Hi Dr. JLo,

LOVE the show! My questions are, why do so many patients lose their butts after weight loss and then more after the LBL? Is their something that can be done during weight loss to "plump" or firm it to keep it from going too flat? Is there something that could be done surgically to help if I am deflated, besides butt implants (can't do that one)? I'm an African American woman and I can't drop it like it's hot if I have no junk in the trunk!:tongue:

Second question: I have had a breast reduction almost 20 years ago. Viewing pictures of after photos of weight loss patients I have noticed that the breasts shrink and/or sag. I am afraid also that the girls are going to deflate too. What I have now is pretty much breast tissue as I have not gained weight up there and they have remained the same size for years. What other options are available besides implants in the event my girls decide they don't want to sit at attention anymore?

Hi. Flattening of the buttock comes first from loss of fat in that area, if the skin sags and is then lifted by an LBL there will be even more flattening. An example is case #11 at John LoMonaco M.D., P.A.

If a patient wants to avoid this, I will transfer fat fat from the hips to the buttocks as a "flap" (also called "autoaugmentation") and also I may inject fat from liposuction (a "brazilian buttock lift") to 'round out' the buttocks. See case #13 at John LoMonaco M.D., P.A.

Remember that the gluteus is the biggest muscle in the body and you can build it up with excercise to offset some of the flattening.

Best wishes,

John LoMonaco, M.D., F.A.C.S.

Houston, Texas

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