When patients ask about "side effects" of operations, they are usually inquiring about the risk of complications from a particular surgery. In the case of gluteal augmentation, the risk of complications varies with the technique used to augment the buttocks. A more recent trend in buttock augmentation is the use of fillers such as Radiesse to add volume to the buttocks. Although we do not employ this technique, we have seen patients who have received Radiesse and other fillers to augment the buttocks. Complications we have seen from this procedure include migration of the filler, irregularities of the the skin contour, and, most commonly, suboptimal gluteal augmentation and symmetry.Fat transfer or "the Brazilian Butt Lift" is an increasingly popular approach to gluteal augmentation. This involves transfer oft fat, usually from the abdomen, flanks and thighs to the buttock to increase gluteal projection and width. The most feared complication from this procedure is fat embolism, in which fat enters the bloodstream and causes damage, most commonly, to the lungs. The incidence of this complication is exceedingly low, but when it happens, it can be quite serious, so a surgeon's level of suspicion for this complication should be high. In general, its occurrence correlates with the transfer of very large volumes of fat. The more common complications seen with fat transfer to the buttocks are resorption of the fat overtime, resulting in inadequate correction of the gluteal contour, asymmetry of the two sides of the buttock, lumpiness or waviness of the skin of the fat recipient site, lumpiness or waviness of the fat harvest site, discoloration of the skin over the fat harvest site, cysts or infections of the fat recipient sites.Gluteal augmentation with implants is another very effective way to increase the volume of the buttocks or improve its shape and contour. The most common complication seen with gluteal augmentation with implants is wound dehiscence, i.e., an opening of the incisions through which the gluteal implant (s) was/were placed. In the most serious cases of wound dehiscence, the implant itself is exposed, necessitating its removal. When this occurs, the implants cannot usually be replaced again for many months. Other complications associated with gluteal implants include, migration of the implants, asymmetry of the two sides, hematoma (a collection of blood inside the implant pocket), seroma (a collection of clear fluid inside the implant pocket), and infection. It is important to understand that there is a risk of complications with any surgical procedure, and that this risk varies, depending on the type of procedure undertaken, the skill and experience of the surgeon, the quality of the patient's tissues and the nuances of the patient's particular anatomy, the composition of the implant or other material being placed inside the patient's body, the medical health of the patient, and the patient's compliance with postoperative instructions, to list just a few of the variables involved.