Welcome to our page on the healing process from the Brazilian Butt Lift (BBL), also called a buttocks fat transfer, fat grafting or augmentation procedure.
The recovery process for a BBL lasts up to 6 weeks after surgery. This is because patients should avoid putting prolonged pressure on their buttocks (lying down or sitting) for the first 3 weeks to prevent pressure necrosis or tissue death of the transferred fat cells. Most patients will return to work around 2 weeks after their operation, and can expect to experience moderate pain, bruising and inflammation through the first 3 weeks after surgery. Strenuous exercise and weight lifting should be avoided for the first 6 weeks of recovery. You can read more specific recovery instructions below.
It is important that your procedure be conducted by a board-certified plastic surgeon with hospital privileges and experience with the type of surgery you will undergo. You can schedule a free, virtual consultation with one of our surgeons or check out their before and after results on our website.
What is a BBL?
A Brazilian Butt Lift (BBL) is a procedure that combines liposuction and fat grafting techniques to augment the volume of the buttocks and/or hips. A common goal is to decrease the waist-to-hip ratio (WHR) to 0.7 or less to “feminize” the body shape.
The surgery consists of two parts. In order to collect fat to transfer into the desired area, it must be first collected via liposuction from “donor sites” using a sterile suction tube called a cannula. Small incisions are made by your surgeon in the donor sites to liposuction fat out of them. Typically, the patients select the abdomen and back (or flanks) as donor sites. Patients can also have fat taken from the arms or thighs if they would like.
The second part of the surgery involves processing or purifying the fat so that it has a better chance of survival once it is transferred into the buttocks and/or hips region. The surgeon will then make small incisions–mostly on the top, but also in the bottom of the buttocks shelf–to inject fat subcutaneously: between the skin and the muscle.
An experienced surgeon will “overfill” the area since only 60% of the fat injected tends to hold in the long term. The final amount of fat injected will depend on the amount you surgeon can gather from the donor sites, the quality of the fat, and the anatomy of the buttocks/hips region.
What is the difference between a Brazilian Butt Lift and other “lift” procedures like a breast lift or a tummy tuck?
While termed a Brazilian Butt Lift, this is not like other “lift” procedures (such as a facelift or abdominoplasty/tummy tuck) because skin is not excised and “lifted.” That said, if you have excess skin that you would like to be removed, this can often be combined with a liposuction and BBL procedure.
It is important to note that in recovery, most pain comes from liposuction and the excision of skin. Fat grafting may also result in some soreness and bruising, though the majority of inconvenience that patients face in recovering from a BBL comes from not being able to put pressure on their posterior for about a month post-op.
Our board-certified plastic surgeons have experience in body contouring procedures to help patients meet their desired results. You can schedule a free, virtual consultation with one of our surgeons today to create a unique plan for meeting your goals and to discuss any specific questions you might have about recovery.
Where can I get my fat removed from to augment my buttocks?
The first step of a BBL is harvesting fat: removing it with liposuction and purifying it so that it can be grafted into the buttocks. Liposuction is a procedure designed to remove stubborn, unwanted fat deposits in areas of the body that do not easily reduce with diet and exercise.
Most often, fat is grafted from the abdominal area for a BBL. Patients can also often solicit liposuction in the following areas pictured below: the upper arms, the waist or trunk and/or the thighs.
The first 24 hours after surgery
You will wake up after surgery in a recovery center lying on your stomach. You will be wearing a compression garment and/or bandages. Soreness and pain is expected.
BBLs are usually an outpatient procedure, meaning most patients will be discharged from the hospital the same-day as your procedure. Someone else will need to pick you up from the hospital or surgical facility.
We strongly encourage you to be accompanied by a care person for at least the first 24 hrs after surgery.
Please avoid showering for at least 24 hours after your procedure. If you were sent home with drains, you need to wait until after they are removed by our staff before you are cleared to shower. Drains are not commonly utilized for BBL procedures unless combined with other procedures such as an abdominoplasty (a removal of excess skin in the stomach).
Warning signs: when should I call my doctor?
If you experience the following symptoms during the initial recovery period, call your doctor for urgent help:
Moderate to severe pain that lasts beyond the first 2 weeks
Fever
New areas of swelling, bruising or redness of the skin that were not present previously
Shortness of breath, painful breathing and/or chest pain
Signs of a blood clot:
Redness, swelling and/or pain concentrated in your arm, leg, groin, calf or at the back of the knee
Blood or other fluids leaking out of surgical incisions.
If you experience abnormal bleeding, compress with firm pressure for 10 minutes until it stops
If heavy bleeding occurs, go to urgent care and inform your surgeon
The first 2 weeks after surgery
Moderate to severe pain should subside around 5-7 days post-op. Patients can expect mild soreness to last for around 3-6 weeks.
Prescription pain medications are prescribed and typically utilized on an as-needed basis during this time frame. Do not operate a car or consume alcohol while on prescription pain meds.
Rest as much as possible to help reduce inflammation and pain. You will need to rest on your stomach to avoid putting pressure on your buttocks during this time.
You will need to wear a compression garment and/or compression wraps 24/7 for at least 3 weeks after surgery. The garments and/or wraps can be removed briefly to take a shower. The location and size of your compression garment and/or wraps will depend on where you got liposuction.
Do not submerge yourself underwater until 3 weeks post-op. Showering is fine.
Light walking daily is important for your circulation and blood clot prevention.
Many surgeons recommend a low-sodium diet to reduce inflammation for the first 2 weeks after surgery.
By the end of week 2, most patients will return to work.
Is it true that you cannot sit or lie down while recovering from a BBL?
During recovery newly injected fat is vulnerable to pressure necrosis: when tissue dies because too much pressure is put on it. This is because when fat is transferred, it loses its initial blood supply and has to find a new one in the buttocks to survive long-term. Fat survival allows the fat-grafted areas to maintain their augmented shape and volume.
First three weeks: Avoid placing pressure on your buttocks for the first three weeks. This means you should avoid sitting down and should try to sleep by laying on your stomach. Of course, you can still sit down to use the bathroom, but try to avoid being seated for more than 10 minute increments at a time. If you cannot sleep on your stomach, you can use a large doughnut-shaped pillow to avoid putting pressure on your buttocks.
Week 4-8: Once the surgeon gives clearance, patients can begin to sit down for short periods of time using specially designed “BBL pillows.” These allow the pressure of sitting to be placed onto your thighs.
Weeks 3-8 after surgery
We encourage patients to submit virtual post-op photos to be assessed at the 2 week, 6 week, 3 month and 6 month marks to monitor your healing.
Compression garments need to be worn for a period of time after surgery according to your surgeon’s preferences. This is typically anywhere between 3 weeks to 3 months. Compression helps reduce swelling and allows for improved uniformity of body contouring results.
Pain usually subsides during this time. You might feel some light soreness until week 6.
The majority of inflammation reduces during this time with consistent use of compression garments. You’ll be able to get a sense of what your final results look like in 6-8 weeks. It will still take 6 months to a year for everything to settle.
Still try to avoid placing pressure on your buttocks as much as possible. If you have a desk job, this might mean getting a standing desk or getting permission to work from home so that you can lie on your stomach.
Begin light exercises week 3-6 once you get clearance from your surgeon. Try to avoid heavy lifting, bouncing and fat burning activities as these can impact your results.
With clearance from your surgeon, you can take up most of your activities like vigorous exercising around 6 weeks post-op.
Patients may resume smoking no sooner than 3 weeks from surgery.
How can I speed up the healing process?
Smoking and alcohol consumption: Do not smoke tobacco for at least 3 weeks before and 3 weeks after your procedure, as this can lead to significant problems with delayed wound healing. Please do not drink alcohol for at least 1 week before and after surgery. Alcohol can not be taken with prescription pain medications.
Diet: Eat regular, nutritious meals. Some doctors recommend patients eat smaller meals at a higher frequency. Additionally, we recommend 2 weeks of a low-sodium diet to reduce inflammation after surgery.
Staying hydrated: drinking lots of water helps combat dehydration which can be common after surgery.
Avoid drastic weight fluctuations: Trying to maintain post-op weight is key to maintaining your results. By six weeks, you will get a sense of your final results; however, drastic weight gain can undo them.
Compression: wear your compression garment and/or compression wraps 24/7 except for bathing to help your results from the procedure hold.
Exercise: Walk regularly. Slowly incorporate exercise as your healing progresses. Start slowly with walks throughout the day.
The emotional recovery process
Recovering from a body contouring procedure can feel overwhelming and emotionally exhausting. It is common for patients to experience temporary feelings of depression and even regret as your body recovers from the physical toll of surgery. For this reason, we highly encourage patients to think beforehand about what can bring them comfort as they sit through difficult emotions. For example, we recommend getting as much rest as possible during the first two weeks after surgery, engaging in activities that bring you joy, taking light walks outside, taking up a mindfulness practice and leaning on your support network (like friends and a mental health professional). Below we discuss some common causes of emotional unease during recovery:
Feelings of depression and helplessness: During the first two weeks after surgery you will be most dependent on others to accomplish daily tasks. Likewise, pain, inflammation and discomfort is at its worst during this time. During this time especially, patients may report temporary feelings of helplessness, depression and emotional highs and lows. For patients who get liposuction with or without fat grafting (including a BBL), the greatest source of pain and discomfort you can expect to experience is from the liposuctioned areas, rather than where the fat is injected.
Sleeplessness and feelings of irritability: BBL or fat grafting patients sometimes report difficulty sleeping through the night if they are not accustomed to sleeping on their stomach. Sleeplessness can make the emotional recovery even more difficult for patients: increasing feelings of depression, overall irritability and frustration with the process. Practicing sleeping on your stomach before surgery and/or buying a special doughnut-shaped pillow to allow you to lay on your back without putting weight on your posterior can help with this issue.
Exhaustion and annoyance with healing protocols: BBL patients are asked to avoid sitting and laying down directly on the buttocks for the first three weeks after surgery. From weeks 4-8, with your surgeon’s clearance, you can begin to sit down for short periods of time, but only on specially designed “BBL pillows.” Not being able to sit down properly for two months often feels exhausting and frustrating for patients.
Temporary feelings of regret: After any major plastic surgery, patients may experience temporary regret or dissatisfaction while they struggle through recovery. This is a normal response to the pain and discomfort of physical recuperation. Not to mention, it can be difficult to have to wait 3-6 months after surgery to see what your final results will look like. It is important to note that permanent post-operative regret for gender-affirming procedures is rare.
When can I see my liposuction and fat grafting results?
We usually get a sense of what your final results will look like about 6 months after your surgery. By 6 months, most patients will begin to see their final results. Still, it can take a year for results to settle due to inflammation.
Scars from liposuction procedures are generally small and well-healing. If your procedure includes more extensive scarring from removing excess skin (such as an abdominoplasty), those scars will take a year to fully mature. For this reason, we recommend that patients keep their scars out of the sun or covered with sunscreen for the first year.
How long will my BBL results last?
It is generally regarded that whatever fat grafting takes at the 6 month mark is considered permanent. Some patients will seek out touch-ups at the decade mark if fat deposits in the buttocks reduce. Drastic weight changes can put the results at risk. Weight gain can cause weight to come back to the areas that were liposuctioned. Weight loss can result in the gains in volume from a BBL to be reversed.
What other procedures can I get simultaneously with a BBL?
Body contouring: It is common to combine liposuction with other body contouring procedures like fat grafting or skin excision. Skin excision is solicited when a patient would like to get rid of excess skin. Fat grafting: putting the liposuctioned fat into an area you would like to get augmented. This is most commonly the buttocks and/or hips.
Top surgery: chest reconstruction, breast reduction or breast augmentation can be done simultaneously with liposuction.
Bottom surgery: Some bottom surgery procedures can involve a simultaneous liposuction. For example, panniculectomy is common with a metoidioplasty and phalloplasty to make the penis look more visually apparent.
Facial surgery: We usually do not recommend that patients get liposuction alongside a facial surgery because of the intensity of the recovery.
Will my procedure cause scarring?
After surgery, small incisions (about 1 centimeter) will be present from liposuction cannula that typically heal and fade very well to be barely perceptible.
However, skin excision scars are more apparent. We try to place them in more concealable areas whenever possible. Scar care is important if you want to reduce the visibility (size and discoloration) long-term. You may find more information about scar care here.
How can I maximize my body contouring results through recovery?
Besides trying to avoid drastic changes in body weight, which can undo the results of body contouring, closely following the recovery guidelines can help you preserve your body contouring results. Dr. Facque (he/him) talks about this more in the following video:
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