In the quest for a curvier, shaplier, fuller derriere, butt injections reign supreme. Even though there are other ways to enhance the buttocks, injections are the mainstay, says Dr. Steven Williams, a board-certified plastic and reconstructive surgeon in Dublin, California. But that comes with one major (and we mean major) caveat: there are very few substances that are safe to inject into the area. Injecting the wrong substance and/or performing the injections in the wrong way can quickly lead to a life-or-death situation. If you’re considering butt shots, here are five other things you absolutely need to know.
1. Fat injections are the best, safest option
Injectable fat transfer, otherwise known as the Brazilian butt lift (BBL), is the gold standard in buttocks augmentation, says Dr. Adam Schaffner, a board-certified plastic surgeon in New York City. “Everything else is inferior,” agrees Dr. Williams, adding that the concept of using autologous fat has completely changed the butt enhancement game. (It bears mentioning that the BBL has a 86% Worth It Rating among RealSelf members and remains one of the most researched and discussed procedures on RealSelf.)
During the procedure, your own fat is harvested via liposuction, typically from the abdomen, back, and/or flanks. This alone enhances the appearance and the contour of the buttocks by creating a smaller waist and a more hourglass shape, notes Dr. Williams. The fat is then injected into the buttocks, to add volume and fullness. It’s not cheap; the doctors we spoke with say a BBL can cost anywhere from $12,000 to $20,000. However, the results are permanent—although there is always the possibility of some of the transferred fat dying before it fully integrates.
2. Injectable fillers are also safe
For those who don’t have enough fat to harvest or who want an off-the-shelf option, butt filler is another possibility. Hyaluronic acid fillers (such as Juvéderm and Restylane) are sometimes used off label, but the amount needed makes them extremely expensive and the results are temporary, says Dr. Schaffner. Sculptra butt injections are the most common; the biostimulatory agent (poly-L-lactic acid) helps to thicken the tissue and stimulate collagen production, and it can create a bit of a lifting effect, explains Dr. Schaffner. However, he’s quick to note that the results are hardly equivalent to the increase in volume and size that can be achieved with a BBL.
Butt filler is also incredibly expensive. “In a BBL, we’re using at least 400 to 500 ccs of fat—about ¼ of a two-liter bottle of Coke,” says Dr. Williams. When you’re talking about fillers, just one cc can cost up to five hundred dollars. That quickly becomes cost prohibitive for most people, he explains. It’s for these reasons that both doctors say Sculptra butt injections are a better solution for smaller areas, such as hip dips, or subtle lifting and contouring rather than increasing the overall size of the butt. And while the results are longer-lasting than those of HA fillers, they’re not permanent.
Radiesse is another injectable filler (also a biostimulatory one) that some providers may offer, however, the doctors we spoke with were not enthusiastic. Dr. Schaffner says he doesn’t recommend it, largely because it’s nonreversible in the instance of an injection complication, and notes that Sculptra’s mechanism of action is more effective for the buttocks. Dr. Williams adds that again, it quickly becomes extremely expensive to use in the large quantities needed in the buttocks; he cites an average cost of $750 per syringe.
You may also have heard of collagen injections as an option for buttock enhancement, but they’re no longer used, due to the potential of allergic reactions from the bovine sources of the collagen derivatives, says Dr. Williams. In fact, both doctors say they’re unaware of any type of (legitimate) injectable collagen on the market. PMMA (polymethylmethacrylate) injections are still sometimes used; the filler is made of microspheres suspended in collagen. However, Dr. Schaffner says he foresees PMMA also being taken off the market soon.
3. Butt injections have inherent risks
Whether it’s with fat, Sculptra, or black market butt shots (more on those in a minute), injecting anything into this area comes with a unique set of risks. “There are big blood vessels located deep within the buttock muscles. If you inject improperly and damage them, whatever you’re injecting can quickly get into the venous system. These are large enough vessels that the substance can quickly get into the right atrium, where it blocks the lungs’ ability to oxygenate the blood and can result in death,” Dr. Williams explains. It’s why there are many safety concerns surrounding the BBL, though he notes that modern injection techniques and practices have greatly alleviated many of these risks. Still, it’s absolutely paramount that anyone performing butt shots be licensed, trained, and experienced. Ideally, this should be only board-certified plastic surgeons, who understand the deeper anatomy beneath the skin, notes Dr. Williams.
While infection is a possibility with almost any type of cosmetic procedure, Dr. Schaffner says the risk is greatly increased when it comes to butt injections. “This is an area that’s dirty—you’re sweating, going to the bathroom. Any bacteria present is going to get pushed into the body if you don’t sterilize the skin properly. That means it’s essential to prep the area the same way we do before a breast augmentation or tummy tuck, with a surgical solution, not just by swiping an alcohol swab across the butt.”
4. Nothing besides fat, hyaluronic acid fillers, and biostimulatory fillers can be safely injected into the butt
Repeat after us: Nothing. Silicone butt injections get a lot of hype but are extremely dangerous. “Silicone is a permanent, non-dissolvable material. If it gets infected or inflamed, it’s very difficult to remove. And if it’s injected into or around a vessel, it can cause tissue necrosis,” notes Dr. Schaffner.
Be wary if someone claims they are using medical-grade silicone, adds Dr. Williams. “True medical-grade silicone costs thousands of dollars per cc. The idea that someone is walking around with half a million dollars of it and is going to inject it into your butt in a hotel room and charge you five hundred dollars makes absolutely no sense,” he says.
5. Black market butt injections are all too common—and extremely dangerous
Silicone isn’t the only thing shady practitioners are injecting into people’s butts. Dr. Schaffner says he’s seen botched butt injections containing Fix-A-Flat and super glue; Dr. Williams adds caulk and cooking oil to the list. (There’s even a documentary about butt injections gone wrong, not to mention countless news stories about all kinds of illicit practices.)
A few telltale signs that something illegal—and dangerous—is going on? First and foremost, no medical professional is ever going to perform a BBL or any kind of butt injections in a house or a hotel room, cautions Dr. Wiliams. (Remember when Cardi B talked about getting butt injections in a basement apartment in Queens?) “That’s a massive red flag. It’s impossible to have the type of monitoring, sterility, and even record keeping needed for these types of procedures,” he says.
Price is another factor. As is the case with the silicone mentioned above, “the cost has to make sense,” he explains. For example, Sculptra costs around $500 per vial and three sessions, using 8 to 10 vials each, are usually needed. If you’re getting a “deal” for $1,000, something is definitely off. Finally, unless it’s your own fat that’s being injected, you should also be able to ask your medical provider for the tracking number, lot number, and expiration date of the filler they’re using, says Dr. Williams.
