BBL Incisions Are Small — But Scarring Risk Is Not Zero
A BBL involves two types of incisions: liposuction access points (typically 3–5mm) in the abdomen, flanks, and back, and fat injection access points (similar size) in or near the buttocks. These incisions are small compared to a tummy tuck or breast augmentation, and they are placed in areas that are typically concealed by clothing.
For most patients, BBL incisions heal to thin, flat, barely visible lines within six to twelve months. But for patients with a genetic predisposition to keloid or hypertrophic scarring — which is more common in individuals with Fitzpatrick skin types IV through VI (medium-brown to very dark skin tones) — even small incisions can produce raised, thickened, or widened scars that may be cosmetically bothersome.
This is not a reason to avoid a BBL. It is a reason to have a specific conversation with your surgeon about incision placement, closure technique, and post-operative scar management — before the procedure, not after.
What Your Surgeon Should Do Differently
Incision placement. For keloid-prone patients, incision placement should prioritize areas of lowest tension and areas that are naturally concealed. Experienced surgeons may use fewer access points, strategically placed in skin folds or along natural creases, to minimize visible scarring.
Closure technique. Meticulous layered closure, tension-free wound edges, and the use of absorbable deep sutures reduce the mechanical tension on the incision — one of the primary triggers for keloid formation. Skin-surface closure with adhesive strips (Steri-Strips) or tissue glue, rather than surface sutures, reduces suture-track scarring.
Post-operative scar management protocol. For keloid-prone patients, proactive scar management should start two to three weeks after surgery (once incisions are fully closed): silicone scar sheets or silicone gel (applied daily for three to six months), pressure garments (which the BBL recovery already requires), and avoidance of sun exposure on incision sites. Some surgeons prescribe a short course of topical corticosteroid or offer early intralesional steroid injection if a scar begins to thicken.
What If I Already Have Keloids?
If you have a history of keloid scarring from prior surgeries, piercings, or injuries, tell your surgeon during the consultation. This does not disqualify you from a BBL, but it elevates the scar-management conversation from optional to essential. Your surgeon may recommend a pre-operative dermatology consultation or a prophylactic scar-management plan that starts immediately after surgery.
The incisions from a BBL are small enough that even with keloid-prone skin, the scarring risk is manageable — especially with proactive management. The risk is significantly lower than with procedures involving longer incisions (tummy tuck, breast augmentation) where keloid formation is more clinically significant.
Frequently Asked Questions
Will I get keloids from a BBL?
Not necessarily. Keloid-prone skin is a risk factor, not a guarantee. Small BBL incisions, meticulous closure technique, and proactive scar management (silicone sheets, pressure, sun avoidance) significantly reduce the likelihood and severity of abnormal scarring.
Should I avoid BBL if I have dark skin?
No. Darker skin tones do not contraindicate BBL. The additional consideration is keloid risk, which can be managed with proper surgical technique and post-operative scar care. Many surgeons in Colombia regularly operate on patients with diverse skin types.
What is the best scar treatment after BBL?
Silicone scar sheets or medical-grade silicone gel, applied daily starting 2–3 weeks post-op and continuing for 3–6 months, are the most evidence-supported scar treatments. Compression garments (already part of BBL recovery) also help. Sun protection on incision sites is essential.