Gluteal augmentation with fat grafting - BBL (Brazilian Butt Lift)

Oslo plastikkirurgi clinic has so far carried out several hundred BBL operations and we are very concerned about patient saf0ety – that is why everyone is carefully assessed whether they are good candidates for this type of surgery. The aim is to achieve a good shape and fullness 360 degrees around this area with nice symmetry in relation to the rest of the body.

The demand for fat grafting to the buttocks/buttocks (BBL) rose sharply from 2014, when this operation became more known via the media and is also more generally accepted, and that the technique has developed in the right direction.

The clinic’s senior physician is frequently invited as a faculty lecturer to present the clinic’s technique and our method for increased patient safety. Oslo Plastic Surgery has developed 20 medical guidelines in this very field; How to raise competence and results and raise quality and safety of method.

Dr. Kalaaji was invited to London in 2018 during the UKAAPS (UK Association of Aesthetic Plastic Surgeons) as a guest lecturer and expert on BBL operations and how this can be done safely and responsibly.

We have published our study in the internationally recognized medical journals Aesthetic Surgery Journal: Gluteal Augmentation with Fat: Retrospective Safety Study and Literature Review.

READ MORE HERE: https://doi.org/10.1093/asj/sjy153
Amin Kalaaji, MD, PhD, Stine Dreyer, MS, Line Vadseth, MD, Ivana Maric, MD, Vanja Jönsson, Trond H Haukebøe, MD, Aesthetic Surgery Journal, Volume 39, Issue 3, March 2019, Pages 292–305

About the procedure

Some develop asymmetric shape and/or volume on the bottom. It can be flat or disproportionate to the figure and it can be difficult to find clothes that fit or sit nicely. Others develop asymmetry on the sides and seat which can be aesthetically or practically unsightly.

If you have excess fat in nearby areas such as the waist, stomach, or the outside/inside of the thighs, this can make it look more disproportionate in relation to the bottom. It is therefore beneficial to remove fat from one or more areas where it is unwanted, and then insert it into the buttocks/seat area.

You must think carefully about which areas you want the fat to be taken from. The fat can be taken from different places on the body and in consultation with the surgeon, the areas that are best suited to take fat for buttock augmentation are determined. Fat transplantation to the buttocks (BBL) can be perceived by many as a win-win situation as you also get fat removed from unwanted areas for insertion in the buttocks.

The amount of fat needed for the procedure depends on the desired and achievable volume of the buttocks. The result of this type of surgical technique depends on resorption of the injected fat, i.e. the extent to which the body itself absorbs the fat. Usually, the fat is incorporated (grows) well in the receiving area. You must expect that the body absorbs up to 30-40% of the amount of fat in the first months, therefore you fill a little more than you need (overcorrect) to compensate for this loss. There is no guarantee that someone will absorb more than 40%.

Handling the fat is crucial for it to grow firmly. There are several conflicting techniques for processing the fat that is removed so that only pure fat is injected. The fat must be treated carefully without damaging the fat cells. A centrifugation process in which a simple machine separates the fat is considered to meet these requirements. We use a low degree of centrifugation to separate the fat but retain the intimate fat fluid that supplies the fat cells with, among other things, the natural growth factors and stem cells that give the best result for the BBL procedure.

It is not uncommon for a new injection to be needed, and in case of resorption of more than 40%, a new fat injection is offered free of charge within the warranty period; this on the condition that there is sufficient fat for injection for any volume increase or if asymmetry occurs. If the fatty tissue is not sucked away from the body, so that the volume is not satisfactory, this remains a natural and long-lasting result. With a standard fat injection, small scars of approx. 2 mm where the needles are inserted.

Pick-up and accommodation

If you live some distance from the clinic, we recommend that you spend one night in or near Oslo Plastic Surgery Clinic so that our caring staff are on hand to reassure you should any issue arise, that will cause you concern.

You must agree in advance with a person to pick you up at the clinic approx. 1 hour after the end of the operation, as you cannot drive, take public transport or taxi alone. You should also have someone with you the same day and the first night.

If you live far from the clinic, we recommend that you spend the night in Oslo, either with family / friends or at a hotel.

Hotels near Oslo Plastic Surgery:
-Frogner House Apartments, Bygdøy Allé 53. Website: https://frognerhouse.no (We have an agreement with Frogner House Apartments).
-Hotel Gabel’s Hus in Gabel gate 16. Website; www.nordicchoicehotels.no

Pre-Operation preparations

To get optimal results and avoid complications: Avoid stress, stay out of the sun, eat healthily, keep your weight within a normal BMI range, exercise regularly, and refrain from alcohol for 2 days prior to surgery and 2 weeks after surgery. Please refrain from smoking/snoozing for at least 2 weeks before surgery and a minimum of 2 weeks after surgery as smoking can interfere with the result.

Before surgery

You must ensure your personal health on the day of surgery. Please contact us as soon as possible if you are in doubt, as we may have to postpone your surgery therefore saving you a journey to our clinic.

Prior to surgery you will have received a prescription for antibiotics, pain killers and Hibiscrub 40 mg/ml which are all available from your local pharmacy. The day before surgery you must shower using the Hibiscrub and again on the day of the procedure immediately
before surgery. Use a clean towel for drying and put on clean clothes when you leave home and change the sheets on your bed.

YOU MUST NOT EAT ANYTHING 6 HOURS BEFORE SURGERY, but you may drink water and light juice (not milk) and chew gum up to 4 hours prior to your surgery. You may take necessary medication/s with a sip of water on the morning of the operation.

Please decide for an adult friend to pick you up after surgery, as you will not be able to drive or take a cab alone. We also advise you to have a responsible adult person staying with you during the first 24 hours.

Taking medications prior to surgery:

It is very important that you stop using the following medications 2 weeks before surgery: Acetylsalisyre, Albyl, Albyl-E and other medications that cause extended bleeding as Ibux, Alka-Seltzer, Antineuralgica, Asacol, Artrizin Alka, Brufen, Butazolidin Alka, Codacetyl, Confortid, Dispril, Dispril med kodein, Doloxene Forte, Denobid, Felden, Fenylbutazon, Gamaquil Comp, Globentyl, Globoid, Indocin, Kodein-Magnyl, Kodifen, Licyl, Magnyl, Magnyl-Koffein, Mundisal, Napren, Naprosyn, Novid, Novid with koffein, Paraflex Comp., Tanderil, Vitamin E, and Selen, Tricycliske antidepressiva.

We also recommend you omit
Garlic, evening primrose oil, Gingko Bilabo, Aspirin and any drug containing blood thinners.

The above products are known blood thinners therefore not beneficial when you are having surgery.

For Marivan we have individual arrangement. Please request this information on your consultation.

Day of Surgery

After a final discussion with your surgeon the planning process will begin. You will be photographed, and markings will be made on your surgical areas. At this stage you will have time and the opportunity to ask any questions that you may have forgotten so that your surgeon can reassure you that he fully understands your goals and expectations.

You will be introduced to your anesthetist (who will be happy to discuss any fears or issues you have regarding your anesthetization). You will also meet your theatre nurse.

The sedation which you are given in your arm is a quick and painless procedure and you will fall asleep very quickly.

You should be ready to go home within 1 hour following surgery and remember to arrange for someone to pick you up. You should have adult company with you for the next 24 hours to assist you with general tasks, so that you can relax and take it relatively easy.

We will provide you with the cell phone numbers to call us should you feel the need, but this is very rare. We just need to reassure you that we are there for you 24 hours a day.

After Surgery

We will require you to come to the clinic for a follow up check. WITH ALL SURGERY THIS IS IMPORTANT AS YOUR SURGEON NEEDS TO SEE HOW YOU ARE SETTLING.

We do not recommend you fly for 48 hours post-surgery. You may feel nauseous and tired in the hours following surgery. It is important to take your painkillers and drink enough fluids.

You may experience dizziness if you get up quickly from a chair or perhaps when you are lying in bed, so be sensible, take it easy and move slowly. This is quite normal following surgery and should pass within a couple of days.

In the first hours after the operation, you may feel a little tired, and occasionally a little nauseous. It is important that you take painkillers as prescribed and as needed, and that you drink plenty of water for the first day. Some people may feel a little dizzy, and it is therefore advisable to take a few minutes when getting up. For the first two days, you must rest and lie as still as possible, with your upper body elevated. For the next five days, you can move carefully. If you have an active job, it’s a good idea to stay at home.

After a BBL procedure, you must rest and lie as still as possible for the first two days. For the next five days, you can walk upstairs carefully. You should not put pressure on the transplant area as by sitting on it, you can buy a BBL cushion or bathing ring for use for short periods after the operation if you want to lie flat on your back. Feel free to sleep on your stomach or side for the first ten days. You must use a bodysuit that does not press on the fat. It is recommended that you tape the scars with skin-friendly, surgical tape for 2-3 months, like Micropore or Steri-Strips. Some may experience allergies for these types and can then use silicone tape.

You will receive compression garments from us on the day of the operation, which should be worn both night and day for 4-6 weeks, you can go without when it is time to wash.

One must expect that approx. 30% of the inserted fat disappears within 4 months after a BBL.
We take this into account and transplant some more fat to give a satisfactory result. In some cases, more than 40% of the fat disappears. We therefore have a guarantee where we transplant new fat free of charge within 1 year if there is a medical indication.

The result can only be assessed after 3-6 months. Follow-up checks are agreed with the clinic; the day after surgery, after 1-2 weeks and 3-6 months, as well as a final check-up after a year. You must call yourself to arrange the appointments, or alternatively make a booking with the clinic on the day of the operation.

In principle, BBL does not provide a basis for sick leave, but if you have a physical job, we recommend that you take this into account in the first days after surgery. Physical training and hard physical work should be carried out for approx. 4 weeks.

Follow ups will be carried out at the clinic/alternatively through phone or video consultation:
1 day after surgery, after 1-2 weeks, after 3-6 months and finally after 1 year when our guarantee to you is completed.

Bleeding and infection are unusual and if they do occur, they may need to be treated with a small operation and/or an antibiotic.  Asymmetry, incorrectly placed implants, or the formation of hard capsules” capsular contracture” can also occur. If corrections are needed, they will be scheduled free of charge within one year after your surgery. Anesthesia allergy is extremely rare.

If correction is necessary due to complications or unsatisfactory results, this is done free of charge within one year if there is a medical indication and a clear potential for improvement. This is our warranty period.

Contact form

If you want to know more or have questions, use the form and we will reply to you within a short time.

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Dr. Amin Kalaaji

Dr. Amin Kalaaji, MD, PhD is a board-certified plastic surgeon and head of the clinic at Oslo Plastic Surgery, and president of the Norwegian Association for Aesthetic Plastic Surgery (NFEP) 2018-2020.

Dr. Kalaaji has established the Oslo plastic surgery clinic in the Frogner district, central Oslo, in 2002. In 2022, the clinic will celebrate its 20th anniversary.

Dr Kalaaji participates in many meetings and holds lectures and trainings around the world. This benefits all our patients as he is always up to date on the latest and most advanced treatments and surgical techniques. Patient safety, high quality and individual treatment always weigh the most at Oslo Plastic Surgery.

Dr. Kalaaji is trained in plastic surgery in France (Paris) and Sweden, with a doctorate in plastic surgery from Sweden, in bone transplantation for cleft lip and palate. He was previously chief physician at the plastic surgery department at Telemark Central Hospital, and chief physician and acting head of department at the plastic surgery department Ullevål, Oslo University Hospital. He now works at Oslo Plastic Surgery in Oslo and has had clinic responsibility there for over 20 years.

In recent years, his focus has been on aesthetic procedures including breast surgery, fat transplantation to all parts of the body, especially the face, eye, chin, chest, BBL buttock augmentation with own fat and intimate surgery. In addition, correction of inverted nipples is carried out (where he has developed a very special technique that preserves the function of breastfeeding), rhinoplasty and the usual face operations such as facelifts, eyelid surgery and ear surgery. He has also researched the quality of life of patients who have undergone breast surgery such as breast implants, breast lifts with implants, intimate surgery, and rhinoplasty.

Dr. Kalaaji has published several scientific articles and has given over 400 presentations and courses on plastic and aesthetic surgery in the Nordics, Europe, and the world.

Among other things at ASAPS, ISAPS, ISPRES, IMCAS, and at many national and international aesthetic surgery meetings and participates as Faculty in global aesthetic courses for the «International Society for Aesthetic Plastic Surgery» (ISAPS), in ASAPS (The American Society for Aesthetic Plastic Surgery) at a congress in Boston in 2011, which deals with the quality of life of women with breast implants and in New York 2018 with courses in Mommy Makeover in aesthetic surgery and other widespread combined operations, and the importance of choosing combinations. Many works have been published in the Norwegian journal «Kirurgen» in April 2012 and in the prestigious Aesthetic Surgery Journal and PRS (Plastic and Reconstructive Surgery) from 2013 to now.

He has also given lectures and been a guest lecturer in London, Manchester, Berlin, Rome, Paris, Marseille, Tours (France), Helsinki, Linköping, Stockholm, Gothenburg, Karlstad, Uppsala, Tromsø, Lofoten, Oslo, Copenhagen, Marrakech, among others. , Tunis, Aleppo, St. Petersburg, Cape Town, Rio de Janeiro, Miami, Cairo, Beirut, Kota Bharu (Malaysia), Dubrovnik, Coventry, Belgrade, Sarajevo and Kyiv, about breast augmentation with fat transplantation, buttock augmentation with own fat, the clinic’s own operating method regarding inverted nipples that preserve breastfeeding function, rhinoplasty, intimate surgery, and breast lift with implants at high-quality international conferences.

Dr. Kalaaji currently sits on the editorial board of the Journal of Plastic surgery and Hand Surgery, and of the prestigious Aesthetic Surgery Journal in addition to the Acta Chirurgiae Plasticae Editorial board.

Dr. Kalaaji is an active member of the international organization International Society for Aesthetic Plastic Surgery (ISAPS) and was a member of the membership committee of the same organization. ISAPS is a leading organization for experts in cosmetic plastic surgery.

He has also been an active member of the American Society for Aesthetic Plastic Surgery (ASAPS) since 2007 and has since attended this prestigious annual meeting in the USA.

Dr. Kalaaji serves as a member of the International Committee of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2009-2023.
“The time and dedication offered by Dr. Kalaaji to the Society is truly appreciated by the members and by the Board of Directors of the American Society of Aesthetic Plastic Surgery (ASAPS),” stated ASAPS President, Dr. Jack Fisher, MD. 2017.

Dr. Kalaaji is also included on the International and Education/Program Committees of the American Society for Aesthetic Plastic Surgery (ASAPS).

In October 2015 and 2017, 2019, 2021, Dr. Kalaaji chaired the Norwegian American Aesthetic Meeting (NAAM 1,2,3,4) in Oslo. Link: www.naam.no

Dr. Kalaaji was chairman of the board of the Norwegian Association for Aesthetic Plastic Surgery (NEFP) 2018-2020, before this he was a board member of the Norwegian Association of Plastic Surgery from 1999-2001 and was elected as a board member of the Norwegian Association of Aesthetic Plastic Surgery (NFEP) 2014-2018. In addition, Dr. Kalaaji is an active member of the Nordic Plastic Surgery Association and the International Society of Plastic Regenerative Surgery.

In July 2017 and 2021, Dr. Kalaaji was elected as National Secretary of ISAPS in Norway for a period of 8 years, and in October 2018, Dr. Kalaaji was unanimously elected to the board of the International Society of Plastic Regenerative Surgery (ISPRES) 2018-2020 and is acting chairman of the membership committee in ISPRES (2020-2022)

Dr. Kalaaji was recently elected in June 2022 as the Assistant Chair of National Secretaries for all ISAPS National Secretaries, 2022-2024.

He has just published as editor-in-chief a book in two volumes: Plastic and aesthetic regenerative surgery and fat transplantation. Clinical application and operative techniques. This book—with its 117 chapters, approximately 2,000 pages, 1,625 educational figures, and 131 video clips—proudly represents the knowledge and expertise of 242 authors, including 72 female colleagues, from 31 countries and 5 continents.

These engagements and the roles Dr Kalaaji participate in mean that we are always up to date in the latest treatments, patient safety and surgical techniques.

FAQ

Oslo Plastikkirurgi answers here frequently asked questions, and we hope that this will give you good information. We want to be helpful in the process before an operation. If you have more questions, just write or call us.

The criteria for being able to take a BBL are a lack of shape and/or volume on the bum, which may be flat or disproportionate in relation to the figure or is asymmetrical in shape. To be able to take a BBL, you have to have fat in other places on the body to harvest from.

Prostheses are not used for buttock augmentation in Norway as the procedure is debated, and there are many possible complications, as well as the long-term satisfaction being worse than with the insertion of fat.

The result of this type of surgical technique depends on resorption of the injected fat, i.e. the extent to which the body itself repels the fat. Usually, the fat is incorporated (grows) well in the receiving area. You must expect that the body absorbs up to 30-40% of the amount of fat in the first months, therefore you fill a little more than you need (overcorrect) to compensate for this loss. There is also no guarantee that someone will absorb more than 40%.

The aim of the operation is to achieve good fullness with nice symmetry in relation to the rest of the body.

In the first hours after the operation, you may feel a little tired, and occasionally a little nauseous. It is important that you take painkillers as prescribed, and make sure you drink plenty of water for the first 24 hours. Some people may get a little dizzy, and it is therefore a good idea to take a few minutes when getting up. You should take it easy for the first few days after the operation, except for coming for a check-up the following day. You will feel some discomfort and pressure as new fat has been injected into the buttocks. It is individual how long the discomfort lasts, but 1-2 days is normal. BBL is not experienced as painful, more bursting and stiffer. You will be swollen for 2-3 weeks; some will bruise which will also disappear relatively quickly. You must use compression stockings from immediately after the operation, which you receive at the clinic for 4-6 weeks. We recommend that you purchase compression cloth to be able to change.

The first 4 weeks, both night and day, then only during the day.

For the areas from which fat has been harvested, after 5-6 days, you can take off the bodysuit and, if necessary, shower the areas that have been liposuction, apply new tape and then put the bodysuit back on. The body must be worn day and night for the first four weeks, and then during the day for 6 weeks.

You should not put pressure on the transplant area, such as by sitting on your bum or sleeping on your back for the first 4 weeks, unless you use a BBL pillow, possibly a bathing ring. You can sit without straining your bum, but only your upper thighs. You must wear a bodysuit that is loose over the buttocks and does not press on the injected fat.

BBL does not provide grounds for sick leave, you do not need to be bedridden and can resume work after a few days.

Normally, you can exercise carefully after 4 weeks.

You can work normally after 1-2 days if you do not have hard physical work. Consult your doctor about this at the consultation just in case.

 

All patients must have a consultation before the operation. The consultation is conducted by our experienced plastic surgeon who will confer with you and your medical condition and motivation for surgery. An examination is then performed, and the surgeon assesses a possible operation.

If you are suitable for the procedure, you will receive information about the procedure, precautions for the time before and after the procedure, and you will receive answers to your questions.

In a consultation you get a prescription for antibiotics, possibly painkillers and Hibiscrub solution 40 mg / ml which you can buy at the pharmacy.

You must be healthy on the day of surgery. If you are in doubt about whether you have a cold or the like, you must contact us. The operation is not performed when you have the flu and / or fever or cough or other infection in the body. Our staff will receive you and together complete you for the operation, the surgeon looks at you before the procedure and draws up the planned procedure, as well as answers your questions. Anesthesia staff also come to greet you and answer your questions. After the operation, you will be served food and plenty of drinks in the form of bread, yoghurt, and juice (tell us if you want another diet / have allergies).

In Norway, it is not allowed to show before and after pictures from cosmetic procedures during marketing or on the clinic’s website. However, we can show great pictures from previous patients when you come for a consultation with the surgeon. This can be very helpful when choosing the shape and size of the implant, and it can make it easier for you to imagine a result. We do not send photos.

We have a 1-year warranty. If correction is necessary due to complications or unsatisfactory results, this is done free of charge within one year if there is a medical indication and a clear potential for improvement. This is our one-year warranty agreement.

Attachments:

Feel free to read our own publications about breast implants (Norwegian and English).

1 – Gluteal Augmentation With Fat: Retrospective Safety Study and Literature Review.
Amin Kalaaji, MD, PhD, Stine Dreyer, MS, Line Vadseth, MD, Ivana Maric, MD, Vanja Jönsson, Trond H Haukebøe, MD,
Aesthetic Surgery Journal, Volume 39, Issue 3, March 2019, Pages 292–305, https://doi.org/10.1093/asj/sjy153

2 – Summary_BBLjoined BAABS 2018-19

3 – Youtube interview with ASJ, ASAPS 2018

4 – TV Interview NRK

5 – Tv2