Very Very Flat Butt, Considering BBL or Implants. What Do You Recommend For My Case?

Loose your weight first and when you have plateaued this is probably the best time.

Here is some information about how to choose your procedure: Butt Lift vs. Brazilian Butt Lift vs Buttock Implants

There are many options to have a shapelier butt. The key to making the right decision lies in the hands of a board certified plastic surgeon who will examine you and determine which procedure is best for you. You need to listen to their advice as they are the experts and examined you whereas our comments have limited application without an exam.
This is a good forum however to let you and others know their options. They include a Brazilian Butt Lift if there is adequate fat available for fat transfer, buttock implants and a butt lift. Fat transferred to the Buttocks is generally called a Brazilian Butt Lift. Some surgeons, including myself harvest fat in particular from the lower back to give it an S shaped contour that defines and sculpts the top of the buttocks giving it the illusion that it is bigger and definitely more shapely before the fat transfer is actually done. Similarly, sometimes fat is taken from the upper back of the thighs to also define the edge of the buttocks while taking care of what many women call the "banana rolls" as well as the "diamond" shape space that is attractive at the highest point of the inside of the thighs when viewed behind. Also the amount of fat that takes is highly technique dependent and experience dependent.
Implants are generally reserved for those that want more fullness but have inadequate fat available for transfer. It is more involved and has a longer recovery. Lastly Butt Lifts generally refer to using "flaps" of redundant soft tissue that are tucked inside the but while tightening up the skin envelope. This requires the longest time for recovery and results in the largest scars which visible.
In other words there are many subtleties that make all the difference between a good result and a great result.  My suggestion is to go to a board certified plastic surgeon with significant experience in these techniques. His exam will determine which course if right for you.

Hi there-

It is often necessary when seeking advice on forums such as this one, to separate what you are told because it is in the surgeon's best interests from what is being told to you because it is objectively what is in the best interests of the average patient with a similar question.

So the best information would come from those having lost of experience with both options, right?

There can be no doubt that if you could gather all surgeons in a room and ask them all the question of safety, natural appearance of the result, and maintenance over time, that those surgeons with the most experience in buttock enhancement procedures nationally would tell you that the Brazilian Butt Lift is the way to go.

The outcomes are more natural because they are achieved with your own fat. And in experienced and skilled hands, most surgeons have a resorption rate of 15-20%. The risk of infection is MUCH lower than with implants, and you will not need to have the operation re-done every 5 years or so, as is often the case with implants.

I personally perform both procedures, but because of the above, believe that implants are a better option for women only if they are not a candidate for BBL.

I am going to tell you what you may not hear from others.  Currently the only two safe and effective methods for Buttock Augmentation are Autologous Fat Transfer (transfer of your own fat to the buttocks, aka "BBL") and Buttock Implants (semi-solid soft silicone rubber implants).  Both are very good options so what it comes down to, like any surgery, is proper patient selection.  Indeed because at least 50+ % of the fat transferred will melt away within a year, most patients are not good candidates because they lack an adequate amount of fat to harvest.  Thus buttock implants become a very good, safe, and long term reliable option for most patients seeking buttock augmentation (at least in my practice).  The implant should always be placed under or within the gluteus maximus muscle.  In this position, the implant is less palpable, less visible, and does not sag over time unlike implants placed on top of the muscle.  Therefore it is extremely important to seek consultation with a board certified plastic surgeon who specializes in this technique.  Additionally, in this type of surgeons hands the often quoted "high risks" of complications especially infection are actually much lower around 5%.  BBL is not without very similar complications including death from fat embolism.  Best of luck...RAS

The BBL is the way to get the most optimal results. The use of fat transfer can allow customization of the buttock enhancement and will give the most natural results with the least complications. If you are very flat it isa possible that you may need a second grafting after 3 months to get the optimal enhancement. But you should first stabilize your weight prior to undergoing surgery. Good luck!

Nothing will look better than BBL if done right.  Implants in the gluteal region will always carry a risk of complication throughout life(although usually low).  With fat grafting, your buttocks can be sculpted to fit your body perfectly.  Regardless of technique, you should definitely wait until you are at a stable weight.  Significant fluctuations in weight up or down will change your results!  I hope this helps!

All the best,

Rian A. Maercks M.D.