Skinny patient wanting a bigger butt. What are my options?

Like any booming fad or fashion, there are always scammers trying to get a peice of the pie. Buttock augmentation/enhancement has become another victim - companies and individuals promoting magical creams, potions, lotions and pills...NONE OF WHICH WORK. It is not yet possible to take a substance that only and exclusively make your derrière grow. Other than being genetically blessed in the buttock and/or rigorous dedicated exercise, there is no "natural" way to grow the buttock other than surgery. Please read on for more surgical details: Regarding buttock/hip augmentation, let me start off by saying that I currently see at least 2 - 3 patients per week that failed "brazilian buttock lift" (i.e. the fat melted away after 10 - 12 months) and are now seeking a more reliable and permanent option (i.e. buttock and/or hip implants). 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 options but 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. 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 liquid silicone, PMMA, and hyaluronic acids. Also fillers, when injected in large quantities, have a relatively high infection rate, guaranteed tendency to migrate away from the original area they were injected, and almost always stimulate a lot of inflammation with a subsequent and 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/hip augmentation (at least in my practice). I prefer to insert the buttock implants through a 1 1/2 inch long incision along the inner curve of each upper buttock cheek at the level of the tailbone, similar to two opposing parentheses ")(" (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. On the other hand, hip implants are placed under just the fascia because no significant muscle exists in this region. However, because they are much smaller and lighter, their likelihood of migration is relatively low. Because all of this, it is extremely important to seek consultation with a board certified plastic surgeon who specializes in this procedure so that the implant placement is precise for both locations. And in this case too, at least in my surgical practice, the infection rate is minimized to <2% (much lower than and contrary to popular belief by many other surgeons not experienced in buttock implants).Depending upon the amount of your current fat reserves and their distribution, you may or may not be a reasonable candidate for fat transfer. If you are wanting to utilize the fat to further augment your buttock in addition to implants, then I caution you against this. The reason being that the fat needs to be placed into the buttock muscles for optimal survival, however,a this is exactly where the implant needs to reside and thus risks infection and/or death of the fat. Because of this risk, I frequently avoid fat grafting into a buttock that has an implant. Bottom line, I recommend consulting with a board certified plastic surgeon specialist in buttock augmentation (BOTH implants and fat transfer) to determine what option is best for you. Glad to help.

This is a very common question as butt augmentation has
become so popular over the past few years. The three most common methods of
butt augmentation are the Brazilian Butt Lift (fat transfer), butt implants and
a combination of fat transfer and butt implants. Which treatment is best for you really
depends on your aesthetic goals, body frame and available fat. The good news is
that skinny patients have options too that can give them a phenomenal
result.

The Brazilian Butt Lift is typically a great option for
patients that have sufficient fat for their augmentation. Patients are usually surprised that they have
enough fat for their augmentation.
Patients with a BMI greater than 22 in general will have enough fat for
their Brazilian Butt Lift procedure. The
benefits of the Brazilian Butt Lift procedure are that it not only enhance the
buttock, it improves the overall figure of the patient. It can transform a patient from a square to
more of an hourglass figure. The
combination of shaping the waist and enhancing the buttock is what has made the
procedure so popular.

Butt augmentation with implants is a great option for
patients that do not have enough fat for a Brazilian Butt Lift. The implants give patients a great shape that
can lift and augment the buttock in thin patients. The implants not only enhance the size, but
they improve the overall shape of the buttock.
The butt implants (just like breast implants) come in a variety of
shapes and sizes. They can also be
placed in a variety of locations depending on the needs of the individual
patient.

The third option is a combination of fat transfer and butt
implants. This option allows your waist to be shaped with the liposuction (fat
harvest), the augmentation and projection of your buttock with the implant and
then the fat is used to soften the buttock and enhance any further areas that
the implant did not augment such as the hips.
This combination can be a very powerful tool for augmentation as it
combines the positive effects of both butt augmentation procedures.

These three methods of butt augmentation can help the vast
majority of patients achieve their butt augmentation goals. This give people a variety of choices to help
them get the look they desire. Please
discuss you butt augmentation procedure with our board certified plastic
surgeon who can help guide you through the process.

   All of the patients for whom I perform butt implants are skinny or muscular with very low body fat.  The result can be natural.Kenneth Hughes, MDBeverly Hills, CA