Big butt implants: How big can you go? What's the recovery time? (photo)

In short, a combination of sculpting your waistline with liposuction and augmenting your buttock with implants provides the best chance for a long lasting "hour-glass" figure. Please read on for more surgical details:

One of the most important factors in creating the perfect derriere with implants is indeed selecting the right size AND shape. I have found the best way to assure this is to simply measure the actual dimensions of the patient’s buttock cheeks. With these anatomical measurements, I can select an implant that not only significantly augments the buttock but also supplies the correct 3-dimensional enhancement to look as real as possible...even in the most petite patients. Traditionally, teardrop oval implants have a 30+% risk of rotation and thus unnaturally change the buttock shape/appearance when doing so.  However, one year ago I created and patented a new "Stanton Anatomic" shaped implant that avoids this issue AND provides as much projection as similar volume (cc's) round implants - I have not had a single rotation problem in 200+ patients. The benefit of this is the fact that ~80% of female and ~30% of male patients have more of an oval shaped buttock cheek than round, thus creating a much more natural and harmonious buttock contour. Thus, the only way for you to know what implant works best is to consult with a board certified plastic surgeon specializing in this procedure and have him/her take your measurements before selecting an implant and proceeding with surgery. 

The largest stock buttock implant currently available in the USA is a 750cc round implant. For the implant brand i prefer and my Stanton Anatomic Oval implants, the largest is 600cc. Indeed custom implants can be ordered larger, not only at a premium price but at a premium risk for most patients'. Unlike breast implants which are placed under the very expandable tissue of the breast and half of the pectoral major muscle, buttock implants should only be placed under or at least within the largest strongest muscle of the body, the gluteus maximus muscle, which is not nearly as expandable or forgiving. Thus most patients simply do not have a large enough native buttock muscle to fit an implant much over 500 ccs', without leading to significant complication such as wound breakdown/opening &/or implant exposure...necessitating removal. If a patient wants larger implants, 9-12 months after the initial implants have settled in to place and the muscle relaxed/stretched, then a second operation can be performed to replace them with larger ones (similar to the process of going bigger with breast implants).   

Be aware, the "subfascial" space that is sometimes talked about is not a real potential space to place a buttock implant. It is essentially the same as a subcutaneous pocket (ie on top of the muscle/under the skin and fat layer only) and therefore should be avoided at all costs.

Some of those sought after video-vixen and celeb-types (without mentioning names) with cartoonish bottoms could have either gotten extremely lucky with a huge oversized implant (very unlikely if properly placed under the muscle), had a very large volume of filler injected such as silicone, PMMA, Sculptra, or hydrogel - all NOT recommended because of high risk of severe infections, migration and/or hardening over time,  and even deadly consequences in rare but significant instances (if mistakenly injected into the blood stream); and/or have been genetically "blessed" - although quite unlikely.I generally do not recommend fat grafting at the same time as placing buttock implants because of a significantly increased risk of infection. For fat to survive it must be grafted into muscle, however that is also where the implant sits. Thus, if fat it injected into the implant or implant pocket then it will die and almost assuredly get infected - necessitating removal of the implant as well. Fat transfer later on must be done very carefully and cautiously, preferably by the original surgeon, for the very same reasons as above. In both instances, the risk/reward ratio is very high (meaning high risk to very low potential reward) because over 80% of the fat is likely to melt away yielding very small gains in augmentation. Nonetheless, buttock implants are a proven safe and effective method of buttock augmentation as long as the recommendations of a board certified plastic surgeon specialist are adhered to.Glad to help.

Dear Tiffygirl,   Thanks for submitting your goal picture, though, your back and side view pictures would have been very helpful.  Implants size is determined by your desire ,  your buttocks measurements (length and width) and the implant's pocket anatomical  location.   The 2 most common techniques for  implants' placement are intra muscular (inside the muscle) and sub fascial (on top of the muscle). The earlier technique allows for only small to moderate size implants and it is painful with long recover . It is also unnatural, bubble like and does not have the desirable 'S' curve (shelf) and round hips (hourglass).   The sub fascial approach is the best technique, in my opinion,  and was developed by Dr Jose Abel de la Pena from Mexico, who is a board certified plastic surgeon and a Professor of anatomy at the university  of Mexico City. Unlike what was mentioned in a previous comment, it is not under the skin , but rather under the strong fascia that covers the muscle. This techniques allows for much bigger size implants . The biggest that I used is 660 cc oval round. (One of my patients told me that a surgeon who used the other technique, offered her that implants'  size in 2 stages and at double the cost and recovery time ! ) . Larger size implants can be used, but they cost much more since they are considered custom made - $3000 extra. The result is also more attractive and natural, because of the 'S' curve and the round hips that can be achieved with this technique and not the other.   Always, consult with experienced board certified plastic surgeons who operate in  accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with the above mentioned features. Also, check the reviews on 'RealSelf' for ratings and good experience reports.                           Best of luck,                                              Dr Widder

Typically, the patient  must refrain from sitting on the area for about 10 - 14 days post op.  At your consultation we will go over different options if you have to sit.  Be sure to choose a Board Certified Plastic Surgeon that specializes in buttock augmentations.