After harvesting fat from the abdomen, flanks and back via liposuction, the fat is injected into the buttocks. If injecting too deep into the pelvis, fat can be inadvertently injected into the deep pelvic veins. From there, the fat travels to the heart, as a fat embolism, lodging in the heart and lungs, leading to death. This is similar to a blood clot traveling from the deep veins of the leg to the heart in a pulmonary embolism. A fat embolism can be more deadly because, unlike a blood clot, there’s no way to dissolve the fat. Luckily, there are various techniques that can make this procedure safer – a safe BBL.

How is a safe BBL different?

In the past, some physicians would inject fat into the gluteus maximus muscle in the buttocks. The idea, aside from providing more buttock projection, was to increase survival of the fat by placing it in a vascular-rich environment like the buttocks.

But the risk of accidentally injecting fat into the deep veins of the pelvis when injecting into or under the muscle is just too great. That’s why one technique of the safe BBL is injecting fat only on top of the muscle.

Additionally, by always injecting away from the deep veins of the pelvis, the surgeon can avoid direct venous injection. For example, when filling in the hip dips (the depressions on the sides of the thighs), injection can take place in an outward direction, through under-buttock incisions. To provide more buttock projection, the fat-injecting cannula uses the incision over the sacrum. With this angle, not only is the surgeon injecting away from the deep pelvic vessels, the sacrum protects the vessels, making it virtually impossible to inject deep.

Statistically safe BBL

By combining these techniques, the BBL can be safer than a tummy tuck. According to the AAAASF surgery center accrediting organization, the risk of death from a tummy tuck is around 13,000. Whereas the safe BBL has a risk of 1 in 26,247 according to the World Association of Gluteal Surgeons (WAGS). A patient may think it’s just about how much fat is injected. It’s really more about how you inject.

To watch Dr. Kaplan perform a safe BBL and check pricing, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post The Safe BBL first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

After the protests in June, and celebrations involving Memorial Day and July 4th weekends, we’re seeing an inevitable surge associated with mass gatherings. This leads to a continuing shelter-in-place, reducing travel plans and working from home for the foreseeable future. These mass gatherings and changes in consumer behavior are leading to a surge in both coronavirus and cosmetic surgery. What’s the connection?

Coronavirus and Cosmetic Surgery are surging

This phenomenon of increasing cosmetic surgery along with an increase in the coronavirus was recently highlighted in this article.

Since March, consumers are home, on ZOOM, seeing their reflection more than ever before. Naturally, some will see things they want to address. Like Botox or fillers for wrinkles.

They’re also realizing this is the best time to get that Mommy Makeover or other procedures they’ve been considering. With trips cancelled, that frees up more disposable income. And with the ability to work from home after a procedure, it’s easy to avoid questions from coworkers about why you were “out” or what you had done. If you just had a Brazilian Butt Lift, you won’t have to explain why you’re sitting on a pillow!

This increase in cosmetic surgery isn’t isolated. Across elective surgery websites, including BuildMyBod.com, where consumers can check pricing on outpatient services, traffic is up 73.4%! So while not everyone is getting cosmetic surgery or other elective procedures, they’re certainly considering it.

Think of a sales funnel. More consumers are entering the top of the funnel and checking pricing. As more folks enter the funnel, more will progress through the funnel, ask questions, schedule consults and then book surgery.

Safeguards with coronavirus and cosmetic surgery are surging

With the increasing surge in both coronavirus and cosmetic surgery, new safeguards are necessary. For plastic surgeons that perform cosmetic surgery at hospitals, their ability to operate is being curbed. As discussed here, cosmetic surgery is slow to start for several reasons at hospitals. Most significantly, the need for hospitals to make up lost revenue with better paying elective cases like orthopedic procedures.

But for outpatient surgery centers or office-based operating rooms, surgeons are performing a great deal of cosmetic surgery. To keep those patients safe, patients are undergoing COVID testing in the community prior to surgery. And in some offices, like ours, we perform an antibody test the morning of surgery.

While the coronavirus is a serious ongoing pandemic, it’s becoming increasingly clear that the end is not in sight. Therefore, we must mitigate the risks and move forward with our lives as safely as possible. That includes accommodating patients that want non-essential procedures such as cosmetic surgery. And based on web traffic and bookings, they’re clearly on board.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Why coronavirus and cosmetic surgery are surging first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

The evolution of the butt

This isn’t the first time we’ve put a fuller figure on a pedestal. Peter Paul Rubens, (28 June 1577 – 30 May 1640), a Flemish painter, is well known for his voluptuous women. An overweight, full-bodied woman was all the rage in early modern history. And that’s the way it has been for centuries. “But” things change.

It was until the 90’s, the 1990’s that the idea of a petite, thin supermodel was considered “hot.” So fairly recently. And just as fast as that trend came, it went!

Whether it was the influence of hip hop and Latina culture on American pop culture, or the simple fact that it was easier to be curvy than super thin, voluptuous was back. This was specifically clear in regards to the butt. The arrival of J Lo on the scene in the early 2000’s brought fuller buttocks back into vogue.

The big butt really caught on with the Kardashians in the 2010’s. However, it wasn’t just a big butt. Interested women now wanted a narrow waist and full hips. Specifically, elimination of the hip dips (the natural sunken area between the pelvic bone above and the hip bone below) was the next step in this journey.

Now we’re seeing big round butts with round hips. Sound familiar? These trends, like so many, have come full circle. While it doesn’t include the obesity of the Rubenesque paintings in the 1500 and 1600’s, the ideal aesthetic women are requesting from their plastic surgeon is a return to this more voluptuous silhouette!

The evolution of the butt video

To check pricing on a Brazilian Butt Lift from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post The evolution of the butt [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

The World Association of Gluteal Surgeons (WAGS)

As a reminder, the Brazilian Butt Lift is the harvesting of fat from the patient’s abdomen, flanks and back and injection of the fat into the buttocks. There is a much discussed risk of accidentally injecting fat too deep into the buttocks. If that occurs, the fat could enter the pelvic blood vessels and embolize (travel) to the heart and result in death. A fat embolism is similar to a pulmonary embolism (blood clot from the veins in the legs), except that in the former, fat travels to the heart and in the latter, a blood clot travels to the heart.

While obviously death from a fat embolism in the case of a BBL is tragic, this is the exception. Injecting superficially with the protection of the underlying sacrum, will be a major teaching point during the conference.

BuildMyBod Health CEO presenting on practice management

In addition to clinical topics, practice management discussions will also take place. For example, Dr. Jonathan Kaplan, founder/CEO of BuildMyBod Health will talk about cultivating loyal, recurring patients with subscriptions.

So instead of running specials, doctors can create subscriptions or memberships. Thus incurring loyalty or long term investment on the part of the patient, not one-off deal seekers.

If you want to see how much Dr. Kaplan (aka Dr. Bae) charges for a BBL, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post World Association of Gluteal Surgeons (WAGS) Annual Meeting first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

The BBL: It’s more than just a bigger butt

If you listen to what most women are looking for in a butt, it’s not about the size. You hear words like contour, shape and hip dips. Very few are coming in asking for huge buttocks.

1. Silhouette

Many women want a BBL to accentuate their silhouette. Specifically, they’re looking for that hourglass figure. This requires aggressive liposuction to the abdomen and flanks to make the waist as narrow as possible. The combination of a narrow waist and fuller buttocks will achieve that hourglass shape.

2. Filling in the hip dips

The hips dips are perfectly normal anatomic features. this is the depression between the hip bones and the thighs bones.

Even though these are normal contours in the body and no one should feel as though something is wrong with them, popular culture is driving women to fill these in (as seen below). Rounding out the thigh does contribute to that idyllic hourglass figure so many women strive for.

3. Rounded buttock shape

Ultimately patients want fat injections to the buttocks but this does not require liters upon liters to achieve their stated goals. Fat to provide projection as well as rounding out the upper portion of the buttocks to blend into the hip dips provides a very aesthetically pleasing shape. Gone are the days of the upper buttock shelf. That’s not currently in vogue.

With just the right amount of fat, an older woman can lift and volumize her buttocks just as one would for deflated breasts. With different aged women, their goals vary and we must adjust our techniques to help them attain those goals.

To check pricing for a BBL or any procedure from a doctor near you, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post The secret to the BBL isn’t a bigger butt first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

BBL Aftercare

One of the most common issues after a BBL is the inability to sit directly on the buttocks for approximately 6 weeks. The idea is to keep pressure off the buttocks to allow for the potential ingrowth of blood vessels to the newly transplanted fat cells. But just because you can NOT sit on the buttocks does NOT mean you can’t sit.

A decorative round couch pillow or a specially designed BBL pillow allows the patient to sit on their thighs rather than the buttocks. This offloads pressure from the buttocks. This sort of pillow is perfect for sitting at work or while driving. And if anyone asks why you’re sitting on that type of pillow, tell them you had hemorrhoid surgery. That’ll end the conversation in its tracks!

Massages

Many physicians recommend massages after a BBL to help with two issues. Because there is a lot of swelling after a BBL, massages can help stimulate lymphatic flow under the skin to reduce swelling. The other potential benefit of a massage is to dissolve any dead fat and expedite its clearance from the area. While massages can be helpful, the body will automatically clear dead fat cells, with or without massages. The massage is not proven to do this faster but there’s something to be said for patients feeling proactive and not helpless during the healing process.

If you’re considering massages, you can find YouTube tutorials on how to do this. It may save you some money after the large investment you already made in your BBL.

Garments and Drains

Garments and drains both help with reducing swelling through two mechanisms. First, garments compress the skin, “squeezing” out excess fluid, leading to reduced swelling. But garments also help with pain. When the tissues are swollen, this puts stretch on skin. This also stretches pain fibers resulting in, well, pain. The compression from a garment can reduce that pain.

Drains also help with removing excess fluid in the tissues. The faster the fluid is evacuated, the faster the swelling resolves which also reduces pain.

BBL sitting protocol video

Every physician may have different BBL aftercare instructions and must haves, so start with a consultation with Dr. Kaplan here and check pricing here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post BBL Aftercare and Must Haves [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Source: AAresTT/Shutterstock.com

Book A Consultation With Dr. Kaplan

What Is a BBL?

A BBL is a procedure during which your plastic surgeon takes fat from the torso via liposuction and injects the fat back into the buttocks. And the answer is “no,” you don’t have to gain weight. You can get great results with a skinny BBL. Along with a BBL, many patients are interested in buttock augmentation procedures. If you desire a rounder, firmer derriére, opting for a BBL and implants can be a smart choice that leaves you with better-fitting clothes and greater confidence. While prices for this procedure vary, you can secure a more elevated bottom, narrow waist, or fuller hips within your budget. Visit Pacific Heights Plastic Surgery’s website for a detailed breakdown of a BBL price. 

The Skinny BBL and You!

Even skinny patients have enough fat for a BBL without gaining weight. The first point to address is what result patients are looking for. They don’t all want a bigger butt. Most are looking for a better shape which can be achieved in three ways: 

• A narrower waist
• Rounder buttocks
• Fuller hips

No matter what a patient desires, none of these require significant amounts of fat. For most patients, the fat the doctor can get from the abdomen, back, and, if necessary, the inner thighs or arms is enough to address those areas. The narrower waist is possible through aggressive liposuction, while the rounder buttocks and fuller hips are created with fat injections appropriate to the patient’s size. For example, 400cc per buttock might not sound like a lot, but, in smaller patients, that is plenty to achieve the shape the patient desires. The result depends on fat placement, not the sheer quantity of fat.

Book a Consultation with Dr. Kaplan

Skinny BBL example #1

105 pounds, 5’3″, BMI 19

Skinny BBL example #2

120 pounds, 5’2″, BMI 22

Skinny BBL example #3

131 pound, 5’6″, BMI 21.6

So, as you can see, it’s possible to achieve the results you want without gaining weight. To check pricing from Dr. Kaplan, click here.

Schedule Your Consultation Today

If you’re not happy with the shape of your butt and aren’t getting the results you want from exercising, a Brazilian butt lift could be the answer for you. To learn more about the BBL procedure and schedule a consultation, call Pacific Heights Plastic Surgery at (415) 923-3005 today. 

The post What Is a BBL & Should I Get One? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

We’ve all seen the questions online or on social media when it comes to who is or is not a BBL candidate. Do I have enough fat for a BBL (Brazilian Butt Lift)? Do I need to gain weight? We finally have the answer! As long as you’re healthy and your doctor agrees, even a thin patient can be a BBL candidate. Just check out our 5’4″, 105 pound patient!

Who’s a BBL candidate?

Aside from being healthy, patients considering a BBL should have reasonable expectations. If they are morbidly obese, a patient should consider medical or surgical weight loss first. At the other end of the spectrum, a very thin patient can still be a candidate.

The abdomen and flanks (love handles) are the typical go-to location for fat harvesting during liposuction. But this presents a unique challenge in a thin patient. And not because they don’t have enough fat. If a patient is thin, they’re at an increase risk of contour deformities from the liposuction cannula. That’s why it’s important to use a smaller liposuction cannula during fat harvest (3 or 4mm). But where else can fat be found?

Surprisingly, there is more fat that most realize in the inner thighs and back. The inner thighs offer up some of the best, most golden brown fat there is! Due to the large dimensions of the back, even a thin layer of fat can add up. Significant liposuction to the  back and waist is critical to achieving great results. While some fat will reabsorb over time, the buttocks can still appear larger because of aggressive liposuction around the waist.

To check pricing on a BBL from a doctor near you, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Even a 5’4″ woman that weighs 105 pounds is a BBL candidate! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

For the uninitiated, BBL is short for Brazilian Butt Lift. Some think it’s only an operation for those starring in a J. Lo  or Pitbull video. “Butt” it can be appropriate for more patients than you’d expect.

Who’s a candidate for a BBL?

Due to popular culture, it’s not surprising most people think a BBL must result in a bootylicious derriere. But as the patient above in her 50’s demonstrates, it can simply offer a way to volumize the buttocks due to age. Similar to how women get breast implants and/or a lift, to restore their breasts to a more youthful position, the same can be done for the buttocks.

I recently had a patient that was worried about getting a BBL along with her tummy tuck and lipo 360 (liposuction to the torso). A Brazilian Butt Lift automatically includes liposuction to the torso so the question was, should she simply throw the fat away or inject it into her buttocks (a BBL).

Her concern was that if she had fat injected into her buttocks, that would result in a huge rear-end. Despite reassurances that we could inject as much or as little fat as she wanted, she still deferred the procedure. Unfortunately, she can’t decide later to get a BBL since we harvested all of her available fat during the tummy tuck and lipo 360.

Regardless, it’s important for each patient to make their own decisions based on accurate information. Cosmetic plastic surgery provides a buffet of options to the patients. Your plastic surgeon is simply your maitre d’!

To check pricing on a Brazilian Butt Lift from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post To BBL or not to BBL? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

The case for a BBL in your 50’s

After pregnancy, women can develop ptotic, pendulous breasts. Getting a breast aug and/or lift is a natural next decision by those patients. Even without pregnancy, a woman’s breasts may start to sag with age, instigating them to consider a breast lift. We wouldn’t think someone getting a breast lift or breast aug due to breast ptosis as an outrageous decision. In this context, a BBL is no different.

As we age, everyone gets a droopy butt as well. Volume is lost and the buttock skin envelope slackens. In the same way a patient would want to restore volume to their breasts, it’s not unreasonable to want to restore volume and perkiness to the buttocks either. While a BBL can be performed by placing implants into the butt, similar to implants for the breasts, the more prevailing technique is fat injections.

The benefit of using fat for a Brazilian Butt Lift is that the patient gets two operations in one. First, they undergo liposuction to the front and back of the torso to collect fat. That fat is then purified and injected into the buttocks to give the patient a fuller, more lifted buttock. This leads to better fitting clothes as well as a “lifted” attitude and outlook. So if someone you know in their 50’s is considering either a breast lift or buttock lift, don’t judge!

Check pricing on a BBL or even a breast aug or breast aug and lift from Dr. Kaplan by clicking on the corresponding links.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post A BBL can be tasteful – even in your 50’s! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

How to get a rounder booty!

The best way to achieve these results is by fat injections or fat transfer into the buttocks in a procedure called a Brazilian Butt Lift or BBL. A BBL consists of two steps. The first is to remove the patient’s own fat from their abdomen, flanks and back. Doing so “snatches” the waist and already gives the appearance of a larger buttock even before any fat is transferred. In some patients who are looking for a more subtle change, that is enough. But for those who are looking for more projection like these celebrities, on to step two!

The second step is to take the fat harvested from the torso and inject that into the buttock. Fat injected into the buttock will give the projection that most people are looking for. It’s also important to add fat into the side of the buttock to ensure that the transition from butt to the hips is seamless and gives the patient an hourglass figure.

Typically, the buttocks are “overfilled” with fat. This is because some of the fat injected will not receive a proper blood supply after the transfer and will slowly die. Therefore, between surgery and the first four weeks post op, the BBL will actually get smaller. The fat cells that establish a new blood supply will survive, keeping the booty round.

What about butt implants?

Now why not use butt implants? Butt implants come with risks and complications including displacement or movement of the implants, fluid collection in the buttock and capsular contracture. And even if the implant placement is successful, the implants are not permanent. It is recommended that patients have a butt implant replacement (or removal) about 8-12 years after the initial procedure. Lastly, the results of butt implants look and feel less natural that the results of a BBL with fat.

Therefore, whether you’re looking for a round, athletic booty or a booty from one of those rap videos, a Brazilian Butt Lift is the way to go! And in the words of Jason Derulo, “You know what to do with that big, fat butt… Wiggle, wiggle!”

To check pricing on a BBL and get a rounder booty, click here.

Click here for the original blog post written by @japsiecam for BuildMyBod.

Thanks to @japsiecam for writing this article!

The post The Booty is All the Rage! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.