Thank you for your questions regarding whether you need a BBL, buttock implants, surgical butt lift or exercise to cure your flat butt syndrome. Thank you for your questions regarding your butt and what you can do to achieve more buttock projection. In regards to your individual situation, I would suggest buttock implants. You do not have much fat to harvest for a BBL. If you are seeking only subtle projection and elimination of fat elsewhere on your body, then I would suggest a BBL. However, on the pictures you submitted, you do not have much fat to transfer. The more reliable situation in your specific case, would be insertion of buttock implants. Buttock implants are made of a semi solid silicone approved by the FDA for buttock insertion. Buttock implants are inserted in the vertical buttock crease and are inserted into the buttock muscle. These would lead to permanent buttock augmentation. With fat transfer to the buttock or BBL, there is an eventual absorption of fat over time. Exercise would be ideal however, it is very difficult to build up that amount of gluteal muscle mass. In addition, once you build up the buttock muscle, you would have to continue that work out routine to maintain that muscle or the buttock muscle would shrink. With permanent silicone buttock implants, you do not have to exercise. A buttock lift would not help your flat butt syndrome because a buttock lift would only lift the buttock and not add buttock volume. The buttock lift would only remove excess buttock skin, some buttock fat, and eliminate the buttock wrinkles, but NOT add volume. Therefore, in my opinion, your best option would be buttock implants. Please seek an experienced plastic surgeon who has performed many buttock implants. Thank you your question regarding permanent buttock augmentation with FDA approved silicone implants. I hope that I have answered your questions regarding whether you need a BBL, buttock implants, surgical butt lift or exercise to cure your flat butt syndrome. I specialize in buttock implant insertion. If you have any more questions regarding buttock implants, buttock implant surgery, buttock implant insertion, or buttock implant revision, please contact my office. Since buttock implant surgery is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience buttock implant insertion. Do your research. If you cannot find an experienced, buttock implant plastic surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)