I am under BMI requirements for a BBL or Skinny BBL. How can I get a bigger buttocks? (Photos)

Question

How can I get a bigger buttocks with me being under the bmi requirement for a bbl or skinny bbl. I’m 5’5 and weigh about 110.

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

There are currently only two FDA approved surgical options for augmenting the buttock/hip area:  1) Buttock and cosmetic Hip Implants (which are soft semi-solid silicone rubber implants that cannot rupture &/or leak) and 2)Brazilian Butt Lift (aka BBL) - which utilizes the patients own fat from liposuction then transfers this fat into the buttock. On the other hand, BBL using fillers such as hyaluronic acids, Sculptra, etc… is a dangerous, guaranteed waste of money, and is NOT FDA approved. So what it comes down to, like any surgery, is proper patient selection and long-term results. Implants provide the only guarantee for a sustained permanent result and tend to be ideal for perking up not only lean or deflated buttocks but also providing substantial projection to any butt, which is what every single patient wants. Typically a combination of sculpting the waistline with liposuction and augmenting the buttock with implants +/- the hips with implants provides the best chance for a long lasting and desirable "hour-glass" figure.  Based upon your photos, a Stanton Anatomic®️ shape buttock implant may serve you best.

Please read on for more detailed information.

Unfortunately, fat typically melts away leaving disappointing results after 12 months, often sooner.  Unless your BBL surgeon is injecting only 200 to 300 ccs of fat into each buttock cheek, a large percentage of that fat is going to die.  Dead fat leads to dents and dimpling like cellulite, unevenness, loss of projection, and fatty necrotic oil cysts which are hard marbles and can be very tender 
Unfortunately, because ~70+ % of the fat transferred will melt away within a year or two, most patients are not good candidates for BBL because they lack an adequate amount of fat to harvest. Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation. Even those patients that had adequate amounts of fat pre-operatively, still end up seeking buttock implants after a year or so because most of the fat transferred melted away leaving them with minimal result.

Fillers such as Sculptra are cost prohibitive, provided enough volume is injected (i.e. at least 400 cc of active ingredient costing over $300,000) and last only 12 - 18 months.  Additionally, any physician promoting “biostimulators” for buttock enhancement is just a joke, and any board certified plastic surgeon promoting such, should not be trusted with your butt.  So, if you're looking for a reliable, predictable, and long-term permanent option that also provides projection in the central buttock and hips, buttock and hip implants are your solution.

Please note that an extremely few number of board certified plastic surgeons specialize in buttock or hip implants, so you may need to travel far and away from home to find this particular surgeon.  Getting it done right the first time around is not only the best chance for success, but also will save you from a lot of headaches and money in the future. Glad to help.

Hooman Khorasani, MD · Answer

1. SculptraSculptra (poly-L-lactic acid ) is an injectable filler used to augment the buttocks in patients with limited fat reservoirs or those unable to tolerate liposuction. Sculptra is an effective global volumizer with a long safety record. Sculptra has a unique molecular composition that stimulates your body to produce new, healthy collagen that helps shape and lift your buttocks over time. Unlike a fat transfer with a traditional BBL, the Sculptra® Butt Lift will require a series of 3-4 treatment sessions spaced 6 weeks apart. Most patients will also need annual maintenance treatments to prolong their results.
Buttocks augmentation with Sculptra utilizes an injectable filler with a proven track-record of safety and efficacy to enhance the shape and size of your rear-end. Sculptra contains a biocompatible synthetic substance that’s used for stimulating collagen production. This same substance has been used in absorbable sutures for the last 50 years and has an excellent safety record. Unlike other fillers, Sculptra does not initially offer significant volumization.
It works by stimulating your collagen and therefore, the results are gradual, but significant. Patients are typically treated over three separate visits, six weeks apart. The final results are evident approximately six months after the last treatment. Results can last up to two years; however, most patients do not go back to their original baseline and some residual volume tends to last for years. Sculptra is Dr. Khorasani’s filler of choice for global volumization of the buttocks.

Anna Chacon, MD, FAAD · Answer

For individuals who are under the BMI requirements for a Brazilian Butt Lift (BBL) or Skinny BBL, there are several alternative approaches to enhance buttock size and shape:

Gluteal Implants: Surgical insertion of silicone implants can increase buttock size. This option is suitable for individuals with insufficient body fat for traditional fat transfer procedures.

Sculptra Injections: Sculptra is a dermal filler that stimulates collagen production, gradually enhancing volume in the treated area. Multiple sessions may be required for optimal results.

Exercise and Strength Training: Targeted exercises such as squats, lunges, and deadlifts can help build and tone the gluteal muscles, contributing to a fuller appearance over time.

Dietary Adjustments: Increasing caloric intake with a focus on protein can support muscle growth when combined with strength training.

Consultation with a Specialist: A consultation with a board-certified plastic surgeon or a cosmetic specialist can provide personalized recommendations based on your body type and aesthetic goals.

Each option has its own set of considerations, including recovery time, potential risks, and expected outcomes. A thorough evaluation by a qualified professional will help determine the most suitable approach for achieving your desired results.

Mats Hagstrom, MD (license on probation) · Answer

If that transfer isn’t an option, then implants are the only surgical alternative.
I do not recommend gluteal implants because they have very high complication rates and poor overall patient satisfaction rates.
The only realistic non-surgical option is exercise.
Best,
Matt Hagstrom M D

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