High volume HA for butt enhancement or has everyone gone strictly to biostimulators?

High-volume hyaluronic acid (HA) fillers and biostimulators are both used for gluteal enhancement, but their popularity and usage can vary by region and provider preference.

### Hyaluronic Acid (HA) Fillers for Gluteal Enhancement

HA fillers, such as those specifically designed for body contouring (e.g., Macrolane), can be used for buttock augmentation. They offer the advantage of immediate results and are less invasive than surgical options like fat transfer. However, HA fillers can be quite expensive, especially when large volumes are needed for significant enhancement, and they are temporary, requiring maintenance treatments.

### Biostimulators for Gluteal Enhancement

Biostimulators like Sculptra (poly-L-lactic acid) and Radiesse (calcium hydroxylapatite) have gained popularity for gluteal enhancement. These products work by stimulating the body’s own collagen production, leading to gradual volume increase and longer-lasting results compared to HA fillers. However, they also tend to be costly and require multiple sessions to achieve desired outcomes.

### Regional Practices

In North Carolina and the tri-state area (typically referring to New York, New Jersey, and Connecticut), the availability of specific treatments can vary:

1. **North Carolina**: While there might be fewer providers offering high-volume HA fillers for gluteal enhancement, some practices do exist. It's worth contacting larger aesthetic clinics or plastic surgery centers in major cities like Raleigh, Charlotte, and Durham to inquire about their offerings.

2. **Tri-State Area**: This region generally has a higher concentration of aesthetic practices and plastic surgeons, so you may find more options for both HA fillers and biostimulators. In cities like New York City, advanced aesthetic treatments are more readily available.

### Cost-Effective Alternatives

If cost is a primary concern, consider the following:

- **Combination Treatments**: Some providers may offer combination treatments using both HA fillers and biostimulators to optimize results and manage costs.
- **Payment Plans**: Many aesthetic practices offer financing options or payment plans to make treatments more affordable.
- **Non-Surgical Butt Lifts**: Some clinics offer non-surgical butt lift options using radiofrequency or ultrasound technologies, which can be less expensive than fillers or fat transfer.

### Recommendations

1. **Consult Multiple Providers**: Schedule consultations with several providers in your area to compare options, costs, and outcomes. This will give you a better understanding of what's available and help you find a provider who meets your needs.

2. **Research Online**: Use online platforms like RealSelf, Yelp, or Google Reviews to find highly-rated providers and read about patient experiences.

3. **Professional Associations**: Check with professional organizations like the American Society for Aesthetic Plastic Surgery (ASAPS) or the American Board of Cosmetic Surgery (ABCS) for certified providers in your area.

Ultimately, the choice between HA fillers and biostimulators will depend on your specific goals, budget, and the expertise of the providers you consult.

The reason most providers prefer biostimulators like Radiesse and Sculptra for non-surgical BBL is that they serve more long-term benefits and are generally safer to inject into the glutes. They provide immediate volume and also help to build collagen and elastin in the tissues. This will give you more long-term results and help maintain shape and projection over time. HA fillers would be just as expensive if not more expensive in most practices and your results won't last as long.

In order to achieve desired augmentation it would require significant amount of filler in the range of 250-350 ml per buttock. This would be extremely expensive and would last for a limited time. There is no better buttock augmentation than with fat grafts and, in same cases, buttock implants. Both of these are by far cheaper than fillers. Hope this helps.