• kenneth benjamin hughes

Previous Pulmonary Embolism - Can I Get a Brazilian buttlift (BBL) and What is Risk of Death?

Updated: Aug 10

Question: I had a pulmonary embolism back in 2015. Can I get a BBL?

Answer: You would definitely need evaluation by a hematologist and clearance before considering surgery. Early ambulation, shorter surgeries, venous compression devices prior to induction of general anesthesia, and anticoagulation in the appropriate candidates can help manage this risk. However, the risk will not be zero no matter how well you are managed, and this is something every patient should realize prior to surgery.

If smaller areas of liposuction are considered, local anesthesia could be considered to further reduce the risk for deep venous thrombosis (DVT) and pulmonary embolism (PE). It is important to realize that pulmonary embolism can result in respiratory failure and patient death. Dr. Kenneth Benjamin Hughes, MD, Board Certified Plastic Surgeon in Los Angeles, CA


Question: Saggy BBL - What can I do to improve this condition? I really don’t want to go under the knife for it again.

Answer: A plastic surgeon would require before and after photos or a physical exam, data regarding amount of fat harvested and injected, and duration of wear of compression garment, weight fluctuations, and general health to comment on the path ahead.


Question: How bad are the scars after liposuction with fat transfer to the buttocks? Does liposuction give you loose skin in the stomach area?

Answer: In Dr. Hughes's practice, the liposuction or liposculpture procedure involves making a few small (4 mm) incisions through which instruments called cannulae are inserted to remove the fat in a very precise fashion.  Many varieties of liposuction are available including ultrasonic, smart liposuction, laser liposuction, vaser liposuction, power-assisted liposuction, and conventional tumescent liposuction. The results depend very little on the method used and very much on the surgeon selected.

Liposuction may not create a greater problem with skin laxity, but liposuction will not improve the skin quality. The skin can tighten after liposuction as the swelling continues to resolve over three to six months after surgery. 


Question: Lumps and bumps after BBL and liposuction. Is this just a process of healing or should I be worried? It looks disgusting.

Answer: At 11 days following liposuction, lumps are common.  Even after 6 weeks lumps are common.  Massage may help, but time will be the best treatment.  You may not see your long term results for at least 6 months.  Much of this depends upon the extensiveness of the liposuction and the size of the area treated. 



Question: Brazilian buttlift with only 200cc of fat per cheek, will all fat survive?

Answer: For most patients, Dr. Kenneth Hughes notices that the fat transferred usually lives to the extent possible during the first 4 weeks. About 50% of the fat that is transferred lives and becomes a part of you.  This will hold stable as long as there is no weight fluctuation.


Question: I had open heart transplant surgery 2 years ago. Can I get a Brazilian buttlift and tummy tuck?

Answer: Having had heart transplant surgery does not automatically exclude you from being evaluated as a candidate for a Brazilian buttlift and tummy tuck. You would have to receive medical clearance from all the specialists involved in your surgery and treating you now.  Your plastic surgeon, anesthesiologist, and surgical team would need to review medical history, lab work, medications, etc. to determine if the surgery would be worth the risks. 


Question: Which shaped BBL would be best for me: heart or bubble?

Answer: You would need to be seen in person or provide additional photos for you and your board certified plastic surgeon to discuss your end goals and the likelihood of achieving them based upon your fat reserves and anatomy.


Question: Is a BBL more dangerous for a thin patient? Are they at higher risk due to more muscle than fat in buttock area?

Answer: No. The thinner patient requires an expert at liposuction to remove as much fat as possible while leaving the skin smooth.  There are a lot of women who can get nice results despite thinking that there is not enough fat.


Dr. Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA


A: Will a BBL make my stretch marks off of my abdomen look better or they will stay the same? (Photos)

Removal of skin is the most effective stretchmark treatment available.


Dr. Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA

A: Should I put on more weight to achieve my desired look? (photos)

Gaining weight is often counterproductive. If you gain weight that is fat, some of the fat will likely be associated with the buttocks.  In almost every case, I do not recommend weight gain prior to a BBL. I think it is better to maintain your stable weight.  

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA

A: Does BMI matter for a BBL when you could be more muscle than fat?

BMI is just one measure of your fitness for surgery; current health is also important.  In my practice I look for a BMI approximating 30 to lessen the risks of complications during and after surgery and to enhance the results of the procedures. A BMI of 35 is probably the upper limit that a plastic surgeon would consider for this procedure.

Gaining weight is often counterproductive. If you gain weight that is fat, some of the fat will likely be associated with the buttocks.  In almost every case, I do not recommend weight gain prior to a BBL. I think it is better to maintain your stable weight and be within 10 pounds of your weight goal for three months or more prior to the BBL.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA

A: Q:Is 500cc enough to make a big difference? (photos)

An exam would provide a better way to evaluate you for the procedure.  You may notice the enhancement you are seeking with 250cc fat SURVIVAL in each buttock if the liposuction creates more contours to give the illusion that your buttocks are larger.  You and your PS will have to determine whether the fat harvest and transfer will provide a significant improvement.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA

A: If I gain 10 pounds for a BBL, do I have to maintain that weight I put on after surgery?

Gaining weight is often counterproductive. If you gain weight that is fat, some of the fat will likely be associated with the buttocks.  In almost every case, I do not recommend weight gain prior to a BBL. I think it is better to maintain your stable weight. 

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA

A: Is there a certain limit on the amount of fat tat can be transferred in a bbl?

For safety reasons, 5000 cc is the generally accepted upper limit for liposuction in an outpatient setting, with the transfer being less than that.  Depending upon how much the buttock will stretch, you may be able to inject 2000 cc per buttock. Larger volumes of liposuction can lead to greater chance for fluid shifts and patient death.


Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA 

A: Ride Back after BBL - Is a 45 minute drive back too long to take after the surgery?

This is a question which should be answered by the board certified plastic surgeon who is to perform your lipo and BBL.  My post-operative protocols may be different than your PS's and I will not have the benefit of knowing the extent of your surgery and seeing you in person to know how you are recovering.  My LVN helps all my patients matriculate from the recovery room to their mode of transportation to ensure that they are comfortable and safe.  He reclines the seat at a 45 degree angle and places a folded pillow under their thighs.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA


Question: Can a bbl and tummy tuck be performed at the same time? If so how long after having a baby would be considered “safe”?

Answer: A patient could have surgery as early as 3 months following an uneventful childbirth, but each individual recovers differently.  Therefore, depending upon how quickly a patient returns to a stable weight, a patient may want to schedule consultations with board certified plastic surgeons who are experts at both procedures at about 2 months after delivery.


Sometimes, the tummy tuck and Brazilian buttlift (BBL) can be done at the same time.  Sometimes, the liposuction and BBL is needed before the tummy tuck to produce a better result. In a patient with a particularly thick upper abdominal flap, a patient will get a better result with liposuction and BBL first. If the patient has a hernia or an overwhelming amount of skin, the tummy tuck may be necessary before liposuction is performed.


Kenneth Hughes, MD, ABPS (American Board of Plastic Surgery) Board Certified and Harvard Trained Plastic Surgeon, practicing in

Los Angeles, California.


A: I have low hemoglobin. Is it possible to get an iron infusion before a BBL surgery this month?


Have your labs repeated a few days before your scheduled surgery.  If they remain low, ask your PS if he/she recommends that you postpone your BBL until they reach a satisfactory level. Besides eating dark leafy veggies, liver, lentils, almonds, dried apricots, beets, and other high iron foods, your PS or internist could prescribe iron pills and Vitamin C based upon the cause of the anemia.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA


A: Am I too skinny for a BBL? Should I get butt implants? (photos)

Gaining weight is often counterproductive. If you gain weight that is fat, some of the fat will likely be associated with the buttocks.  In almost every case, I do not recommend weight gain prior to a BBL. I think it is better to maintain your stable weight.  The thinner patient requires an expert at liposuction to remove as much fat as possible while leaving the skin smooth.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles,CA

A: Do majority of BBLs result in a cellulite looking appearance on the butt?

Fat transferred to the buttocks can and does improve dimpling.  In the thousands of BBLs I have performed, I have not found the buttocks to look saggy as you heal. In general, the dimpling, which is different from true cellulite, is improved with the BBL and typically resolves with time as the fat becomes part of your body and swelling subsides.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA


A: Is it possible that my body rejected or reabsorbed the fat? (Photos)

Your body did not reject the fat. The results you experienced are typical:  at about six weeks 50% of the fat transferred has an established blood supply and is viable.  The revision implies that there is less fat than the first time, and scar tissue will make the surgery much more difficult on the surgeon.  The percentage of fat survival in the BBL the second time should be about the same. Photos show major improvement in contours from liposuction. Also remember that the greater the amount of fat transferred, the greater the risk for fat necrosis (death of fat due to lack of blood supply).


Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA


A: Am I a candidate for a BBl? I’m 5’9 and 122lbs. I’m 30 years old. I’m looking to get work done in March of 2020. (photo)

Gaining weight is often counterproductive. If you gain weight that is fat, some of the fat will likely be associated with the buttocks.  In almost every case, I do not recommend weight gain prior to a BBL. I think it is better to maintain your stable weight. The thinner patient requires an expert at liposuction to remove as much fat as possible while leaving the skin smooth.  Recommend that you discuss realistic results with a board certified plastic surgeon who performs hundreds of BBLs annually with great results.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA

A: Is it normal to still have firmness in the butt 10 weeks post-op? (Photos)

From my perspective, I hardly ever see fat necrosis after the BBL procedure. I think that this may soften with time.  If there is a large area, it is less likely to soften.  If you are uncomfortable and want it removed, follow up with your PS.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA


A: What type of massages should I be having and how many do I need?

This is more plastic surgeon preference than anything else.  Lymphatic massage is OK, but I do not think it is mandatory.  Recommend that you follow your board certified plastic surgeon's post-operative guidelines.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA

A: Can I get a Lipo360 and BBL with round one to achieve this look? I'm 20 years old and my BMI is 32.6. (photos)

BMI is just one measure of your fitness for surgery; current health is also important.  In my practice I look for a BMI approximating 30 to lessen the risks of complications during and after surgery and to enhance the results of the procedures. It is best to be within 10 pounds of your weight goal for three months prior to the BBL.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA



A: 360 lipo BBL 3 1/2 months ago. Why does my stomach look like this? (photos)

Liposuction will not improve the skin, but it can create a dramatic improvement in the way a person looks. It will not alter the underlying musculoskeletal anatomy or help with any amount of significant laxity. Recommend that you wait six to 12 months after BBL recovery and then consider a tummy tuck to address the laxity on your abdomen.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA


A: And what can I do to lose the fluid on my lower abdomen?

Recovery from BBL is patient dependent. Much of this depends upon the amount of liposuction performed and the amount of fat transferred.   The fluid in your lower abdomen, if not present as a collection, should be absorbed.  Usually by 3 months, the swelling is minimal and totally resolved by 6 months.

Follow whatever post-operative protocols, such as wearing your compression garment, were provided by your PS for optimum recovery.

Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA



A: Would I be a candidate for a fat transfer? (Photo)

Sometimes, individuals will have problem areas that are relatively exercise and diet resistant. These are the focus areas for a plastic surgeon to liposuction. Liposuction will remove the excess fat on your sides, abdomen, and thighs and make the waist as small as possible. The fat harvested can be transferred to the buttocks to ensure optimal fat viability and projection.  Risks of fat transfer include bleeding, infection, embolus, fat necrosis (the fat dies and leads to hard bricks of calcified dead fat).


Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA



A: 3 days post-op I banged my right butt hard. Did this cause fat cells to die? (photo)

Probably not.  I guess anything is possible, but I suspect that the only thing that may occur is a little bit of bruising and swelling. Follow-up with your PS to determine if any damage was done.


Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon

Los Angeles, CA



For more answers to your BBL questions, please visit


https://www.drkennethhughesbbl.com


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Contact Information for Dr. Kenneth Benjamin Hughes

12732 W. Washington Blvd, Suite B

Los Angeles, CA 90232

Phone: 310-275-4170     Email: lorena@hughesplasticsurgery.com

© 2019 by Dr. Kenneth Benjamin Hughes