Am I a candidate for a BBL or Butt Implants? I'm tall, skinny, no fat, tailbone sticks out. Best way to enlarge it? (photo)

Question

I am really unhappy with my flat butt appearance and I don't feel comfortable with my tailbone always sticking out. I have done squats for a year and seen no results. I'm just not sure how I would go about making it bigger and what risks/costs it would carry?

Ryan A. Stanton, MD · Answer

This is the question of the current decade...Allow me to share
with you some information that you may not hear elsewhere. There are only two
proven safe and relatively effective methods for Buttock Augmentation and Hip
Augmentation: 1) Autologous Fat Transfer (using your own fat, transferring from
one area of the body to the other) and 2) Buttock/Hip Implants (semi-solid
silicone rubber implants that cannot rupture &/or leak). Both are very good
options so what it comes down to, like any surgery, is proper patient
selection.  Depending upon the
amount of your current fat reserves and their distribution, you may or may not
be a reasonable candidate for fat transfer.  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. Another tip
is that if you purposely gain weight (i.e. fat) for the procedure, the fat you
lose first as you get back to your baseline weight is that very same fat that
was transferred into your buttock...so don't fall victim to this
recommendation.  Although using your own fat is relatively safe, the one
serious complication that can rarely (< 1%) happen is "fat
embolism" in which some of the fat gets into the blood stream and travels
up into the lungs, heart, and/or brain causing serious problems. This
complication is more likely to happen with the larger amount of fat being
transferred. This is even more likely to happen when using fillers like PMMA
and hyaluronic acids. Also fillers, when injected in large quantities, have a
relatively high tendency to migrate away from the original area they were
placed and tend to stimulate a lot of inflammation and a subsequent disastrous
amount of scar tissue/hardening.Thus buttock/hip
implants become a very good, safe, and long term reliable option for most
patients seeking buttock augmentation (at least in my practice). I prefer to
insert the buttock implants through a 2 inch long incision over the tailbone
(concealed within the crevice between the buttock cheeks) and the hip implants
through a ~ 1 inch incision just below the beltline above the hip region. The
buttock 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 or shift/migrate 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 procedure (in fact both implants and
fat transfer so that s/he is not bias). And in this case too, at least in my
surgical practice, the infection rate is minimized to ~5% and the infection rate is minimized
to ~2%.
I generally do not recommend fat
grafting at the same time as placing buttock implant because of a
significantly increased risk of infection.  For fat to survive it
must be grafted into muscle, however that is also where the implant sits. 
Thus, if fat is injected into the implant or implant pocket then it will
die and almost assuredly get infected - necessitating removal of the implant as
well. Because
of this risk, I frequently avoid fat grafting into a buttock that has an
implantBecause of all this, I strongly recommend consulting
with a board certified plastic surgeon that performs both procedures and not just the
Brazilian buttock lift so that s/he can provide you with an unbiased
recommendation for surgery with realistic long term results.Again, like any surgery, the key to a
satisfactory outcome is both patient education and a skilled board certified
surgeon specialist.

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. It is hard to provided with a valid medical opinion with those photos.  I would suggest to be treated by board certificated plastic surgeon with experience in this procedure, to get the best desired results.
Kind Regards,Dr. Emmanuel Mallol Cotes.-

Larry S. Nichter, MD, MS, FACS · Answer

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  Please visit my page on finding the right doctor at drnichter.com on some suggestions on finding the most qualified Plastic Surgeon for a BBL Always insist on a board certified plastic surgeon. 
Candidates for Buttock Augmentation surgery desire an enhancement in the buttock area to offer a more balanced, defined or shapelier contour to the body. There appears to be two different groups of patients seeking the procedure. One group of patients is younger and has goals of transforming their bodies into more curvaceous figures, like popular Hollywood stars, J. Lo or Beyonce Knowles. The other group of patients is women that have aged and would like to restore a more youthful backside with buttock fullness to replace now sagging areas. Men have also been requesting buttock implants as well.

Martin Jugenburg, MD · Answer

Although I would need to do a physical exam to better asses if you are an appropriate candidate for a Brazilian butt lift\butt implants, from you photos it appears that you do not have sufficient amount of fat to transfer to your buttocks (which is a good problem to have!), I would not waste your money. However, your best bet is to book a consultation with a board certified plastic surgeon who has a lot of experience with Brazilian but lifts to determine if you are a good candidate. Best of luck.

Kenneth Hughes, MD · Answer

I have done the BBL on many patients 105 to 110 lbs, transferring 500 cc
 to 1000 cc per buttock.  I perform Brazilian buttlift on very thin women, and I perform butt 
implants.  I think that both are reasonable.  I would have to examine 
you to determine if you have enough fat for the Brazilian buttlift.Kenneth Hughes, MDLos Angeles, CA

Sugene Kim, MD, FACS · Answer

You may be a candidate for the BBL procedure. But its hard to access your donor sites form the pics.  However, an in-person consultation is required to make any recommendations.  In the BBL procedure, we take excess fat and transfer the fat your buttocks.  We also liposculpt the buttock to improve the shape and overall appearance.  Please see a board certified PS experienced in the BBL procedure to learn more about your options.

Daniel Shapiro, MD · Answer

Most doctors recommend a BBL as it provides a more natural looking result and offers less risks and complications through and after the surgery. Because you are quite thin, an in person consultation is necessary to determine if you have enough donor fat areas for a successful BBL. Good luck!

Jaime Campos Leon, MD · Answer

Thanks for your pictures, I understand your concern, I have had many skinny patients with a nice BBL result, but I rather check in person the donor areas prior to assure you that you are a good candidate. I always recommend the BBL instead the implants but both of them are viable. Please have an in person consultation to discuss thoroughly all your expectations vs. possible outcome and the technique that will suit your case the most. Good luck in your PS Journey!

Luis E. Redondo, MD · Answer

I have a simple Surgery selection criteria for Buttocks augmentation, Shape.If you like the shape of your Buttocks, then implants will always be the best, and more lasting solution.If you want to reshape your buttocks, in my hands Fat is the best option.If you want to reshape and augment and you have enough fat, then a BBL will be enough, but if you don't have enough fat, we will use the fat available to reshape and Implants to augment.For your case i would suggest to reshape your buttocks with the little fat we can find (fill the indents in the sides) and place intramuscular implants to augmentation.I, like a few other colleagues offer online consultations where you send us your photos and we can estimate the cost. Find a Board Certified Plastic Surgeon and discuss what will be the proper treatment to achieve the result you desires.Regards,Dr. Luis Redondo

Steven Wallach, MD · Answer

You do look thin, and I am not sure you have enough donor sites for harvesting to give you a satisfactory result. Best to be seen in person.

Am I a candidate for a BBL or Butt Implants? I'm tall, skinny, no fat, tailbone sticks out. Best way to enlarge it? (photo)

Answers (11)

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