Dents After a BBL: Causes, Prevention and How to Fix Them

Dents after a BBL are usually caused by uneven liposuction of the donor areas, uneven survival of the transferred fat, fat necrosis, a fluid collection (seroma), or pressure on the buttocks while the grafts are healing. Some lumps and unevenness in the first 3 months are a normal part of healing and settle with time. A dent that is still there at around 6 months is unlikely to fill in on its own, but it can usually be corrected with a small revision using fat grafting, liposuction or subcision.

This guide explains what causes dents and lumps after a Brazilian butt lift (BBL), how to tell normal early unevenness from a permanent dent, how to prevent BBL dents, and how they are fixed. If you are in the first few weeks of healing, our week-by-week BBL recovery guide sets out what to expect at each stage.

What Are Dents After a BBL?

A dent after a BBL is a small area that sits lower than the surrounding contour of the buttock, hip or donor area. Patients call them BBL dents, dimples, divots or “holes”. They fall into three broad groups:

• Volume dents: a shallow, soft hollow where less fat survived than in the area around it, or where too much fat was removed by liposuction.
• Tethered dimples: a point where a fibrous band or scar tissue pulls the skin inwards, much like cellulite. These often look worse when you stand or tense your muscles.
• Dents next to lumps: a firm area such as fat necrosis or a healing seroma makes the skin around it look uneven, and a dent can appear when the lump is later absorbed.

Dents can appear on the buttocks, but they are just as likely in the donor areas, such as the flanks, lower back, abdomen or inner thighs.

How common are they? A 2026 systematic review of 18 studies and 12,032 patients, published in Plastic and Reconstructive Surgery ↗, found non-embolic complications in 2.67% of gluteal fat transfers. Contour irregularities (32.4%) and asymmetries (25.6%) were the most common of these, ahead of fat necrosis (14.3%), infection (13.1%) and cysts (10.6%)^[1]. Unevenness is uncommon overall, but it is the complication you are most likely to meet.

What Causes Dents After a BBL?

Most BBL dents come from one of six causes, and several can act together, which is why a dent is best assessed in person rather than from a photo.

1. Over-aggressive or uneven liposuction

Every BBL starts with liposuction to collect the fat. If too much is removed from one spot, if suction is too close to the skin, or if the edges of a treated area are not blended into the untreated tissue, the skin settles unevenly over the hollow. This is the usual reason for dents in the flanks, back and thighs after a BBL.

In a 2026 multicentre prospective cohort study of 1,248 patients in the Aesthetic Surgery Journal ↗, contour irregularities were the most frequent complication after liposuction, affecting 5.8% of patients over around five years of follow-up, and 8.7% had revision surgery. High BMI, smoking, removing more than 5 litres and combining procedures all predicted complications^[2]. Smooth, even 360 liposuction of the waist and back matters as much to the final shape as the fat transfer itself.

2. Uneven fat take

Transferred fat is a graft. It arrives without a blood supply and has to connect to the surrounding tissue within days. Cells close to a good blood supply survive; cells too far from one, or squeezed by pressure, die and are cleared away. Around 50–70% of transferred fat usually survives, and the plan allows for this.

The problem is uneven survival. If one zone keeps more fat than its neighbour, the buttock can look lumpy or dented even when the overall volume is good. In a prospective ultrasound study of 50 women, the gluteal fat layer thinned by an average of 18.2% over 12 months, but the loss ranged from 6.8% to 24.8% between patients^[3]. Our guide to BBL shrinking explains how much volume loss is normal.

3. Fat necrosis

Fat necrosis is grafted fat that has died. It usually shows first as a firm, sometimes tender lump under the skin, often within the first 3 months, and can form an oil cyst (a pocket of liquid fat). As the body slowly absorbs the dead fat, the lump can soften and leave a hollow behind, which is why some dents appear months after surgery. Placing large amounts of fat in one spot raises the risk. Our article on fat necrosis after BBL covers the signs and treatment.

4. Seroma

A seroma is a collection of clear fluid in the space left by liposuction or fat grafting. It feels like a soft swelling that moves when pressed. In a 2025 systematic review and meta-analysis of 22,151 patients in Plastic and Reconstructive Surgery ↗, seromas occurred in 2.03% of gluteal fat grafting cases and contour irregularities in 2.29%^[4]. A seroma that keeps refilling can form a capsule of scar tissue that leaves a ridge or dip, so have any new soft swelling checked. Most can be drained with a fine needle.

5. Pressure on the grafts

In the first weeks, grafted fat relies on tiny new blood vessels growing in from the tissue around it. Sitting on your buttocks, lying on your back or leaning against a hard edge compresses the graft and can starve it of oxygen, so more cells die in that spot. Pressure is one of the commonest avoidable causes of a flat or dented area.

6. Compression garment creases

A garment that is the wrong size, rolls down at the edges, bunches into folds or has a tight seam pressing into swollen tissue can leave lines and dents that sometimes persist, mostly on the flanks, back, abdomen and thighs. At Centre for Surgery the garment covers the donor areas and leaves the buttocks free, so the grafted fat is not squeezed.

Other contributing factors

Cellulite, natural dimples over the lower back and dents from old injections can be present before a BBL and may still show afterwards. Large weight loss after a BBL can also make dimples more visible.

Is It Normal to Have Lumps and Dents After a BBL?

Yes, in the early months. Most patients notice some lumps, firmness or unevenness, and on its own this is not a sign that anything has gone wrong:

• Weeks 1 to 2: swelling peaks at around 3 to 5 days, with bruising and firm, uneven areas.
• Weeks 2 to 6: swelling drains and the buttocks often look smaller and flatter. The liposuction areas can feel lumpy and hard while they heal.
• Weeks 6 to 8: “fluffing” begins, as the skin relaxes around the surviving fat and the shape becomes rounder and smoother.
• Around 3 months: most of your result is visible.
• 3 to 6 months: the final result. Fat that survives to around 6 months has its own blood supply and is generally permanent.

The difference between normal early unevenness and a permanent dent is mostly time. Early lumps tend to be diffuse, firm and improving week by week. A dent still clearly visible at 6 months, with no lump under it and no improvement over the previous 2 to 3 months, is unlikely to fill in on its own.

How Do I Know If I Ruined My BBL?

Most people who worry about this have not damaged their result. Sitting for a few minutes by accident, or a garment mark that fades within hours, is very unlikely to cause a lasting dent. Call your clinic if:

• One side becomes noticeably flatter than the other over a few weeks.
• A new firm, tender or growing lump appears, or the skin over it is red or darkened.
• You notice a soft swelling that feels like it contains fluid.

Contact your clinic, or NHS 111 out of hours, for fever, calf pain or swelling, or a red, hot incision. Call 999 for breathlessness, chest pain or coughing up blood. At Centre for Surgery you have your surgeon’s direct number for the first 24 hours, then the clinic on 020 7993 4849 (9am to 6pm, Monday to Saturday).

How to Prevent Dents After a BBL

Preventing BBL dents is a shared job: part happens in theatre, and part happens at home in the weeks that follow.

Surgical technique

Most dents and lumps are decided by how the fat is taken out and put back in:

• Fat placed under the skin only. At Centre for Surgery, fat is injected only into the subcutaneous layer above the gluteal muscle, never into or beneath it. The 2025 meta-analysis found subcutaneous-only injection and ultrasound guidance were both associated with fewer complications, including minor ones such as irregularities^[4].
• Real-time ultrasound guidance. In a series of 4,150 BBLs, surgeons used ultrasound to confirm every fat deposit stayed above the deep fascia, then spread (equalised) the fat with a moving cannula to correct contour deformities before the end of the operation^[5]. Centre for Surgery uses ultrasound-guided BBL on every patient.
• Fine, even layers. Many small deposits placed with a blunt cannula, rather than pools in one spot, give each graft a better chance of picking up a blood supply. Centre for Surgery uses expansion vibration lipofilling (EVL) for this.
• Smooth liposuction. Harvesting by power-assisted liposuction or VASER liposuction, in a criss-cross pattern with blended edges, protects the donor areas from dents.
• Realistic volumes. Overfilling raises the pressure inside the buttock and fat survival falls, so your surgeon plans a volume your tissue can carry.

Point out any dents, dimples or cellulite at your consultation so they can be photographed. Some pre-existing hollows can be partly filled during the BBL.

Avoid sitting on your buttocks for 2 weeks

Do not sit directly on your buttocks for 2 weeks after a BBL. Have a BBL cushion ready before surgery, so that if sitting cannot be avoided, for example in a car, your weight rests on the backs of your thighs. Keep toilet visits brief and lean forward (no cushion on the toilet). From week 3 you can usually sit normally for short spells. Sleep on your front or side, not your back, for the same 2 weeks. Our guide on when you can sit after a BBL has practical tips.

Wear your compression garment correctly

Wear the garment day and night for 6 weeks over the donor areas, with the buttocks left free. To avoid creases and garment dents, pull it straight each time you put it on, smooth out folds at the waist and thighs, check the edges are not rolling down, and replace a garment that has stretched. A seam mark that fades within an hour is normal; a deep line that persists is worth mentioning at your wound check. Our article on the benefits of wearing a compression garment explains how it helps the liposuction areas heal smoothly.

Lymphatic drainage massage, if recommended

Manual lymphatic drainage is a very light massage that moves swelling towards the lymph nodes. It does not fill dents or rescue fat that has died, but some surgeons recommend it to help swelling and firmness settle in the liposuction areas. Centre for Surgery does not provide it in-house: if your surgeon recommends it, you are referred to a qualified therapist and pay the therapist directly. Avoid firm massage over the grafted buttocks in the early weeks. Our guide to lymphatic drainage massage after a BBL covers timing and sessions.

No nicotine, a stable weight and gentle movement

Nicotine narrows small blood vessels and fat survival falls in smokers, so stop smoking and vaping for at least 4 weeks before and 4 weeks after surgery. Be at a stable weight for at least 3 months beforehand and avoid crash dieting afterwards, as large weight swings change the shape of the buttocks and donor areas; our article on gaining weight after a BBL explains why. Walk from day 1, add light cardio such as walking (not cycling) from week 3, and return to full exercise, including weights, from 6 weeks.

How to Fix Dents After a BBL

The right fix depends on what caused the dent, how deep it is and how long ago you had surgery.

Time

For anything in the first 3 months, time is usually the first treatment. Dents that look worrying at 6 weeks are often much less obvious at 3 months. Your surgeon will examine the area, take photos and review you again rather than operating early, as revision on tissue that is still swollen is less predictable and can create new irregularities.

Fat grafting into the dent

For a volume dent that remains once the result has settled, the usual fix is a small top-up of fat placed precisely into the hollow. Fat is collected by liposuction from an area with some to spare and injected in fine layers, under the skin only, to lift the dent level with the surrounding contour. The same rules on sitting and garments apply afterwards.

Liposuction to blend the edges

A dent can look deeper than it is when the tissue around it is fuller. Careful liposuction of the high points blends the contour, and it is often combined with fat grafting into the low point. The same approach treats dents left in the donor areas.

Subcision for tethered dimples

Subcision releases the fibrous bands or scar tissue that pull the skin inwards. A fine blade, needle or blunt cannula is passed under the skin through a tiny puncture to cut the band, and the skin lifts back up. In a study of 232 women with dimples on the thighs and buttocks, subcision improved the surface depressions and satisfaction was high, although all had bruising and discomfort afterwards^[6]. A 2023 multicentre study of device-guided subcision in 74 women also found a meaningful improvement in dimples at 3 months, with no device-related serious complications^[7].

At Centre for Surgery, subcision can be used to release tethered dents, often alongside fat grafting. It suits small, well-defined dimples with little volume missing. Where both are present, surgeons often release the band and graft fat into the space created, which also helps stop the band reattaching. This combined approach was reported in 126 patients with buttock and thigh dimpling, most of whom rated their results good or excellent^[8].

Treating lumps behind a dent

If fat necrosis or an oil cyst is part of the problem, it is treated first. Small areas often soften over months; larger oil cysts can be drained with a needle, and firm lumps that do not settle can be removed or broken up with liposuction. Any dent left behind can then be filled with fat.

Can you fix BBL dents without surgery?

Only partly. Massage, creams and exercise cannot replace missing volume or release a tethered band. Hyaluronic acid body filler can give a modest, temporary improvement in a very small dent, but for a true volume dent or tethered dimple, fat grafting, liposuction or subcision address the cause.

Tap to reveal

Real Centre for Surgery patient, photographed at least six months after BBL surgery.

A settled BBL should have a smooth surface, with the fat blending into the hips and lower back and no step at the edges of the liposuction areas. You can see more real results in our BBL before and after photos.

When Can BBL Dents Be Revised?

Most surgeons wait until the result has settled, and at Centre for Surgery a revision BBL is discussed at the 6-month review. You will be seen sooner if you have a concern, so a seroma, fat necrosis or infection can be treated straight away. Before planning a revision, your surgeon will look at:

• The cause: a volume dent, a tethered dimple, a lump, or a mix.
• Donor fat: after a first BBL and 360 liposuction there may be less fat left, so your surgeon checks which areas can still be used.
• Your weight: it should be stable, so the correction suits your settled shape.
• Safety: revision fat grafting follows the same rule as a first BBL, with fat placed under the skin only. The ASERF task force report found that injecting into the deep muscle was associated with a significantly higher rate of fatal and non-fatal fat embolism^[9]. Scar tissue makes the planes harder to feel, so ultrasound guidance matters even more in a revision.

A BBL cannot be fully reversed, as surviving fat has its own blood supply, but it can be revised. Our guide to revision BBL explains the procedure and what can realistically be corrected. If your BBL was done elsewhere, including abroad, Centre for Surgery can assess it; a different consultation fee applies and it is not redeemable.

Frequently Asked Questions

Brazilian Butt Lift in London

Brazilian butt lift surgery at Centre for Surgery is performed by GMC-registered surgeons at our CQC-regulated Baker Street hospital, rated Good overall by the CQC. Every BBL uses real-time ultrasound guidance, with fat placed only in the layer under the skin above the gluteal muscle. Surgery is a day case under TIVA (total intravenous anaesthesia), and the consultant who assesses you performs your surgery. Aftercare includes a nurse-led wound check at 7 to 14 days, a surgeon review at 6 weeks and reviews at 3 and 6 months, so any lumps or dents are assessed as your result settles. We recommend a two-week cooling-off period before you go ahead. Your initial consultation is £100, redeemable against the cost of surgery if you go ahead. Finance isn’t available for BBL at Centre for Surgery, so the procedure is self-funded.

Phone: 020 7993 4849 | Address: 95–97 Baker Street, Marylebone, London W1U 6RN
Contact us to schedule a consultation

References

1. Domínguez-Millán R, Hoyos A, Cárdenas-Camarena L, et al. Non-embolic complications of gluteal fat transfer: a systematic review of the literature. Plastic and Reconstructive Surgery 2026. doi:10.1097/PRS.0000000000013408 ↗
2. Gentile P, Sterodimas A. Long-term outcomes and complication profile after modern liposuction: a multicenter prospective cohort study with five-year follow-up. Aesthetic Surgery Journal 2026. doi:10.1093/asj/sjag193 ↗
3. Cansancao AL, Condé-Green A, David JA, Vidigal RA. Subcutaneous-only gluteal fat grafting: a prospective study of the long-term results with ultrasound analysis. Plastic and Reconstructive Surgery 2019;143(2):447–451. doi:10.1097/PRS.0000000000005203 ↗
4. Elsaftawy A, Bonczar M, Jagosz M, et al. Gluteal augmentation with fat grafting: a systematic review and meta-analysis of complications and procedural factors. Plastic and Reconstructive Surgery 2026;157(3):381e–393e (published online October 2025). doi:10.1097/PRS.0000000000012437 ↗
5. Pazmiño P, Del Vecchio D. Static injection, migration, and equalization (SIME): a new paradigm for safe ultrasound-guided Brazilian butt lift: safer, faster, better. Aesthetic Surgery Journal 2023;43(11):1295–1306. doi:10.1093/asj/sjad142 ↗
6. Hexsel DM, Mazzuco R. Subcision: a treatment for cellulite. International Journal of Dermatology 2000;39(7):539–544. doi:10.1046/j.1365-4362.2000.00020.x ↗
7. Stevens WG, Green JB, Layt C, et al. Multicenter pivotal study demonstrates safety and efficacy of a new cellulite procedure: 3-month results. Aesthetic Surgery Journal 2023;43(1):97–108. doi:10.1093/asj/sjac179 ↗
8. Uebel CO, Piccinini PS, Martinelli A, et al. Cellulite: a surgical treatment approach. Aesthetic Surgery Journal 2018;38(10):1099–1114. doi:10.1093/asj/sjy028 ↗
9. Mofid MM, Teitelbaum S, Suissa D, et al. Report on mortality from gluteal fat grafting: recommendations from the ASERF Task Force. Aesthetic Surgery Journal 2017;37(7):796–806. doi:10.1093/asj/sjx004 ↗

Related Articles

• Fat Necrosis after BBL – Causes & Solutions
• Revision BBL
• BBL Shrinking: Why It Happens and What Is Normal
• When Can I Sit Normally After a Brazilian Butt Lift?