Curvy or slender, almost everyone who asks Southwest Plastic Surgery about a Brazilian butt lift wants to know the same thing: how much fat can be moved, in ccs. Slimmer patients want to know if there is enough to harvest. Heavier patients are worried about the scale.
Dr. Frank Agullo has answered more than a thousand patient questions on RealSelf.com since 2010. Six of them, about BBL candidacy, are below, paraphrased to protect the askers, with his answers lightly edited for publication. The full set, including the weight-stability and over-the-muscle answers, is on his surgical site. His commentary on why the weight question is the real question is on Dr. WorldWide.
“Am I too skinny for a BBL at 5’7″ and 130 pounds?”
Answered on RealSelf, Sep 2018.
This really depends on your expectations and goals. At your current height and weight, it is possible to obtain enough fat to fill in the indentations in the lateral hip. I would estimate being able to obtain 250 to 300 cc for each buttock. The amount of fat that can be obtained would definitely increase with a 20 pound weight gain, but keep in mind that you would have to remain at that weight after surgery in order to keep the volume.
“My BMI is around 19 and I only want minor changes. Am I a candidate?”
Answered on RealSelf, May 2019.
I can see the hip dips you are referring to. There is often enough fat in the flanks, even in thin women, to fill in these craters. You could also consider Sculptra injections, which are safe and permanent, but expensive.
“Do I have enough fat for a BBL?”
Answered on RealSelf, Jun 2017.
You do have subcutaneous fat in the abdomen and lower back. This fat can be used for a Brazilian butt lift. You can expect a mild increase in buttock size and improvement in shape. If you desire a considerable increase in buttock size and projection you should consider implants.
A very small patient, 5’2″ and 115 to 120 pounds, asked the same thing two years later and got a fuller answer:
You can obtain nice results at your current weight. I would think at least 500 to 700 cc per buttock, not 1,000 or more. You can gain weight. The downside with gaining weight is that you would have to maintain yourself at the new weight even after the BBL. In your case, we are talking about 10 to 20 pounds. You could also consider a combination of BBL and implants. Implants can be placed inside the muscle, avoiding the complications often seen on the internet like double bubbles and being able to flip them.
“Is 500 cc okay for each side for a natural butt?”
Answered on RealSelf, Oct 2018.
The amount of fat to be injected into the buttocks and hips is determined by your current body composition and your objectives. With 500 mL, you will definitely improve the projection and contour. Most of my patients have 1,000 mL or more during their BBL. Keep in mind 30 percent of the volume will go away during the first four to six weeks.
When a wish photo shows a lot of projection, the answer gets shorter. To achieve the look you show, you would need at least 1,000 cc to each buttock.
“I am 5’3″ and 140. Should I lose 5 to 7 pounds before my BBL?”
Answered on RealSelf, Mar 2018.
Your BMI is at 24.8, which is normal. You want to have enough fat for the transfer. You are probably okay at your current weight. You should stay at the same weight you go into your surgery at.
“I am 5’2″ and 275. How much do I have to lose to get a BBL?”
Answered on RealSelf, Jul 2018.
I recommend a BMI less than 35, although some exceptions can be made. To get to this BMI, your weight should be 190 or less. At your current weight you are at very high risk for complications. Your current BMI is 50, which makes you a candidate for a bariatric weight loss procedure.
What the Practice Tells Every BBL Patient
Donor areas are most often the abdomen, flanks, lower back and inner thighs. Even a slim patient usually has enough for the hip dips and a modest round-out. Someone on the slimmer side who wants dramatic projection hears about implants rather than about gaining weight.
Almost everyone asks how much fat they will need. Dr. Agullo usually quotes 1,000 mL or more for most patients, since about 30 percent of the fat is reabsorbed; the volume at four to six weeks is the volume you keep. How the practice washes and handles the fat so more of it survives is in BBL aftercare: massages, garments and the first month.
Dr. Agullo is happy to see patients who are overweight, but above a BMI of 35 he asks for weight loss before surgery; the reasoning is in BMI and eligibility. Grafted fat behaves like the rest of the fat in the body, so fast weight loss after a BBL, especially on a GLP-1, can hollow the result; see 360 deflation after weight loss. The fee is on the BBL cost post and the procedure on the buttock augmentation page.
About Dr. Agullo
Frank Agullo, MD, FACS, is certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at the Mayo Clinic, and is Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has listed him as a Top Doctor every year from 2014 through 2026. He was a founding vice president and president of the World Association of Gluteal Surgeons, and every BBL at Southwest Plastic Surgery is grafted above the muscle under ultrasound guidance.
Ready to Talk?
Bring your height, your weight and a wish photo. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. Dr. Agullo’s answers are on RealSelf. #StayBeautiful
Find Dr. Agullo at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
