Brazilian Butt Lift Surgery: How I Do It

Leonard Tachmes, MD
Article by
Miami Beach Plastic Surgeon

Dr. Tachmes' Personal Approach To Buttock Augmentation Using Fat Transfer


The Brazilian Butt Lift procedure has become one of my most popular surgical procedures that i perform.  I receive over 100 visits to my website each day from patients in the USA and abroad.  The technique has evolved through the years as plastic surgeons have become more skilled in this procedure and the technology and equipment more sophisticated.  Results vary from patient to patient and are based on the patient's skin tone and elasticity, buttock shape and amount of fat available for transfer. 

Each patient presents with a unique body shape and fatty distribution that requires individualization of the procedure.  This is where the "Art of Plastic Surgery" comes into play and patients are wise to search out a very qualified board certified plastic surgeon with significant experience in this surgery. Artistic sensibility and judgement are crucial aspects necessary in order to achieve consistent, aesthetically pleasing results.

How much fat to remove?  From what areas of the body should the fat be taken? How deep or superficial should the cannula be inserted into?  When is enough suctioning enough?  How much and at what level should the fat be injected into the buttocks?  Is the surgeon able to effectively sculpt the buttock to produce maximum results?  How does a female buttock differ from a male buttock?  These questions must be addressed by the surgeon instinctively during each procedure.

I focus on several key aspects of this procedure in order to insure optimum results and patient safety:

- i employ M.D. anesthesiologists to monitor patient vital signs and maintain proper hydration during the procedure.

- i begin with the patient in the supine position for the tumescent liposuction portion of the procedure.  After completion of the fat harvesting, I then rotate the patient into the complete prone position for the fat transfer.

- i am careful to maintain the suction pressure near 18mmHg and never handle the fatty tissue prior to injection.  I use wide bore toomey syringes and cannulas to inject the fat to minimize trauma and damage to the fat cells.  I also use the "Red Head" fat cannister that has a wide Toomey syringe adapter instead of the traditional luer lock syringe system which has a much narrower diameter and produces much more pressure and injury to the fat cells during transfer.

- i rarely perform combination procedures with the Brazilian Butt Lift surgery, as this adds to the chance of complications due to prolonged operative time, more blood loss and changes in fluid volumes that can become a problem during the immediate post operative period.

- i see all patients on the following day after the procedure and emphasize immediate ambulation to minimize the chances of a blood clot complication.

- patients wear a body compression garment for at least one month to help with swelling and shaping.

Finally, I am beginning to experiment with adult stem cell "supercharging" of the fat transfered tissue as an additional adjunct to this procedure.  During the fat harvesting portion of the case, approximately 50cc of fat is sent to a cryopreservation lab to separate adult stem cells from the fat.  Two weeks after the surgery, the stem cells are shipped back to me and i inject them into the patient's buttock area to increase survival of the transfered fat cells.