Butt augmentation surgery (gluteal augmentation) enhances the shape, size, and projection of your buttocks via various tools and techniques. Itâs often combined with hip augmentation and liposuction, to create an hourglass shape.
The most popular butt enhancement procedure is fat grafting (aka fat transfer), commonly called a Brazilian butt lift (BBL), but it can also be achieved with silicone implants or, more rarely, injectable dermal fillers.Â
âThe BBL has become one of the most commonly performed procedures in the world as it shapes the abdomen, waistline, buttock, and hips,â says Atlanta, Georgia, plastic surgeon Dr. Stanley Okoro. âBBL is not only about the butt.âÂ
A BBL procedure is performed in three steps:Â
1. Fat harvesting: A plastic surgeon uses liposuction to remove excess fat from another area of the body, like the abdomen, flanks, lower back, or thighs, which contours the waistline. This is one of the biggest benefits of a BBL. In fact, sometimes strategic lipo can make the butt and hips appear more shapely even without adding more volume.
2. Fat purification: The fat is washed and loaded into thin cannulas or syringes.
3. Fat transfer: The surgeon injects the purified fat to the butt and hips, adding volume and projection to create a more of an hourglass figure (or the patientâs desired shape and size).Â
A Brazilian butt lift is usually performed as a stand-alone surgery, but itâs also being added to a lot of other procedures, says Austin, Texas, plastic surgeon Dr. Johnny Franco.Â
âIt used to be that people thought butt augmentation was only for 20-year-olds or people who wanted to do something moreâlike a Kim K. butt,â he says. âNow I combine it with almost every mommy makeover transformation, because it provides the 3D body contouring people want.âÂ
With a full mommy makeover, patients can get gluteal augmentation, breast augmentation, liposuction, and a tummy tuck.
Gluteal implants are usually requested by people who:
These semisolid silicone prosthesesâsimilar to breast implants but firmer, with less chance of ruptures or leaksâare inserted through an incision between the butt cheeks and placed below the fascia that covers the gluteus muscle or, more preferably, within the gluteus muscle itself, before being secured with sutures.Â
Buttock implants, when placed properly, are lifetime devices, which do not need to be replaced, says Dr. Okoro.
Sometimes these two buttock augmentation procedures are combined into whatâs known as a composite butt augmentation.Â
In one of the earliest papers describing the technique, the authors (two leading BBL specialists) say that this method can give patients âthe best of both worlds: the reliable core projection of an implant combined with the natural appearance and feel of fat.â
âButt implants with fat transfer is very common in my practice,â adds Dr. Franco, who notes a third advantage of the hybrid: the torso shaping provided by liposuction.
Pros
ConsÂ
Your butt augmentation cost depends on the type of augmentation method you choose. On average, the surgeonâs fee for buttock implants is higher than that for a BBL.
Your cost will also depend on the experience level of your doctor and their office location. As a cosmetic surgery, butt augmentation isnât covered by insurance.
The butt augmentation photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.
A BBL is typically a good option for healthy patients who have sufficient fat to transfer. People with a BMI greater than about 22 should have enough fat.Â
âI tend to like to inject 800â1,300cc per side, depending on a personâs body frame and desire,â says Dr. Franco. âBut even if we only get 400â500cc of fat, thatâs still going to be a good bang for your buck compared to something like Sculptra,â an injectable collagen stimulator sometimes used to enhance the butt and hips.Â
Some doctors advocate gaining weight before BBL, to have more body fat to harvest. However, doing so could lead to an increase in both subcutaneous fat and visceral fat. Visceral fat cannot be accessed or removed by liposuction, and itâs much harder to lose through diet and exercise, notes Dr. Okoro. âMost people have enough fat for fat transfer, so thereâs rarely a need to gain weight beforehand,â he says.
Related: Doctors Say the Skinny BBL Makes Butt Augmentation a Viable Option for a Whole New Set of Patients
Skin quality is also key to BBL surgery, because it determines how successfully a surgeon can contour your body shape via liposuction. âHaving loose or excess skin is one of the reasons we most commonly turn people away for a Brazilian butt lift,â says Dr. Franco.
Butt implants are for a niche group, says Dr. Franco. âTheyâre best suited for people who are too thin for a fat transfer to really make a difference and people who are looking for more projection and shape than a BBL alone can provide.âÂ
For best results, good candidates for implants canât have too much loose skinâunless theyâre willing to combine their implant procedure with a butt lift or a nonsurgical skin-tightening procedure, like BodyTite or Renuvion. Implants can create a rounder rear, with more projection, but they don't have much effect on loose or excess skin.
Buttock enhancement surgery is the most common way to boost a booty, but for those averse to surgery or general anesthesia, injections of biostimulatory fillers, like Sculptra Aestheticâmade of collagen-triggering poly-L-lactic acid, the same material comprising dissolvable suturesâcan add volume, with minimal downtime.Â
Be advised, however, that buttock injections like the âSculptra butt liftâ are not true replacements for a BBL or butt implant.Â
âIf youâre looking for a dramatic change to your butt, itâs going to be very, very difficult with Sculptra,â says Dr. Franco. âYouâll need a large amount, and it would be very expensive.â In fact, it can be almost as expensive as a BBL surgeryâthink: tens of thousands of dollarsâeven though results last only about two years.
Plus, with fillers, nothing is being taken away as it is with a BBL. âYou donât have the benefit of subtracting love handles to give someone more of a figure,â says Dr. Franco. âPeople donât realize that if you donât do a good job with the lipo, which is where you can really shape the torso, youâre not going to get a great butt.â
Related: 5 Things You Need to Know About Butt Injections
Silicone injections (sometimes called âbutt shotsâ) have also been promoted as a way to increase the size of your rear end, but doctors on RealSelf strongly recommend against this treatment. The U.S. Food and Drug Administration (FDA) has also posted this warning on their website: âThe FDA has warned against getting filler injected into the breasts, buttocks, or spaces between the muscles. Using injectable filler for large-scale body contouring or body enhancement can lead to serious injury, including long-term pain, infection, permanent scarring or disfigurement, and even death.â
âThe difficulty with silicone injections begins with the quality of the silicone itself. I have seen many cases where industrial-grade silicone has been injected inside the human body. This can be a tremendous disaster,â says Dr. Raj Ambay, a plastic surgeon in Wesley Chapel, Florida. âProblems can include infections, granulomas, cellulitis and persistent skin infections, disfigurement, and skin dimpling.âÂ
Related: 5 Things That Should Never Happen with Butt Augmentation, According to Plastic Surgeons
The nomenclature for buttocks surgery can be confusing. It used to be that the term âbutt liftâ (or âbutt tuckâ) referred to a surgical procedure that removed loose, sagging skin from above the buttocks, to elevate and improve the contours of the rear, making it perkier. It was often performed after significant weight loss, either by itself or as part of a body lift to more completely hike the lower body.
Now that fat transfer and buttock implants have become so common, however, people often say buttock lift when they mean buttock augmentation, explains Dr. Franco. âWhen people say butt lift with augmentation or butt augmentation, theyâre referring to adding something, whether thatâs fat or an implant,â explains Dr. Franco. âTheyâre not always sure how they want to achieve an augmentation, but they know they want to do something to enhance their buttocks.â
RealSelf Tip: Beware of creams or supplements that promise buttock enhancement. âOther than being genetically blessed and/or doing rigorous dedicated exercise, thereâs no ânaturalâ way to grow the buttocks, other than surgery,â says Beverly Hills, California, plastic surgeon Dr. Ryan Stanton.
Whether you get buttock implants or a BBL for your buttock augmentation surgery, expect to have at least two weeks of downtime. This recovery period helps the implants to âsettleâ (so theyâre less likely to move around) and the fat to âtake.âÂ
You can also expect the following during your buttock enhancement surgery recovery:
Related: 8 Products Plastic Surgeons Recommend for a Successful Brazilian Butt Lift Recovery
With either method, youâll see more volume and contour immediately, but final results can take between six months and a full year to surface.Â
Implants are going to be really tight and look a little high post-surgery, and the buttock area isnât going to be nice and round yet, says Dr. Franco. âItâs a preview, but itâs not your final resultâitâs going to get better.â It takes about six months for your new body shape to reveal itself as the swelling goes down and the tissues relax over the implants.Â
With BBL, how you look in your compression garment post-op is how youâre going to look three months down the road. âAt three months, your butt is what itâs going to be permanently, but swelling from the liposuction continues to improve for up to six months,â says Dr. Franco. âThat means the overall result keeps getting better because the smaller your waist, the better your butt.â
The results of both butt augmentation procedures are long-lasting:Â
Butt implant surgery carries risks of incisional separation, implant extrusion, infection, and seroma (a buildup of fluid). Itâs also possible for the implant to move, leading to asymmetry and pain. Complication rates have been dropping, mainly due to doctors gaining more experience in the procedure.Â
BBLs have a higher mortality rate (on par with that of a tummy tuck), but due to the recent adoption of new techniques, theyâre reportedly getting saferâwhen performed by board-certified plastic surgeons.Â
Recent research from a task force of board-certified plastic-surgeon members from the American Society of Plastic Surgeons (ASPS) and the International Society of Aesthetic Plastic Surgeons (ISAPS) shows a drop in mortality rate from 1 in 3,448 in 2017 to 1 in 14,952 in 2019.Â
The main safety precaution that should be taken during a BBL is injecting fat only above the gluteus muscle. If placed into the muscle, below the muscle, or under the fascia that covers the muscle, there is a risk of fatal fat embolism, where fat enters the gluteal veins and travels up to the heart and lungs, causing death.
Additionally, many plastic surgeons are now offering whatâs called an Ultra BBL, or ultrasound-guided gluteal fat grafting, during which they use ultrasound technology to visualize the anatomy and accurately target safe planes for fat injection.
Other risks of the BBL include asymmetry and issues related to fat necrosis. Not infrequently, some amount of transferred fat does not survive the transplant, says Dr. Stanton, âleaving one cheek bigger than the other.â Moreover, when fat cells die, hard cysts and dimpling can also result.
Related: New Risk-Reducing Guidelines Help the Brazilian Butt Lift Reform Its Reputation
Updated October 26, 2022