Let's face it, there are many areas in the body that can reasonably tolerate an implant. Buttocks are not one of them! If you were to spend > 50% of your time laying on your breasts, I would say breast implants would not be tolerated either.
As plastic surgeons, in our enthusiasm to satisfy patients' desires, we have lost track of logic!
I have performed fat grafting to buttocks for enlargement or enhancement with very good outcome. Overall survival at 1 year seems to be around 50% which is quite good especially if you consider a bit of overcorrection. Once the fat cells become re-incorporated into the body, they become a natural part of the patient. No shifting, no palpability, not capsule, etc.
The challenge with fat grafting rests with technique and judgement
