on the amount of liposuction performed (to get the most fat) and the amount of fat to be reinjected into your buttocks. A general guideline is:

  1. Liposuction of 3 areas: minimum 2-3 hours
  2. Fat processing: varies and can be done simultaneously
  3. Fat reinjection: minimum 2-3 hours

You want to have a feel for time in surgery because shortcuts compromise quality resulting in less predictable results. If a surgeon quotes anything less than 4 hours, he’s probably taking significant shortcuts. If performed by one plastic surgeon, it is typical for the procedure to last 5-8 hours. Typical shortcuts which can compromise results are:

  • harvesting the fat with large cannulas (instead of thin cannulas)
  • not centrifuging the fat (to separate the debris, unhealthy, or dead cells)
  • injecting the fat into the buttocks too fast or in large quantities

Any of those shortcuts can result in poor surgical outcome, or the results may not last. Furthermore, if someone is assisting your surgeon with the liposuction or fat injecting, he/she should be a board certified plastic surgeon as well. A surgical tech should not be doing the liposuction or the fat injections! So make sure you know who is performing all parts of the surgery.

5) What is your idea of the best result for me?

You should expect the surgeon to address how your whole body looks, not just enlarge the butt. The waist to hip ratio is very important, so I also pay attention to the hips and I discuss with the patient if she will want fat injected into this area. Too many patients focus on volume of fat retention or how many cc’s they want rather than what looks good. Remember, the objective is to have a great looking body, not just a big butt. Ask the surgeon to describe what he thinks will produce the best result for you, specifically, paying attention to your whole body, not just your booty.

6) What is the likelihood that I will need a revision or touch up? Cost?

This is the acid test. If a surgeon tells you that you might need a touch-up, you can count on it. If the surgeon is vague about redos, he probably has had to do more than he would like to admit.

Touch-ups and redos become necessary because the fat is reabsorbed, which is caused most frequently by taking shortcuts in technique. After over 200 cases of large volume (over 400cc per buttock) Brazilian butt lifts, I have not had a single patient who has needed a redo because of a graft loss. Over ten years, the only few patients who returned for more surgery, were satisfied patients who had gained weight since their original surgery, and wanted more fat injected, for an even bigger result.

The surgeon or his staff should have a clear policy for billing touch-ups/ redos and you should know what it is. A low cost Brazilian butt lift is no bargain if you need a redo!

So, that wraps up the questions you should be asking if you’re considering a Brazilian butt lift. Make sure you get answers to those essentials during your consultation. The plastic surgeon will appreciate your diligence and attention to detail. If not, find another surgeon. In fact, I would also add another valuable piece of information to consider prior to choosing any Doctor, and that is to check out the Doctor’s reviews. The Doctor and his staff believe in their own capabilities, but reviews let you know what previous patients have experienced. Useful places to get patient reviews include ASPS, Doctorbase, RealSelf, etc.

Wondering if a Brazilian butt lift is right for you?

I am a board certified plastic surgeon, boarded by the American Society of Plastic Surgeons and I have been in practice for more than 25 years. I am also a member of the Gluteal Safety Task force, which issues recommendations for safe Brazilian butt lift procedures. Contact Us to schedule your in-office or virtual consultation for just $30 (which gets applied to your surgery when you book). Or just give us a call at 410-494-8100! Note: Virtual consults can also be used to get second opinions.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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