Buttock Augmentation: Getting the figure you want

Lane Smith, MD

Article by
Las Vegas Plastic Surgeon

In the past, it was almost a cartoon cliché’: a woman would put on an outfit and ask her husband “does this make my butt look fat?” The husband was always supposed to say “no dear, it does not make your butt look fat.” But styles and popular looks are changing. A firm round buttock has always been desirable, but now thanks to stars like Jennifer Lopez and Kim Kardashian, even bigger bottoms are considered sexy and sought after. In addition to this, certain cultures, such as the increasing Hispanic or black population, have always favored larger bottoms.

There are currently two good options for buttock enhancement; implants or fat transfer. Just like we can enhance breasts with breast implants, we can achieve buttock augmentation with buttock implants. Just as there are many sizes of breast implants, there are also many styles and sizes of buttock implants. The exact style and shape I use is tailored to the patient’s current buttock size and shape, and the patient’s wishes for how much augmentation he or she wishes to achieve. Buttock implants are made of the same material as breast implants, medial grade silicone. Since sexy buttocks are slightly more firm than breasts, the buttock implants are slightly more firm than the standard breast implants.

The implants can be placed through a small incision located in the intergluteal crease (the crease between the two buttock cheeks, commonly called the “butt crack”). In this position the incision is well hidden and typically not noticeable. The surgery only takes about one hour and can be done as an outpatient. Usually patients may return to work after a week as long as they do not do any heavy lifting at work. After about three weeks the patients may return to light exercise, and after six to eight weeks usually heavy lifting and intense exercise is permitted

The second option for buttock augmentation is fat transfer to the buttocks. This is commonly called a “Brazilian Butt Lift,” though many of my Brazilian colleagues have never heard of this technique. This involves taking fat from one area and moving it to the buttocks. Usually the fat is taken from the waist or “love-handles,” but it can be taken from any area of the body that has sufficient fat to transfer. The advantage of this technique over buttock augmentation with an implant is that it is the patient’s own tissue and the patient gets the added benefit of receiving liposuction in the area from which the fat was harvested for transfer.

Another advantage is that the recovery is fairly quick and it only takes two very small incisions, a quarter of an inch in length, to place the fat. However, there are several disadvantages to this procedure. Usually about half of fat will not “take” and will dissolve away. It is always necessary to transfer more fat than you think you need to account for the fat that doesn’t live. Temporarily the buttock will appear too large after surgery. This will usually resolve by about six weeks after surgery. Also there is a risk there could be some lumpiness. Finally, sometimes a woman will not have enough useable fat to transfer. This is particularly true in the Asian population, who often are very thin and have flat small bottoms.

In general, a buttock implant will give a greater improvement in both shape and size to the buttocks than a “Brazilian Butt lift.” In very thin patients who want buttock augmentation, or in patients who want a large increase in the size of their bottoms, I always recommend a buttock implant. In larger patients or in patients who want a more subtle increase in buttock size, I usually recommend fat transfer (Brazilian Butt Lift.) However, the final choice of which procedure to have is always left up to the patient.

A word of caution to patients who desire buttock augmentation. It is important to have these surgeries performed only by a reputable board-certified or board-eligible plastic surgeon. In general this is a good rule of thumb for any cosmetic procedure. Also there are relatively few plastic surgeons that actually perform both of these procedures. It is important that you choose a plastic surgeon that has experience and performs a large number of these procedures.

There exist unscrupulous physicians and even nurses who will inject silicone droplets directly into the buttocks. Usually these “practitioners” are found in foreign countries such as Mexico or the Philippines, but sometimes they can be found in the United States. They will offer procedures at discounted prices. While silicone injections will give a temporary improvement, eventually the injected silicone will begin to be rejected by the body and/or form scar tissue which can make the buttocks distorted, weirdly firm, lumpy and chronically infected. This is almost impossible to correct. When dealing with your body it is never a good idea to go discount shopping.

In today’s changing society, concepts of beauty are also changing. Larger buttocks are now considered sexy and feminine. It is nice to know that there are good options for buttock enhancement. The vast majority of my patients are extremely happy with the results of their buttock augmentation and I find it has one of the highest patient satisfaction rates of any procedure I perform.