Trish Hammond: Great, well we’re here today with Dr Scott Turner. Dr Scott Turner is a specialist plastic surgeon who does cosmetic surgery as well, and he’s located in Dee Why, a little bit in Leichardt, and also in Newcastle. Thank you so much for joining us today, Dr Turner.

Dr Scott Turner: It’s a pleasure.

Trish Hammond: Lovely. We’re going to have a bit of a chat about the latest trending surgery, I suppose for lack of a better word, which is the Brazilian Butt Lift. Can you tell us a little bit about it, who’s, why is this so popular?

Dr Scott Turner: I think it’s just social media. There’s a lot of people now seeing people like the Kardashian’s and looking at different sort of body shapes, and they’re becoming more fashionable. I think the issue of buttock augmentation in the past has been implants, they’ve had a high complication rate. They weren’t looked on favourably. Now with improvement in fat grafting becoming much more successful and with less problems, that this is happening now that we can perform and people get a great outcome.

Trish Hammond: Yeah, sure.

Dr Scott Turner: Without complications.

Trish Hammond: Alright, so it’s different to implants. Why is it different? You’re not basically having implants put in like you would your breasts, this is just where you use your own fat?

Dr Scott Turner:
Yeah, so with buttock augmentation in the past in the 70’s and 80’s, they initially starting using basically breast implants, putting it into the buttock. Problem with soft gel implants, like in the breast, they can capsule contracture, they can get mal-positioned where they can move, and they can rupture, especially the forces put on a breast implant, if put in the buttock, is significantly higher than if it’s put into the breast, because people have to sit on it and lie on it.

Trish Hammond: Mm-hmm

Dr Scott Turner: Then they went to hard silicon implants, which feel quite unnatural and if you do get a capture contracture or some mal-positioning, it can cause a lot of pain. Due to the where you put it in, the incision is close to that the perineal region, there’s a lot of contamination and the risk of infection is quite high.

The revision with butt implants, traditionally, has been well over 50%. It’s much higher than the four or five percent initially with say, a breast implant. That’s why it fell out of favour. With fat grafting, now we can take fat from areas which is excessive, often we do a lot of liposuction around the abdominal region, the flanks and lower back region, and then add that volume back to the buttock, carefully with the injection techniques to reshape the buttock and add volume and shape.

Trish Hammond: Okay, so say for example if you got really big thighs, a bit of a flat butt and a big belly, you could basically have your belly and your thighs liposuctioned and fill up the empty area in your butt to make it a bit more rounded and more feminine, I guess, for one of a better word.

Dr Scott Turner: Yeah, it’s just a concept of addition and subtraction. You’re taking away from areas which you don’t want the volume, and adding it to areas where you want the volume, so a lot of people ask me to get more of a square buttocks shape, instead of that more rounded with fullest to the top part of the buttock.

We can liposuction that lower back flank area, abdominal area, outer thighs, inner thighs and then add it back to the upper and outer buttock and then blend it into the lateral thigh to give that more hourglass shape.

Trish Hammond: Okay. Is it a long procedure, as in how long, sorry, first of all is it under general anaesthetic that you would do this in a hospital?

Dr Scott Turner: Yeah, we do all of our big liposuction and Brazilian butt lifts in the hospital. The main thing is it takes time cause by the time you do liposuction to two or three different areas, and then have to prepare the fat for re-injection, also when we’re doing liposuction circumferentially around the trunk region so the abdomen flanks, lower back, inner thigh, outer thigh, patients often get turned two or three time during that operation.

Each time we have to carefully turn patients, re-prep, re-drape and do that up to three or four times. That adds some time. The whole operation takes about three hours.

Trish Hammond: Okay, so three hours including the lipo and the putting it, the fat grafting to the butt?

Dr Scott Turner: Yeah, the injection of the fat is fairly quick once it’s all ready to go.

Trish Hammond: Mm-hmm

Dr Scott Turner: What, it takes the longest is to liposuction and that, a lot of that time, it’s about an hour by the time you add it all up, you’re just turning patients and getting them in the right position through the liposuction.

Trish Hammond: Okay.

Dr Scott Turner: Then once all the fat’s prepared and transferred into syringes, then we can then basically start the process of carefully layering the fat in little micro globules to build up the shape of the buttock we’re trying to create.

Trish Hammond: Okay. With the procedure taking, it can basically be done in, it’s a day procedure isn’t it?

Dr Scott Turner: Yeah, so it’s just day surgery. Patients are fairly numb in the areas afterwards. We use the body jet for most of ours now, so it’s the water assisted liposuction technique, where you use the water instead of energy like ultrasound or laser to loosen the fat, then it’s carefully collected. It’s carefully collecting into a lipo canister which collects the fat and washes it as we do the procedure.

Then when we’ve got a sufficient amount of fat or got a, reached the amount of liposuction that we’re going to perform, we can then wash that fat carefully and transfer it into the syringes.

Trish Hammond: Okay.

Dr Scott Turner: Once the fat’s transferred and put back in, the main thing is that you just can’t add pressure to the buttock region, so people have to sleep on their tummy or 3/4 onto their side the first four to six weeks, cause you need that fat that’s transferred to pick up a new blood supply so it survives.

Trish Hammond: Right, okay. Sleeping on your tummy, and so the recovery time, any idea how long it takes to recover, I mean I had liposuction recently and my recovery was really quick, but I didn’t do anything with that fat that just disappeared, but if I was having that fat put in in other parts of my body, would that be a longer recovery time?

Dr Scott Turner:
It’s more, it’s not so much a longer recovery time, it’s pretty much the same as liposuction where for one to two weeks you might be a little bit bruised and sore, and you might take stronger for pain for the first three to five days, and then after that just panadol.

Trish Hammond: Mm-hmm yes.

Dr Scott Turner: The big thing with fat grafting is the garments we wear, we don’t want any compression over the areas where we’re injecting the fat, cause we need to let that tissue expand. We use special garments with cut outs to the gluteal region, so you’re getting compression to the areas where we’ve done liposuction, but not to the buttock region.

Trish Hammond: Mm-hmm yes.

Dr Scott Turner: It’s just a bit of modifying the lifestyle for the first six weeks afterwards, so sitting in a chair, you just have to be careful sitting in a chair, you put a little towel under the back of your thighs so you’re taking the pressure off your buttock region. When you’re sleeping you’re not laying on your back, you’re sleeping on your tummy. It’s a bit difficult in driving in a car. If you drive in a car and you tendency, you might have to put a little role under your side and lower back so you’re not putting pressure on your buttock region.

Trish Hammond: Yep, got it. Behind your legs, you prop a big roll there so that your butt cheeks are hanging in the air so there’s no pressure on them.

Dr Scott Turner: You don’t want to just, like sitting back into a big chair where you squish all the way back and then you get a lot of pressure on the upper buttock where you put that fat.

Trish Hammond: Yeah, sure.

Dr Scott Turner: The way we put the fat, you can’t have any pressure cause if you have pressure on that area that will restrict its ability to pick up a new blood supply, then you’ll get reduced fat graft survival in that area, so you get a less than ideal result.

Trish Hammond: Okay, so that was going to be next question, cause there’s been so many conflicting stories as to how much fat percentage can be done, can be survived or kept or alive when you’re doing fat grafting. Can you tell us a bit about that, if you take out 1/2 litres of fat from somewhere else, will that, all of that fat hold or there is a percentage, or?

Dr Scott Turner: No, the limit to how much fat you can put into each buttock and it depends on how much people have got to take from liposuction, depending on their weight, but also generally with fat grafting, somewhere between 70 to 80% of the fat graft, if it’s placed, if it’s harvested correctly and it’s prepared correctly, and it’s re-injected in a careful technique, will survive if it’s done appropriately. Generally when we do a Brazilian Butt Lift, we’ll probably really put in somewhere between 300 and 400 cc’s of pure fat in each buttock.

Trish Hammond: Mm-hmm yes.

Dr Scott Turner: If you start putting more than that, then you’re overloading the ability of the body to make a new blood supply and you risk getting a large volume of fat dying and getting fat necrosis or lumpiness or hardness in the buttock.

Trish Hammond: Okay.

Dr Scott Turner:
There is a limit to how much you can put in, and somewhere between 200 and 400 cc’s is pretty reasonable. The majority of it will survive, but it can be sometimes a little bit unpredictable. Some might survive more in one buttock region than the other, and so with all fat grafting stages there’s always a small revision procedure that may need to be done at six or twelve months just to tweak the result to give a better aesthetic outcome.

Trish Hammond: When you do that revision procedure, do you charge again?

Dr Scott Turner: It depends on what needs to be done, sometimes it can be a small touch-up procedure in their rooms, where you might only need to suck out 100 ml of fat, just the little irregularity.

Trish Hammond: Okay, yep.

Dr Scott Turner: That can be done in the rooms, and there’s no real cost. If it’s something where it had to be done in the hospital, then generally we just get the patients to pay for the hospital fee, or any ancillary fees, and we don’t put a charge or an extra surgeon fee. It’s a much reduced cost.

Trish Hammond: Got it.

Dr Scott Turner: If it’s another hospital admission, cause it’s a cosmetic approach and they would have to pay a hospital fee.

Trish Hammond: Sure. Say for example, someone has it done and thinks, “Oh my gawd, my butt is too big.” We did have this happen to lady who had implants, actually, she couldn’t wait to get them out. Is there a way to, I suppose you can just reverse it by just doing lipo again?

Dr Scott Turner: Yeah, so you can do liposuction. The concern with liposuction is risk of dimpling and irregularities, so it’s a bit tricky doing liposuction around the buttock region.

Trish Hammond: Yes.

Dr Scott Turner: You could do that, things like Velashape or Core Sculpting could be used a little bit. I think liposuction would be the main. They need this working out as well, cause it will look over-corrected for the first two to three months just due to swelling and everything.

Trish Hammond: Yeah.

Dr Scott Turner: Then letting the swelling come out, whatever fat grafts survived to show through, then waiting that six months before and then you could do a tweak if you need to, do some liposuction to reduce some volume, yeah.

Trish Hammond: Right, and you want to be at your ideal weight, don’t you? You want to be where you’re going to be when you have this procedure, you don’t want really to go up and down in weight if you can avoid it.

Dr Scott Turner: You see a lot of people, and people think you need to put on weight for it. The problem is if your weight fluctuates a lot, that hormonal fat that you’re sucking out and putting back in will fluctuate when you put it into the buttock region.

Trish Hammond: Mm-hmm yes.

Dr Scott Turner: If someone put on ten kilos, you remove that fat from the abdomen and put it in their buttock, they look great, then they drop their weight back to where they want to be, then the volume in the buttock will decrease slightly, as well.

Trish Hammond: Mm-hmm.

Dr Scott Turner: The closer they are to their ideal stable weight that they’re happy to stay at, is better. It’s like most areas, the more they fluctuate the more difficult it is to give them a stable long term result.

Trish Hammond: Yep, and the only scars are really just the little lipo holes, aren’t they?

Dr Scott Turner: Yeah. No big incisions, so liposuction around the tummy. You might have a little one around the groin crease or around the belly button, sometimes you might have one on the, a small one on near the hip region for the lateral thigh, and then the incisions for re-injecting is generally into the, in between the gluteal crease, between the two buttocks, or in the fold of the buttock region. By six to twelve months, those incisions are barely noticeable.

Trish Hammond: Yeah.

Dr Scott Turner: They heal pretty well.

Trish Hammond: Aw, great. I don’t think there’s anything else I’d want to know except when can I book in? I’m kind of annoyed now that I just threw my fat away.

Dr Scott Turner: Fat grafting, it is changing a lot of what we do. You see a lot of women, you have tummy tucks and want a breast lift, you can do the tummy tuck, do the liposuction, do a breast lift and re-inject into their breast to improve their cleavage, so a lot of people are doing small volume fat grafting with tummy tucks, so you’re getting a tummy tuck and liposuction and you do a little bit of fat grafting around the lateral pit region and into the upper buttock just to improve that shape with the tummy tuck.

Trish Hammond: Kind of makes sense, cause if you’re gonna have it done, you might as well fix, just neaten it all up around there and give yourself more of a look that you want, I guess when you’re getting it done.

Dr Scott Turner: No, no. I think now that it’s becoming much more of a reliable procedure with the techniques for fat grafting, there’s no, just little areas that are, turn you, you can use that fat now. It doesn’t take that much longer to take it safely with a fat grafting procedure compared to a standard liposuction procedure.

Trish Hammond: Mm-hmm yes.

Dr Scott Turner: It’s not going to add that much more time.

Trish Hammond: Yes, it’s changed a lot in the last three years. Three years ago it wasn’t really that popular, but now it’s becoming really popular.

Dr Scott Turner: Yeah, and I think it’s just people’s understanding the science behind it, and the literature’s getting behind it. There’s much more evidence to show how effective it is.

Trish Hammond: Yep. Yeah, no that’s so true. I’m pretty excited by it. We get a lot of enquiries, it’s great. Alright, well thank you so much for taking the time to talk to us today.

Dr Scott Turner: No, that’s fine.

Trish Hammond: We really appreciate it. If you listeners out there, if you’re thinking of having what they call a Brazilian Butt Lift procedure and you are in located in Sydney area, definitely pay Dr Scott Turner a visit. You can either Google him, or you can send us an email to info@plasticsurgeryhub.com.au. Thank you so much, Dr Turner.

Dr Scott Turner: Okay.

Trish Hammond: Have a great day.

Dr Scott Turner: Bye.

Trish

Trish is a plastic surgery blogger. She is passionate about wellbeing, health and beauty, and doesn't mind a little bit of 'help' from the amazing cosmetic and beauty procedures that are available today. Trish spends her days talking to women and men who are looking for suggestions and advice on procedures that are available to them. Cutting through the sales pitch and hype, a down-to-earth response on general information is what you will get.

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