Best and safest method of increasing my butt size for a fuller look at the top (photos)

Thank you for your question. You actually have a very nice buttock as you are. I performed both buttock augmentation with implants and with BBL-fat transfer. I often do these as a combined approach. In your case, I believe a subtle enhancement would be recommended which would include liposuction of the hips and outer thighs with fat transfer to the top and outer portion of the buttock. These areas are the most safe zones of the buttock to perform fat transfer. I think that buttock implants, although a great choice for many patients, would be overkill for you. Best wishes to you.

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 and/hips. On the other hand, BBL using Sculptra is a dangerous 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.

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, 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 actually cost prohibitive for most people, provided enough volume is injected to make any significant difference (i.e. at least 400 cc of active ingredient will cost over $300,000) and lasts only 12 - 18 months. So, if you're looking for a reliable, predictable, and long-term permanent option that also provides projection in the central buttock, 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. Glad to help.

Based on these photos, your best option is a fat transfer. You do not have much of the fat on your torso but is seem to be quite sufficient for augmentation you need. In person consultation with a board certified plastic surgeon with good reputation in this surgery, is recommended. Good luck.