Brazilian butt lift reversals and buttock restoration

The Brazilian butt lift (BBL) is still a popular procedure for buttock enhancement and augmentation, but there is a growing number of patients that wish to reverse their BBL results.

During a BBL, unwanted fat is harvested from other areas of the body, such as the abdomen, back, thighs or flanks, through liposuction and liposculpting. The harvested fat is then injected as microdroplets throughout the fatty layer of the buttocks to create a fuller and more lifted appearance. With weight gain or exaggerated BBLs, the size of the buttocks may become disproportionate to the patient's body.

In recent years, more and more patients have been looking to reverse their BBL procedures to achieve a more natural look. Some now claim it's the "end of the BBL era" that was led by celebrities like the Kardashians.

Why do patients want to reverse their BBLs?

Patients may wish to reverse or undo the results of a BBL because of various reasons, such as dissatisfaction with the outcome, an exaggerated augmentation, asymmetry, cellulite or changes in personal preference and trends.

For some, the result of a BBL may be unwelcome when the newly created buttock size does not match the rest of the patient's body. This can happen when large-volume fat transfer is performed in order to create excessively larger buttocks.

Another cause of a mismatch between buttock size and a patient's body is weight gain. Weight gain can result in further expansion of the fat cells within the buttocks and, thus, additional buttock enlargement. Unfortunately, this enlargement is not always uniform and thus may create a less-than-desired buttock shape.

More recently, patients are seeking BBL reversals due to a shift in personal preferences and trends. Over time, an individual's aesthetic preferences and desires may change, and they might no longer desire the enhanced appearance achieved through a BBL. The popularity of enhanced buttocks from the past decade, led by some celebrities, is no longer fashionable as trends continue to shift and evolve.

What are the options for BBL reversal?

Some believe that BBL reversal is as simple as performing liposuction on the buttocks, but it can be more complex. Liposuction only works for a small number of patients.

One of the main considerations for whether a BBL reversal will be successful is if the initial BBL was performed correctly. If fat was injected above the muscle layer, then BBL reversal can be performed. Keep in mind that if your surgeon performed the BBL by injecting fat into the gluteal muscle, fat in that location cannot be safely removed. In these situations, a traditional butt lift to remove buttock tissue and lift and reshape the butt may be recommended.

Another consideration is skin elasticity, or the skin's ability to contract after being stretched. As we age, skin elasticity declines. Fat is what helps the buttocks retain their shape, so if fat is removed, skin that has poor elasticity could sag or become unshapely. This can affect the quality of the results. In such cases, skin tightening procedures or the removal of excess skin during surgery may be necessary.

How is BBL reversal achieved?

Since a BBL is performed by injecting fat into the buttocks, one may assume that removing fat via liposuction would solve the created problem. However, buttock liposuction can result in loose buttock skin that can appear as contour irregularities, just like a weight loss patient. Liposuction alone only works for patients with a high degree of skin elasticity.

The presence of loose skin after buttocks liposuction can vary depending on several factors, including the elasticity of your skin, the amount of fat removed and the patient's age.

Here are some key points to consider:

• Skin elasticity: Younger individuals typically have more elastic skin, which tends to retract better after liposuction. On the other hand, older individuals or those with reduced skin elasticity may experience less skin retraction, leading to the possibility of loose skin.
• Amount of fat removed: If a significant amount of fat is removed from the buttocks, it may lead to loose skin, especially if the skin's elasticity is compromised. When a large volume of fat is removed, the skin may not be able to fully contract and conform to the new contours.
• Liposuction technique: The liposuction technique used can also impact skin retraction. Ultrasound-assisted liposuction can stimulate collagen production and improve skin tightening to some extent.

Not everyone will be able to have BBL reversal only with liposuction. The choice of the technique needed is dictated by several factors:

• How big are the buttocks relative to the rest of the patient?
• How much reduction is desired?
• Is there skin sagging and laxity?
• Is there buttock cellulite and dimples?

Your plastic surgeon may look at a few different options depending on your needs.

For those who need minor to moderate reduction and have excellent skin elasticity, your plastic surgeon may use ultrasound-assisted liposuction to remove the excess transferred fat while sculpting and reshaping how the buttocks look.

In most cases, patients who want a BBL reversal don't want to return to their original appearance. Many patients still want an enhanced look, just not as dramatic as their initial result. Careful liposuction can be done to only remove the excess fat and leave the patient with the volume and shape they desired in the first place.

However, if you need a moderate to significant reduction, then your plastic surgeon may employ a buttock restoration and reshaping approach to reduce, lift and reshape the buttocks to create a smaller but lifted and perkier butt.

What else should you know about BBL reversal?

Liposuction by itself will not produce the best outcome for most patients since it will also result in buttock skin laxity and dimpling. A suitable buttock restoration technique reduces the buttock volume, lifts the buttocks and reshapes them to result in a perkier but smaller version of your buttocks. This approach is custom-made for each patient, and it is even possible to change the buttock shape from a boxy or V-shaped butt to round or heart-shaped buttocks.

It is important to note that any surgical procedure comes with potential risks and complications, this includes reversing a BBL. If you are considering a BBL or its reversal, it is crucial to consult with a qualified and experienced, board-certified plastic surgeon who is an ASPS Member Surgeon to discuss the options, potential outcomes and associated risks specific to your situation. Always prioritize your safety and make informed decisions about any cosmetic procedure.

After the procedure, you will need to follow your plastic surgeon's postoperative instructions for a smooth recovery. This may include wearing compression garments, avoiding sitting or putting pressure on the treated area for a certain period and taking prescribed medications to manage pain and reduce the risk of infection.