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The Removal of Fat Necrosis (Dead Fat)

Few people know what fat necrosis is, how it occurs, or why it is important.  Fat necrosis is dead fat that occurs usually secondary to the lack of blood supply.  Without the blood supply, the fat dies and becomes calcified and hard.  This necrotic fat then may be painful or create an unpleasing appearance.  Fat necrosis typically occurs as a result of trauma or secondary to transfer of fat during a surgical procedure.

Most commonly, Dr. Kenneth Benjamin Hughes sees this dead fat phenomenon secondary to Brazilian buttlift procedures or BBL procedures.  Dr. Hughes specializes in revision surgery and in this particular surgery as well.  The fat necrosis may need to be removed if it persists over a period of months or is extremely painful.  Sometimes the dead fat can create dents, and sometimes it can create a large unsightly lump.

Dead fat, unlike living fat, cannot be removed by liposuction, or removal of fat through a cannula by pressure extraction.  The dead fat hardened by calcium must be removed in total through an incision in the skin, much like a cyst or a tumor is removed.

If the removal is extensive, reconstruction with additional fat grafting may be necessary as well. Thus, the issue of fat necrosis requires an expert skill set to create the optimal result.

Dr. Kenneth Hughes performs a great number of revisions of all types of surgery. Many times the patients really have run out of options or have no options when they seek out Dr. Hughes’s expertise. Dr. Hughes sees patients who have been to 20 or 30 consultations looking for an answer and have been turned away. This presents a unique situation in which Dr. Hughes frequently possesses the tools and skill to remedy a situation that others do not possess.

The removal of dead fat also called fat necrosis can be a daunting task. Although many times fat necrosis may improve over a period of time, sometimes the fat necrosis or dead fat can be debilitating to daily tasks and can cause chronic pain particularly with sitting or reclining. Dr. Hughes has removed huge bricks of fat necrosis from patients’ buttocks and hips. This always necessitates an incision.

Dead fat cannot simply be removed by the liposuction process or with any type of liposuction technique. Liposuction can only remove lower density materials through the power of vacuum suction. Fat necrosis results when the fat dies due to lack of blood supply and dystrophic calcification occurs -thus creating a hard calcific ultradense brick of tissue. This dead tissue must be cut out or excised.

The question is where to place the incision and how long to make the incision. A patient obviously wants to have as inconspicuous a scar as possible. In the many cases that Dr. Hughes has performed, he typically makes the incision under the buttock. He then dissects upward to the level of fat necrosis for removal. He does this with the help of a lighted retractor so that he can both visualize the offending fat necrosis and feel for it with his opposing hand.

Sometimes the necrotic tissue is hard throughout and is removed as a brick. Sometimes, the dead fat has a hard outer shell and the inside contains more liquid material. Either way these are good things to remove, because the removal reduces pain, can reduce contour deformities, and reduces the risk for future infection.

Most recently, Dr. Kenneth Hughes removed a great deal of fat necrosis from an individual and then removed a great deal of skin from the buttock fold at the same time. This accomplished two goals for the patient. 1) the patient wanted to remove the obviously hard, dead calcific fat and 2) the patient wanted to make the area appear smoother and make the buttocks appear shorter and rounder without a lot of loose, hanging skin. Dr. Kenneth Hughes was able to improve all of these aspects at one surgery with the inferior buttock lift incision.

The inferior butt lift surgery is a surgery that very few surgeons perform or perform in a certain way. The goal of the procedure is not to flatten the buttock or to reduce the buttock/leg definition, but rather it is to tighten the skin of the posterior thigh and improve the buttock shape as well as the sagginess or droopiness if the buttocks.

Sometimes Dr. Kenneth Benjamin Hughes utilizes this approach in conjunction with the lower posterior body lift incision and/or fat grafting. Sometimes, the removal of the dead fat is done at one time with the inferior buttock lift. In the future, the patient can be reconstructed with fat grafting or implants to improve the areas of removal if necessary.

Silicone Injections and Biopolymer Removal from Butt Los Angeles

Injections of various foreign materials have been around for as long as there have been sharp hollow tubes and foreign materials. Silicone and other substances have been injected into the face and almost every other body part you could imagine. The most common foreign body injection performed at this time are performed for buttock, hip, lip, and face augmentation.

These are certainly not recommended by plastic surgeons and these injections are frequently performed by individuals without appropriate training using less than sterile material that is not FDA approved for injection in the first place. There are numerous complications with these injections including skin loss, emboli, death, massive infection leading to death etc. Patients frequently report on-going inflammation and chronic pain syndromes that can result in moving pains throughout the body from the legs down into the ankles and into the abdomen as well. Some of these chemicals that spread in this nature are liquid and are very difficult to completely remove. These include the hydrogel type materials.

Dr. Kenneth Benjamin Hughes removes these types of materials on a regular basis and he attempts to do so through very small incisions placed and hidden appropriately.  However, larger incisions are frequently necessary to remove loose skin as well.  Liposuction is not an appropriate method for removal as the density of the scar tissue and tissue inflammation precludes its use.  Many of Dr. Hughes's revision cases are the result of liposuction attempts by other surgeons that only reduce the amount of fat that could have been used for reconstruction.


The easier removals include solid substances like PMMA. These are discrete materials that can be removed without destroying the innate tissue. This makes for a much easier reconstruction when it comes to fixing the defects caused by the removal of the substances.

Quite frequently, the patient already has defects or skin damage preceding any type of removal surgery. Dr. Hughes minimizes additional damage by removing as little native tissue as possible while removing as much foreign material as possible.

Dr. Kenneth Hughes then has the significant skill set of being able to reconstruct these defects with a variety of fat transfer techniques and butt implants. Dr. Hughes performs these removals and reconstructions every day. The type of removal depends on the type of substance, the amount of surface area involved, and the patient desires. A complete viewing of all of the procedures performed by Dr.Kenneth Hughes is not possible given patient privacy issues, but the willing patients who have participated in the filming of such surgeries are delineated on Dr. Kenneth Hughes's you tube channel.

Black Market Silicone Injections on the Rise


Dr. Kenneth Hughes received a phone call last week from a former Brazilian buttlift patient who was distressed that another doctor had ordered an MRI and had removed some tissue for specimen sent to a lab. Apparently, the other surgeon was unsure if something other than fat had been injected into this patient.  To be clear, the only 2 suitable methods for buttock augmentation are fat transfer to the buttocks and solid silicone gluteal implants (buttock implants).

A significant portion of Dr. Kenneth Hughes's practice is removing foreign material injected into patients by non-plastic surgeons and non-doctors sometimes in hotel rooms or garages. Frequently, the patient does not know if the injector has any credentials at all. In addition, they do not know exactly what was injected or how much was injected. This usually leads to a concern about the danger of having this substance within the body.

Patients frequently have pain, concerns for infection, especially infection leading to death. Dr. Kenneth Benjamin Hughes removes these substances sometimes several times a week from patients from all over the globe. The injections of these substances into the buttocks would be considered malpractice or negligence and are simply not an option among doctors practicing medicine. Unfortunately, many surgeons will refuse such patients because there is more intrinsic risk in operating on a patient who has non-sterile injections of unknown material present. Dr. Kenneth Hughes has been removing these substances for years to help alleviate symptoms and to help allay fears and eliminate worries of those patients who made the previous poor decision to have these substances injected.


To view more information about Dr. Kenneth Hughes and the Brazilian buttlift, please visit

To learn more about silicone and biopolymer removal please visit

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