Fat transfer for BBL - is it better to inject the fat into the muscle of the buttock or above the muscle of the buttock?

in regards to the injection of the fat for a BBL, is it better to inject the fat into the muscle of the buttock or above the muscle of the buttock? Is it significantly more dangerous to inject into the muscle? Does one have better long term results than the other? Is one better than the other for thin patients with limited fat supply?

Doctor Answers 9

Where is the fat injected for my Brazilian Butt Lift, is it into the muscle or above it?

This is a great question as butt augmentation has evolved over the past several years.  The fat is great for your augmentation as your own natural body tissue is used for the augmentation.  However for the fat to survive over the long-term it has to be integrated into the surrounding tissues.  This happens over the first several weeks after your surgery.  The fat is a graft and grafts survive by having blood vessels grow into them over time.  With all of this said the fat survives best when it is surround by good health tissue.    Since the fat has to be surrounded by good healthy tissue there is a limit to how much fat can be injected into any one specific area (above the muscle or in the muscle).   The majority of my patients want a significant augmentation with 800cc to 1100cc transferred to each side.  For this fat to survive it needs to be dispersed throughout the buttock.  I typically inject the fat into the muscles and above the muscle as this maximizes the amount of fat that can placed in the buttock and have the best chance of survival.   I also typically inject fat into the hip area as well during my butt augmentations as this will help improve the overall shape of the buttock.  There is limited muscle in this area and thus the fat is mostly injected into the soft tissue of the buttock.   Please consult with a board certified plastic surgeon that performs a high volume of butt implants about your surgery. 

Austin Plastic Surgeon
4.9 out of 5 stars 114 reviews

BBL techniques

Hello, thanks for your inquiry. As you have read already it is important to have the fat injected into several layers in order to achieve a better long lasting result. Every surgeon is different and have different techniques. Try researching before and after photos and reviews which will give you a good idea on the matter.  Please make sure that you and your surgeon are on the same page. Don't forget to discuss all your concerns, options and expectations thoroughly. Have a safe and pleasant PS Journey!
Dr. Jaime Campos-Leon
Board Certified Plastic Surgeon

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 252 reviews

Best BBL Results

This is a great question! There are a lot of different BBL techniques being used, but what I have found gives my patients the best and most long lasting results is to transfer the fat in multiple levels – below, within and above the muscle. You should find a board certified plastic surgeon who has significant experience in performing Brazilian Butt Lift procedures to make sure your procedure is not only safe, but also gives you the results you are looking for. Good luck!

Jimmy S. Firouz, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 18 reviews

Brazilian Butt Lift, where to inject the fat?

Thank you for your question. For best results, with Brazilian butt lift,  fat cells are transferred in microinjections throughout multiple planes in the buttock tissue so that they can gain new blood supply and live in their new home, providing increased volume and shape to the buttocks. 

Carolina Restrepo, MD
Colombia Plastic Surgeon
5.0 out of 5 stars 18 reviews

Fat Transfer Recepient Sites

Thank you for your thoughtful questions.  The short answer is that there are not well controlled clinical studies to formally answer this question.  There are a lot of opinions about this issue that are based on very reasonable assumptions.  If we put fat in a better vascularized plane like muscle rather than fat, one may expect more survival.  Some studies even show that the stem cells from fat can be converted to muscle like cells, but the exact impact on volume and clinical outcome is not known definitively.   Placing fat in both the fat and muscle planes is one of the technical attempts to improve volume retention.  The downside to this approach is that the fat injection is done blindly and there are large blood vessels within and just below the gluteal muscles.  Most surgeons use blunt tipped injection canulas to reduce the risk of injecting fat into the blood vessels.  This can lead to a potentially life-threatening complication called fat embolization.  Keeping your fat transfer to the subcutanous plane alone is an attempt to make the procedure safer for patients and the direction that many surgeons are headed.  Until there is convincing clinical evidence that one approach is superior to the other, it probably makes more sense to use the safest approach.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Fat injection to buttocks

I think that most place the fat in multiple layers of the buttocks to obtain maximal results.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


Thanks for your question. It is necessary to place the fat in all layers of the buttocks for the best results.  The muscle has the best blood supply for volume enhancement but the sides are best rounded by placing the fat in several subcutaneous layers. Best of luckDr T

Douglas Taranow, DO, FACOS
New York Plastic Surgeon
4.8 out of 5 stars 56 reviews

BBL technique

Generally it's best to inject as much fat into the gluteal muscle to allow for more long term fat survival. Some fat does have to be injected just above the muscle as well- regardless of patient size.Best wishes,Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 377 reviews

Brazilian butt lift injection plane

The answer is both. The injection into the muscle is very effective since you have a very good perfusion and fat graft survival is generally very good. This mainly increases the volume of the butt. To shape, it is also necessary to infiltrate the more superficial levels especially on the sides, where fat graft take is a bit more uncertain, yet important.

Alexander Aslani, MD
Spain Plastic Surgeon
4.8 out of 5 stars 302 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.