Ultrasound-Assisted BBL in NYC

In a standard BBL, or “Brazilian Butt Lift”, fat is harvested from one area of the body (often the abdomen, waist and/or back) and injected into the buttocks to give them a more curvy, lifted appearance. An ultrasound assisted BBL, or ultrasonic BBL, is exactly the same with one very important difference. In standard BBLs, the fat is injected blindly into the buttocks. It is impossible to know how deep the fat is going. In an ultrasound-assisted BBL, ultrasound is used to see through the skin and know the exact depth at which the fat is being placed.

Ultrasound-assisted BBL technology is a huge leap forward in the safety of the very popular BBL procedure. Standard BBLs can be dangerous as it is impossible to know exactly how deep the fat is being placed. If fat is placed too deep in the buttocks, specifically within the gluteus maximus muscle (see below), there is an increased risk that this fat can travel into the large blood vessels in the muscle. From here, the fat can travel to the heart (this is called a “fat embolism”) and potentially cause death. Instead, fat should be placed in the gluteal fat pad that is over the muscle. In ultrasound assisted BBL, we are for the first time able to see the exact depth at which we are placing our fat grafts, and ensure we are staying in a safe location outside of the muscle. Another added benefit of ultrasonic BBL is that we can make sure we are placing the fat in the correct fat compartment. Fat should be grafted into the deep fat compartment as it can flow evenly here and produce a natural, plump result. If fat is injected too close to the surface, it cannot flow evenly. This leads to a flat, unnatural appearance and unwanted changes in skin quality.

In ultrasonic BBL, a device called an ultrasound transducer (see below) is positioned over the site of fat injection. This device is both a speaker and a microphone. It uses its speaker to send out ultrasound waves (sound waves outside the range of human hearing). It then listens for those waves to come back with its microphone. Since all materials reflect sound differently, a computer can create an image of the area of interest based on how the ultrasound waves are bounced off the tissue targeted by the device. In ultrasound assisted BBL, we are therefore able to see exactly where we are placing the fat graft and ensure it is going into a safe location.

The ideal candidate for ultrasonic BBL is in good health and has a BMI close to their goal range. Individuals with less overall body fat may be good candidates for the “athletic” ultrasonic BBL, in which small amounts of fat are collected from multiple body areas and combined to produce a subtle, natural-appearing increase in buttock definition and projection.

Ultrasound assisted BBL is an advanced technique requiring a specialized skill set and specific equipment, so it is generally priced above a traditional BBL. Fees are quoted individually after your consultation and depend on the number of harvest areas and the anesthesia plan. Financing is available through CareCredit and Alphaeon Credit, and the $500 consultation fee is applied toward any procedure you book.

An ultrasound-assisted BBL is elective cosmetic surgery, so it is not covered by health insurance. Dr. Smith is out of network with all insurance plans; the practice helps patients use out of network benefits toward care. What a case costs depends on how much fat is harvested and from where, how many donor areas are treated, and how long the operation takes. Combining it with another procedure changes the quote, so tell Dr. Smith at your first meeting if you are considering more than one.

A quote is given after an examination, not before one. The consultation fee is $500 and is applied toward any procedure you book.

The quote is itemized into the surgeon's fee, the facility fee and the anesthesia fee, so you can see what each part costs rather than a single figure. All post-operative visits are included. The quote is valid for thirty days, and a ten percent deposit is taken at booking. Financing is available through CareCredit and Alphaeon Credit.

Dr. Smith may prescribe pain medication and antibiotics; some patients manage with over-the-counter medication alone. A compression garment is worn for four weeks after liposuction. The bigger practical consideration is sitting: for the first two weeks you should avoid sitting or lying directly on the buttocks, sleeping on your side or stomach instead, and a donut pillow or a pillow under the thighs helps after that. Light activity is usually reasonable after a few days, while strenuous activity and prolonged sitting directly on the buttocks are avoided for two to three weeks. Plan your time away from work around that rather than around pain.

Be sure to factor in your time off of work, additional medications, and supplies into your total costs for the surgery. You will also need a trusted friend, family member, or hired driver to give you a lift home after your procedure. You’re not allowed to drive after liposuction.

You go home the same day in your compression garment. The first three days bring the most pain and swelling, and medication makes that manageable rather than absent. Bruising in the areas treated by liposuction is expected and fades over the following weeks. Numbness over the buttock is common and usually settles, though in some patients a patch of altered sensation persists.

Expect swelling and bruising in the treated areas, with the most soreness in the first days after surgery. Avoid sitting or lying directly on the buttocks for the first two weeks: sleep on your side or stomach, and once you do sit, use a donut pillow or place pillows under the thighs to keep pressure off the grafted area. Light activity can usually be resumed after a few days, while strenuous activity and prolonged sitting directly on the buttocks should be avoided for 2 to 3 weeks. Compression is worn for 4 weeks after liposuction. Numbness in the buttock region is common and usually diminishes over several weeks, though in some cases a patch of altered sensation persists. Most of the initial pain and swelling has subsided by 4 to 6 weeks.

Ultrasound guidance lets Dr. Smith see the exact depth at which each fat graft is placed, so the fat stays in the gluteal fat pad above the muscle rather than within it. A consultation is where you find out whether ultrasound-assisted BBL fits your anatomy and your goals.

Dr. Smith’s practice is located at the Ritz Tower, 111 East 57th Street, Ground Floor, New York, NY 10022, in Midtown Manhattan. The office welcomes patients from across the five boroughs, the tri-state area, and well beyond.

Choosing where you have surgery matters as much as choosing who performs it. New Yorkers come to Dr. Smith because his work reflects the city itself: refined, exacting, and never one-size-fits-all. Whether you’re a lifelong New Yorker or traveling in for a consultation, you’ll find a practice that treats every patient with the precision and discretion that have made Manhattan one of the destinations plastic surgery patients travel to from around the world.