Hello, thank you for your questions regarding buttock "auto-augmentation" during a lower body lift (360 circumferential lower body lift, lower body dermo-lipetomy, belt lipectomy). I specialize in the lower body lift and posterior lower body lift procedure. I treat every patient individually. Basically, there are four ways to create a butt: injection of Sculptra, injection of your fat, buttock flap or buttock implants. Since you stated that you have "ZERO butt", I would suggest an autologous local flap. This flap is created at the superior or upper aspect of the buttocks. To create this upper buttock flap, the epidermis and part of the upper dermis are remove. The fat is left intact and the flap is rotated around its blood supply. If you have a lot fo upper buttock fat to create this flap, this upper buttock flap can yield excellent results. However, since you stated that you have "ZERO butt", so you can probably achieve only modest results. Also, you stated that you do not want the Brazilian Butt Lift or BBL. I wonder why you would not want the BBL? The BBL in conjunction with the 360 circumferential lower body lift can create outstanding results. To answer the rest of your questions: "how common is this?" The frequency of autologous buttock flap creation depends how many your chosen plastic surgeon has performed. During the lower body lift, I perform the buttock autologous flap on about 25% of my weight loss patients. The buttock autologous flap surgery is relatively "safe" in an experienced plastic surgeon's hands. thank and good luck. I hope that I have answered your questions about buttock "auto-augmentation" during a lower body lift. If you have any more questions regarding an "auto-augmentation" during a lower body lift lower body lift, buttock flap, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or extended tummy tuck with buttock lift, please contact my office. When seeking reconstructive plastic surgery after massive weight loss, please seek an experienced, board certified plastic surgeon with significant experience in performing the buttock flap and lower body lift. Demand to see before and afters pictures of patients just like yourself on forums like RealSelf and their website. Check out patient reviews of your chosen plastic surgeon on forums like RealSelf. Sincerely, J. Timothy Katzen, MD, FACS, FICS, FASMBS. (Certified by the American Board of Plastic Surgery, member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, and International Society of Aesthetic Plastic Surgery, and fellow of the American College of Surgery, International College of Surgery, and American Society for Metabolic and Bariatric Surgery).