Buttock Lipofilling / Brazilian Butt Lift

EVL = Expansion (E) + Vibration (V) + Lipofilling (L)

EVL is quite simply the safest and most modern way to perform buttock augmentation with fat. Some countries have banned buttock augmentation without EVL.

The main features of EVL include the use of a curved vibrating cannula that creates a gap as the fat is injected. This enables larger volumes of fat to be transferred with greater precision than is possible with a syringe. The larger diameter of the cannula means it is less likely to perforate a vein or vessel. The curved cannula can be rotated to increase its effectiveness.

This revolutionary procedure delivers toned, muscular-looking results and superior fat grafting. What’s more, up to 30% more fat can be injected during the same session.

With the EVL technique, your safety is fundamentally guaranteed.

In the past, and in some cases unfortunately still today, doctors have injected fat into the buttock muscle to perform a BBL. The idea, apart from adding volume to the buttocks, was also to increase the survival of the fat by placing it in a vessel-rich environment. However, numerous studies have shown the risk of accidentally injecting fat into the deep veins of the pelvis when injecting fat into the muscles, which can lead to a complication that we absolutely want to avoid: fat embolism.

To minimize this risk, Safe BBL is now available. This is a technique in which ultrasound is used during surgery to inject fat into the buttocks. By ensuring that all fat cells are injected only into the fat layer above the muscle, the risk of fat embolism is extremely reduced. Sometimes patients think it’s just the amount of fat injected that can cause complications. In reality, it’s more a question of how and where the fat is injected.

By combining EVL techniques with ultrasound-based Safe BBL, buttock lipofilling has become considerably safer than abdominoplasty. To our knowledge, we are currently the pioneers of this technique in Switzerland. At Clinique Bellefontaine, we have not yet had a single case of fat embolism.

Hip dips is a recent term referring to the hollows that can sometimes be seen on the lateral sides of the buttocks. The scientific term is “trochanteric depressions”.

These depressions cannot be “corrected” by simply working your glutes and trying to build up your thighs or buttocks. Hip depressions are either hereditary and cannot be changed, or caused by excess fat. In the latter case, diet and/or exercise can sometimes help reduce the appearance of hip hollows. However, even if you lose weight in this area, the overall shape you have will generally remain the same, which means you’ll still have a hollow even after losing a few kilos.

To correct Hip Dips, we can perform lipofilling in this area: liposuction removes fat from another part of the body – usually the love handles, stomach or saddlebags – and the fat grafting procedure places the fat in the hollow of the buttocks.

The correction of Hip Dips is not necessarily accompanied by an increase in posterior buttock volume, as in the example below.

Buttock lipofilling is a technique for augmenting the buttocks by injecting the patient’s own fat, offering many advantages over a simple buttock implant. It not only increases volume, but also modifies the contours of the buttock and tightens the sagging buttock to make it more beautiful. Lipofilling gives a more natural result than buttock prostheses. Because of its high blood supply, the buttocks are in principle an ideal recipient region for fat augmentation. 300 to 1200 ml of fat per buttock may be required for large buttocks or for very flabby skin! Depending on individual taste and the patient’s basic morphology, we try to reproduce the desired buttock shape. Of course, it’s difficult to get exactly what a patient wants if her basic morphology makes it difficult. But this will be clearly explained to you during the consultation, to avoid any disappointment. Not all lipofillings are created equal. We use the PAL microaire technique with EVL for fat reinsertion. It’s the only technique in the world that not only avoids the risk of fat embolism, but also makes it possible to increase fat volume by up to 30%! To achieve this, we perform low-pressure liposuction and work in a closed circuit to avoid deterioration caused by contact with air. This ensures a perfect match between the fat removal and reinjection systems. During the procedure, between 50 and 90% of fat cells survive. Scars are virtually invisible, measuring less than 4 mm. You are a good candidate for buttock lipofilling if : – you have sufficient fat reserves in the hips and other areas for lipofilling – you are a non-smoker – you have a stable weight – you lead a generally healthy lifestyle and are in good usual health

During the initial consultation, we make sure that buttock lipofilling is the right indication for you. To this end, we clarify questions about your general state of health. We measure body weight, height, fat percentage and thickness of the subcutaneous fat layer. The areas to be treated are drawn and discussed with you in front of a mirror. We discuss the small skin incisions required and the technique we will use. A blood test is required prior to the procedure. When liposuction of the abdomen is desired, an ultrasound scan to check for hernias is systematically performed. Smoking cessation is recommended 3 weeks before and 3 weeks after the operation.

For a harmonious, natural result, problem areas are marked while standing. While lying down, the surgical area is disinfected and sterile-coated. A tumescent solution is then introduced into the marked areas through very small skin incisions, only 3 to 4 millimeters in length. It contains analgesics and medication to relieve the resulting bruising. Depending on the surface and height of the layer, different suction cannulas are used. To ensure optimum results, several intraoperative checks are carried out in the standing position. The fat is then processed and injected into the buttocks under deep sedation or general anaesthetic. Immediately after buttock lipostructure, the patient is provided with a suitable dressing and a compression belt to support the skin’s adaptation processes. The operation is normally performed on an outpatient basis and lasts three to four hours.

Some loss of volume must be anticipated after buttock lipostructure, as not all fat cells will survive after transplantation into the tissues. Therefore, patients should use a specific BBL cushion to sit on in order to achieve an ideal result. After buttock lipostructure, you will need to take antibiotics for three days. To avoid irregularities, LPG Endermologie treatment is strongly recommended one week after the procedure in areas where liposuction has been performed. Regular wearing of the compression corsage is absolutely essential. For three weeks, it becomes a companion – day and night – and is only removed for showering. Any swelling and bruising will disappear after just a few days. After two or three days’ rest, social life can resume. Sport is possible again after three weeks. A stable weight is an important component of an optimal final result. A good result is visible 4 weeks after the operation, but the final result can only be assessed 6 months after the operation.

In areas where liposuction has been performed, the skin’s sensitivity to touch may be slightly reduced. Sensitivity returns in the weeks following surgery. Bruising, redness and slight swelling appear regularly after the operation. These disappear after a few days to a few weeks. Infections, local hematomas and hardening may also occur, but are rare. Slight bumps and asymmetries are also possible. As we perform regular standing checks during the operation, the risk of a bump or asymmetry after surgery is low. EVL is the only technique in the world that avoids the risk of fat embolism. Injecting fat into hip dips alone does not run the risk of fat embolism.

Buttock lipofilling or BBL is one of the Bellefontaine clinic’s specialties. Dr. med. Yann Favre performs several hundred liposuctions with or without lipofilling per year in Switzerland. He specializes in lipofilling of the buttocks, and is one of the few surgeons in Switzerland to use the revolutionary PAL technique combined with EVL, which enables more fat to be injected without the risk of fat embolism. To achieve optimum results and avoid contour irregularities, he takes sufficient time and performs several standing controls during the procedure.