What are the pros and cons of a butt flap? Is a fat graft usually required to give a fuller appearance?

Question

Auto augmentation butt flap question. Following drastic weight loss I require a lower body lift and fat transfer to buttocks. I am also considering the butt flap. Is it a good idea to have this done? What are the advantages and disadvantages? Is a BBL usually required as well to give a fuller appearance? My weight tends to yo-yo so I was thinking the Butt flap wold be a more permanent change while the fat transfer results could change with time? Is this correct? Thank you so much!

Hagen Schumacher, PhD, FRCS(Plast), FEBOPRAS · Answer

Hello,
Thank you for your enquiry. I don't augment buttocks because of the high complication rates. I can give you some general ideas about augmentation.
In general, I prefer fat transfer for volumes up to 200ml. For volume requirements over 200ml flaps or implants are better.
Fat transfer is body tissue and doesn't have implant specific complications such as rupture, extrusion or capsular contracture. It requires often several repeat procedures because some fat disappears.
Flaps are more dependent on a good blood supply. If the blood supply is not sufficient, the flap dies and can cause infection, scar problems or contour irregularities.
Implants can rupture, get encapsulated or extrude.

Ryan A. Stanton, MD · Answer

Although there is nothing wrong with utilizing your own tissue for auto-augmentation during a lower body lift, do not expect enhancement of the entire buttocks cheek length. At best only the top third or so is augmented, leaving the rest flat and not perky. Typically patients with massive weight loss have poor fat transfer survival unless you gain weight back and keep the weight on which of course is counterproductive.  Thus, your only relatively safe, reliable, predictable, and permanent option is buttock implants.  Glad to help

Yannis Alexandrides, MD, FACS · Answer

Hi, 
thank you for your question.

In my practice, I don't like to use the Butt Flap procedure. I do get consistent and satisfactory results with Fat Grafting. In my opinion, if you re looking to have this procedure, you will need to consult with a plastic surgeon that has done a good number of cases and is experienced in this specific operation. I would also advise you to do further research on Fat Grafting and compare it with the Butt Flap procedure, before making a final decision.

Kenneth Hughes, MD · Answer

Hello, thank you for your question. This procedure is only done in combination with a buttock lift for patients that have lost massive amounts of weight. There are several different techniques that use all the subcutaneous tissue (fat) of the area that needs to be removed and create a flap to auto augment  the buttocks and don just take that fat away. Its really important that you realize that this procedure will only make your butt full, but will not change the shape of it, because we have a limit on how far we can move the flap. I recommend you to schedule a consultation with a board certified plastic surgeon.

Daniel Barrett, MD · Answer

Dear riodejaneiro,
at the moment, probably the best method for butt augmentation is fat transfer. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

What are the pros and cons of a butt flap? Is a fat graft usually required to give a fuller appearance?

Answers (5)