What happened
This week Chloe Ferry, who had a Brazilian butt lift at 19, posted from a hospital bed to say she was having the loose skin removed that was left behind when the fat was taken out last year. She said she had not understood at 19 how permanent some decisions can be, that surgery is never as simple as it looks from the outside, and that corrective procedures and removals carry consequences nobody imagines when they make the first decision. Her words, in her own post, reported by the British press on 29 September.
She is not alone in the direction of travel. The 2025 ASPS figures show buttock augmentation with fat down 5 percent in the United States, and the ISAPS global survey published this week counts about 18,400 buttock augmentations a year in Türkiye against 5,500 buttock lifts, a ratio that tells me the second number is going to grow. Patients who had fat placed in their buttocks between 2016 and 2022 are now asking me the question she asked: can it come out, and what is left when it does?
The common misconception
The misconception runs in both directions. The first version is that a BBL is easy to undo: fat went in with a cannula, so fat comes out with a cannula, and the buttock returns to what it was. The second version, the one Ferry’s post will spread, is the opposite: that reversing a BBL always means a second operation with a long scar to remove the skin. Neither is true for every patient. Grafted fat that survived is living tissue; taking it out is liposuction of a graft, not deflation of a balloon. And what the skin does afterward depends on how much fat there was, how long it was there, how old the skin is and how much it has already stretched, which is why the answer is decided patient by patient and not by a rule.
The clinical reality
Removing grafted fat is liposuction, with a graft’s complications attached. Fat that took after a BBL has its own blood supply and behaves like the fat around it, which is why it grows and shrinks with weight, and why it can be suctioned. I have written about the same principle in the face: a graft is not a filler, so there is nothing to dissolve. What makes gluteal grafts harder than facial ones is scale and history: hundreds of milliliters, sometimes more, placed years ago, often with areas of scar, oil cysts or calcified fat where the graft did not survive cleanly. Those areas do not come out through a cannula the way soft fat does, and the surgeon has to expect them and work around them rather than through them.
The skin question has three answers, and the least invasive one comes first. Take out a moderate amount of fat from a buttock with reasonably elastic skin and the skin retracts on its own over months, the same way it does after ordinary liposuction. Take out more, from skin that has been stretched for years, and there is a middle ground that I treat in the same session: subdermal heating with helium plasma, the device many patients know as Renuvion, delivered under the skin as the fat comes out. A randomized trial in 76 patients undergoing abdominoplasty after major weight loss found significantly better excess-skin scores at two years when the device was added, and a study of the neck showed improvement in 82.5 percent of patients at six months. Buttock-specific data do not exist, and I say so, but the tissue is the same. Only when the skin excess is large and the skin quality is poor does the third answer apply: a buttock lift, which removes the surplus skin through an incision hidden in the upper buttock crease and leaves a scar in exchange for a contour. In my practice that is the exception after a reversal, not the rule.
The order is wait, subtract, then decide. Fat that comes out at one sitting is not the whole story. Swelling settles and the skin keeps retracting for months, so a buttock that looks loose at six weeks may look acceptable at six months. I do not plan a lift on a reversal patient before six months have passed, and I say that before the reversal so nobody books two operations for one problem. Reversal in a patient who wants only a modest reduction is a small operation; reversal plus lift in one session is a body-contouring operation, and it counts toward the procedure limit I described in my article on combined surgery.
The original operation is the one that decides how the reversal goes. A BBL done with fat placed only under the skin, in the subcutaneous layer, is the safe way to do the operation and the easy one to reverse, because the fat is where a cannula can reach it. A BBL done into the muscle, the practice that produced the fat embolism deaths and that every major society has advised against since 2018, leaves fat that is not removed; the 2017 task force report that started the safety campaign found the fatal and nonfatal embolism rate significantly higher among surgeons who injected into the deep muscle, and a 2024 survey of 86 surgeons still put the fatality rate from pulmonary fat embolism at about one in 24,000 BBLs. If your BBL was intramuscular, tell me, because it changes what I will remove and what I will leave.
A reversal is not a return. Ferry said it herself: you cannot get back the buttock you had at 19. The skin has been stretched, the fat compartments have been rearranged, and the years have passed. What a good reversal produces is a proportionate buttock for the body you have now, not a copy of the one before the first operation. Patients who understand that are satisfied; patients who expect their old body back are not, whatever I do.
The practical takeaway for patients
Send photographs standing, from behind and both sides, and tell me when the BBL was done, roughly how much fat was placed if you know, and whether you were told it was placed above or into the muscle.
Decide what you want the result to be before you ask for a reversal: full removal, or a reduction to a size you are comfortable with. A partial reduction is often the better answer, because it keeps the skin under tension it can still manage.
Expect one operation, not two, until the skin has been given six months. If a surgeon offers reversal and lift in the same session before seeing how your skin retracts, ask why.
Aftercare is easier than after the original BBL: compression and walking from the first day, and you may sit and lie on your back normally, because there is no graft to protect. That holds after a buttock lift as well.
Honest limits
There is no published series on BBL reversal outcomes, and the skin-tightening trial I cite is on the abdomen, not the buttock. What I have written about retraction, the role of subdermal heating and when a lift is needed comes from my patients, and another surgeon’s threshold for a lift may sit lower or higher than mine. The ISAPS and ASPS numbers describe procedure counts, not why patients had them or how they feel about them now. And a public figure’s post is her account of her own body; I do not know her surgeon’s plan or findings and do not comment on either.
If you had a BBL and are wondering whether to reduce it, remove it, or leave it alone, send photographs and the date of the original operation to +90 544 772 0772. The surgical team reviews them the same day and tells you which of the three answers your skin is likely to need.
Dr. Mustafa Aydınol is a plastic, reconstructive and aesthetic surgeon in Istanbul and a member of ISAPS.
Sources
- Yahoo News UK, 29 September 2026: Chloe Ferry undergoes reconstructive surgery after BBL removal. Link
- American Society of Plastic Surgeons. 2025 Plastic Surgery Statistics Report: buttock augmentation with fat grafting 25,662 procedures, down 5 percent. Link
- International Society of Aesthetic Plastic Surgery. ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2025, country tables for Türkiye. Link
- Mofid MM, Teitelbaum S, Suissa D, et al. Report on mortality from gluteal fat grafting: recommendations from the ASERF Task Force, 692 surgeons, 198,857 cases, 32 fatal emboli. Aesthet Surg J, 2017. DOI
- Agullo FJ, Castro-Garcia JA, Mohan VC. Multidisciplinary experience for gluteal fat grafting: survey of 86 surgeons, pulmonary fat embolism fatality about 1 in 23,878. Aesthetic Plast Surg, 2024. DOI
- Barone M, Salzillo R, De Bernardis R, et al. Efficacy of Renuvion helium plasma to improve the appearance of loose skin in patients undergoing abdominoplasty after massive weight loss: prospective randomized study, 76 patients, 2-year follow-up. Aesthetic Plast Surg, 2025. DOI
- Ruff PG, Bharti G, Hunstad J, et al. Safety and efficacy of Renuvion helium plasma to improve the appearance of loose skin in the neck and submental region, 82.5 percent improved at day 180. Aesthet Surg J, 2023. DOI
- Triana L, Palacios Huatuco RM, Campilgio G, Liscano E. Trends in surgical and nonsurgical aesthetic procedures: a 14-year analysis of ISAPS statistics, including the 2018 safety campaign on gluteal fat transfer. Aesthetic Plast Surg, 2024. DOI
