Patient Details
This 30-year-old woman presented to Dr. Mihail Climov seeking comprehensive body contouring with two primary goals: greater waist definition and enhanced gluteal shape and volume.
At the time of surgery, she weighed 154.6 lbs with a BMI of 27.4. Rather than treating the abdomen or flanks in isolation, Dr. Climov performed circumferential 360° power-assisted liposuction with additional liposuction of the bra line to sculpt the torso from multiple angles.
The harvested fat was then strategically transferred to the buttocks using an ultrasound-guided Brazilian Butt Lift (BBL). Before fat grafting, Dr. Climov performed superficial pre-dissection with CellulEAF to create expanded grafting planes and facilitate smoother, more controlled fat distribution—an approach we refer to as a Smooth BBL.
Procedures Performed
What Is 360° Liposuction?
360 liposuction is a comprehensive approach to body contouring that treats the torso circumferentially rather than focusing on one isolated area.
Depending on the patient's anatomy, liposuction may address the abdomen, waist, flanks, lower back, and surrounding areas to improve the entire silhouette.
The goal is not simply to remove fat. Strategic liposuction is used to sculpt the waist and improve the relationship between the waist, hips, back, and buttocks.
For this patient, additional liposuction of the bra-line area was performed to create a smoother transition between the upper and lower torso.
Why Combine 360 Liposuction with a BBL?
A Brazilian Butt Lift is as much about reshaping the waist as it is about adding volume to the buttocks.
By removing unwanted fat circumferentially, Dr. Climov can create greater contrast between the waist and hips. The harvested fat can then be processed and strategically transferred to the buttocks to enhance shape, projection, and overall proportions.
This combination can help create:
What Is a Smooth BBL?
A Smooth BBL is Dr. Climov's approach to Brazilian Butt Lift surgery that incorporates superficial pre-dissection with CellulEAF before fat grafting.
Instead of simply introducing fat into untreated tissue planes, the superficial plane above the superficial gluteal fascia is carefully pre-dissected using the CellulEAF structural smoothing device.
This creates expanded superficial grafting planes and additional surface area in which fat can be distributed.
Think of it as preparing the tissue before placing the fat rather than relying on fat injection alone to create the final contour.
The goal is to allow the transferred fat to be placed more evenly throughout the appropriate superficial tissue planes while simultaneously addressing areas of tethering or contour irregularity when present.
How Does CellulEAF Pre-Dissection Work?
The buttock is not always a completely uniform canvas. Fibrous attachments within the superficial tissues can contribute to dimpling, tethering, or areas that do not expand evenly during fat grafting.
Before injecting fat, Dr. Climov uses CellulEAF to mechanically pre-dissect selected superficial tissue planes above the gluteal fascia.
This step is designed to:
Fat is then carefully placed throughout these prepared superficial planes.
This is why we refer to the technique as a Smooth BBL: the objective is not simply a larger buttock, but a smoother, more intentionally sculpted gluteal contour.
Smooth BBL vs. Traditional BBL
Both procedures use the patient's own fat to reshape the buttocks. The difference is in the preparation of the recipient tissue and the approach to contouring.
Traditional BBLSmooth BBL with CellulEAFFat is harvested with liposuction and transferred to the buttocksFat grafting is combined with superficial tissue pre-dissectionFocuses on volume and shapeFocuses on volume, shape, and smooth fat distributionRecipient tissue is not routinely mechanically pre-dissectedSelected superficial planes are prepared before graftingFat is distributed within appropriate superficial tissueExpanded superficial planes allow more controlled distributionDoes not specifically address superficial fibrous tetheringSelected tethering can be released when clinically appropriate
A Smooth BBL is therefore particularly appealing when the surgical goal is refined contouring rather than simply maximizing gluteal size.
Ultrasound-Guided BBL
Safety is a central consideration in modern gluteal fat grafting.
Dr. Climov performs BBL fat transfer using real-time ultrasound guidance. Ultrasound allows visualization of the cannula relative to the gluteal fascia during fat placement.
The transferred fat is placed in the subcutaneous tissue above the gluteal fascia, rather than intentionally injecting fat into the gluteal muscles.
Ultrasound guidance provides an additional method of confirming the anatomical plane during the fat-grafting portion of the procedure.
Power-Assisted 360 Liposuction for Waist Sculpting
For this patient, Dr. Climov used power-assisted liposuction (PAL) to perform circumferential torso contouring.
Rather than viewing the abdomen, flanks, and back as separate areas, the torso is sculpted as a continuous three-dimensional structure.
Strategic fat removal can emphasize the natural curves of the body and create a more defined transition between the waist and buttocks.
This is particularly important with BBL surgery because the visual improvement comes from both sides of the equation: reducing the waist while enhancing the hips and buttocks can create a more pronounced change in overall proportions.
Bra-Line Liposuction
This patient's body contouring also included liposuction of the bra-line area.
Fullness of the upper back can interrupt an otherwise smooth silhouette, particularly when viewed from behind or in fitted clothing. Treating this area together with the waist and lower back allows for a more continuous contour from the upper torso into the waist and hips.
Who Is a Candidate for Smooth BBL with 360 Liposuction?
You may be a candidate if you:
Not every patient requires CellulEAF pre-dissection, and not every patient is an appropriate candidate for BBL surgery. The surgical approach is determined after evaluating skin quality, fat distribution, gluteal anatomy, existing contour irregularities, and the patient's desired outcome.
Natural Fat Transfer for Gluteal Enhancement
One of the advantages of a Brazilian Butt Lift is that augmentation is performed using the patient's own fat rather than a gluteal implant.
Fat removed during 360 liposuction is prepared for transfer and strategically grafted to enhance the buttock and surrounding contour.
Because some transferred fat is naturally reabsorbed during healing, the early postoperative appearance is not the final result. The surviving fat gradually establishes its long-term volume, while swelling from liposuction and fat grafting continues to resolve over the following months.
Why Choose Dr. Mihail Climov for 360 Liposuction and BBL?
Dr. Mihail Climov is a fellowship-trained aesthetic plastic surgeon performing advanced body contouring and fat-transfer procedures in the Houston area.
His approach to BBL surgery focuses on the entire silhouette—not simply the amount of fat transferred.
By combining circumferential power-assisted liposuction, strategic waist sculpting, ultrasound-guided superficial fat grafting, and CellulEAF pre-dissection when appropriate, the objective is to create balanced proportions and a smoother, naturally integrated gluteal contour.
Schedule a 360 Liposuction & BBL Consultation in Houston
If you are considering 360 liposuction, Brazilian Butt Lift, or Smooth BBL in Houston, a personalized consultation can determine which approach is appropriate for your anatomy.
Dr. Climov will evaluate your fat distribution, skin quality, waist-to-hip proportions, donor fat availability, and desired gluteal shape to develop an individualized body-contouring plan.
