Q: What are the pros and cons of butt implants?

Pros They can be a good option for people who don’t have enough excess fat for a Brazilian butt lift, those who have already had a BBL but want more projection, or people looking for a less risky butt augmentation procedure. Solid silicone implants can create a rounder, more sculpted rear with a nearly unlimited amount of projection from top to bottom. This full-spectrum projection is an advantage of implant-based butt augmentation surgery. While half of the fat transferred during a Brazilian butt lift may not survive beyond a few months, implants create predictable and permanent volume. “Most of my buttock implant patients have had previous failed BBL procedures,” says Dr. Douglas M. Senderoff , a board-certified plastic surgeon in New York City. There’s no worry of leaks because silicone butt implants are semisolid, not filled with gel. Cons You’ll need 2 weeks of downtime after this cosmetic procedure, and your surgeon may advise you to avoid sitting directly on your butt for up to 6 weeks. If the wrong shape or size is chosen, or the implant isn’t well-placed within the gluteal muscles, you may have visible contour irregularities or implant rotation, flipping, or sagging. Some patients who experience these issues may need to seek butt implant removal or revision surgery, at their own expense. A buttock implant that is too large for your body can put you at risk for visibility of the implant, notes Dr. Franco. Other risks include separation of the incision, infection, seroma (fluid buildup), capsular contracture from scar tissue hardening around the implant, and chronic pain.

Q: Who makes a good candidate for butt implants?

Good candidates for this procedure are: nonsmoking adults in overall good health without too much loose skin (or willing to combine butt implant surgery with a butt lift or lower buttock tuck) “Unlike with BBL, patients of all body mass indices (a.k.a. BMI) are potential candidates for butt implants,” notes Dr. Stanton. A board-certified plastic surgeon who offers a range of options will be able to help you decide whether this is the best butt augmentation method for you.

Question 1

What are butt implants?

Accepted Answer

Silicone butt implants are a buttock enhancement option that predictably adds contour, volume, and projection. They’re similar to the silicone implants used in breast augmentation, but the silicone is semi-solid, not gel, so they’re much more durable and don’t come with the possibility of rupture. “Buttock implants are one of the best options for patients wanting to increase the projection of their buttocks,” says Dr. Johnny Franco, a board-certified plastic surgeon in Austin, Texas.

Butt implant procedures can be combined with a Brazilian butt lift (BBL), a fat transfer procedure that involves harvesting excess body fat via liposuction from another body area and transferring it to the butt and hips. Some plastic surgeons say that this creates a softer, more natural look.

However, because Brazilian butt lifts can be risky—particularly when performed by anyone other than a board-certified plastic surgeon—butt implants alone are considered a safer, more reliable option for butt augmentation.

Beverly Hills, California, board-certified plastic surgeon Dr. Ryan Stanton says that “if the implants are positioned correctly and the appropriate size and shape implant is selected by your surgeon, optimal results are obtained without the need for fat transfer, just as is the case with breast implants.”

This plastic surgery procedure can also be combined with liposuction or other body contouring procedures.

Question 2

What are the pros and cons of butt implants?

Accepted Answer

Pros

They can be a good option for people who don’t have enough excess fat for a Brazilian butt lift, those who have already had a BBL but want more projection, or people looking for a less risky butt augmentation procedure.
Solid silicone implants can create a rounder, more sculpted rear with a nearly unlimited amount of projection from top to bottom. This full-spectrum projection is an advantage of implant-based butt augmentation surgery.
While half of the fat transferred during a Brazilian butt lift may not survive beyond a few months, implants create predictable and permanent volume. “Most of my buttock implant patients have had previous failed BBL procedures,” says Dr. Douglas M. Senderoff, a board-certified plastic surgeon in New York City.
There’s no worry of leaks because silicone butt implants are semisolid, not filled with gel.

Cons

You’ll need 2 weeks of downtime after this cosmetic procedure, and your surgeon may advise you to avoid sitting directly on your butt for up to 6 weeks.
If the wrong shape or size is chosen, or the implant isn’t well-placed within the gluteal muscles, you may have visible contour irregularities or implant rotation, flipping, or sagging. Some patients who experience these issues may need to seek butt implant removal or revision surgery, at their own expense.
A buttock implant that is too large for your body can put you at risk for visibility of the implant, notes Dr. Franco.
Other risks include separation of the incision, infection, seroma (fluid buildup), capsular contracture from scar tissue hardening around the implant, and chronic pain.

Question 3

How much are butt implants?

Accepted Answer

The price you pay will depend on your plastic surgeon’s level of experience, their practice location, which type of implant you choose, and who administers your anesthesia, along with other details of your procedure.

Most surgeons offer payment plans or accept financing options.

See our complete guide to butt implant costs

Question 4

Butt implant pictures: what to look for in before and after photos

Accepted Answer

As you're picking your plastic surgeon, look for butt implant before and after photos of patients who started out with similar proportions to your own and got your desired projection.

Beyond the buttocks themselves, note whether the contours of the hips and the curve from the lower back to the butt looks smooth, proportional, and natural. If you see scars or an outline of the implant below the skin, look for another surgeon.

The butt implant photos in our gallery have been shared by the surgeon who performed the procedure, with the patient's consent.

Question 5

Butt implants vs. BBL: What are the advantages?

Accepted Answer

These are the top advantages of butt implant surgery over a BBL:

It’s safer. While new Brazilian butt lift surgery protocols have reduced mortality rates, this procedure can still carry serious health risks if it’s not performed correctly.
It offers more consistent results. “Implants are more reliable at plumping up and providing projection to the middle and lower aspect [of the butt], areas in which Brazilian butt lift often fails,” says Dr. Stanton. “Brazilian butt lift remains mostly in the upper third of the buttock but rarely in the mid and lower thirds.”
Implants can also create more projection in flat buttocks, so that even if there is considerable flatness, the patient will still have a rounded result, says Dr. Johnny Franco, a board-certified plastic surgeon in Austin, Texas.

Patients without much excess fat can still be good candidates for implants (though more surgeons are also offering a “skinny BBL” that’s expanding the range of candidates for this fat transfer procedure).

Question 6

How common are buttock implants?

Accepted Answer

Of all the buttock augmentation procedures currently available, buttock implants are the least frequently performed. According to the latest data from the American Society of Plastic Surgeons, only 1,179 buttock implant procedures were performed in the U.S. in 2020 by plastic surgeons.

However, its popularity is growing: butt implant surgeries grew by 21% year-over-year, while BBLs declined by 27%.

When it comes to demographics:

Over 86% of the patients were female
A third of these procedures were performed on patients ages 30-39, while 39% of patients aged 40 to 54, showing that the appeal of butt augmentation extends well into middle age and beyond. “I have even performed butt implant surgery on three patients in their seventies,” says Dr. Stanton.

Question 7

Who makes a good candidate for butt implants?

Accepted Answer

Good candidates for this procedure are:

“Unlike with BBL, patients of all body mass indices (a.k.a. BMI) are potential candidates for butt implants,” notes Dr. Stanton.

A board-certified plastic surgeon who offers a range of options will be able to help you decide whether this is the best butt augmentation method for you.

Question 8

Are there different sizes of butt implants?

Accepted Answer

“Butt implants, like breast implants, come in a variety of sizes and shapes,” explains Dr. Franco. “There are not as many options in terms of various sizes and shapes, but there are plenty for patients to choose from.”

Butt implants range from just 100 cc to 715 cc, and choosing the right size for you is one of the most crucial decisions in terms of getting the result you want. “It is important to work with your plastic surgeon to find the best implant for your specific body that will help you achieve your specific aesthetic goals,” Dr. Franco emphasizes. “Patients tend to achieve more projection and shape than they think from a small implant. The most common mistake patients make is trying to go too big with their buttock implants. Patients that choose an appropriate size tend to be very happy for years to come.”

Patients can choose either oval or round implants. “Anatomically, about 95% of the patient population have much more of an oval-shaped buttock muscle than round,” says Dr. Stanton. “The only way to finalize the correct shape and size is by physical exam, to take measurements of the length and width of the muscle. The density and tightness of your muscles are the final determining factor in how thick of an implant (i.e., projection) can be safely placed.”

RealSelf Tip: Along with size, your surgeon should talk with you about implant placement: either over the gluteal muscles or within them (intramuscular placement). Most buttock surgery specialists are strong proponents of intramuscular placement, so that’s probably what your surgeon will recommend. “Buttock implants should really be placed within the gluteus muscles,” says Dr. Stanton. “If they’re placed on top, there’s a risk of complications like unnatural contour and visibility, sagging over time, the implant flipping over, thinning out of the fat and skin layers, and a greatly increased incidence of capsular contracture,” hardened scar tissue around the implant. Intramuscular placement also ensures that the implants aren’t deep enough to risk damaging the sciatic nerve, which runs through the buttocks.

However, placement alone won't be enough to reduce your risks if your implants are too big. “It is important to understand that while an implant in the intramuscular position may decrease the risks of complications, this is dependent on an appropriately sized implant placed in this position. An implant that is too large for the body can create an issue, regardless of the placement position,” says Dr. Franco.

Question 9

What happens during butt implant surgery?

Accepted Answer

This surgical procedure is done under general anesthesia, so you’ll be totally asleep. Once you’re unconscious, your buttock augmentation will go as follows:

The surgeon makes an incision within your butt crack (minimizing visible scars) and inserts each implant either within (i.e. “intramuscular” placement) or over your gluteal muscles (aka “subfacial” placement). Most buttock surgery specialists are strong proponents of the intramuscular technique. “Buttock implants should really be placed within the gluteus muscles,” says Dr. Stanton. “If they’re placed on top, there’s a risk of complications like unnatural contour and visibility, sagging over time, the implant flipping over, thinning out of the fat and skin layers, and a greatly increased incidence of capsular contracture. Capsular contracture is the formation of a capsule of hardened scar tissue around the implant that can be painful or distort the natural contour.” Intramuscular placement also ensures that the implants aren’t deep enough to risk damaging the sciatic nerve, which runs through the buttocks.
Once the implants are firmly in place, your surgeon stitches up all the tissue layers and the incision.
Then, your surgeon may choose to insert thin surgical drains, to reduce any fluid buildup during healing.
You may also be placed in a compression garment to reduce swelling and keep everything in place while you heal.

You’ll be groggy when you wake up, so be sure to have a responsible adult there to take you home and spend at least the first night with you. “Often, a private duty nurse can be arranged by the surgeon’s office, for those who do not have another caretaker,” says Dr. Stanton.

RealSelf Tip: Smoking (even vaping) can increase complications during surgery and slow the healing process during recovery. If you smoke, your doctor may ask you to go cold turkey at least two weeks (and often longer) prior to surgery, and for four weeks afterward.

Question 10

What can you expect during recovery?

Accepted Answer

The typical recovery time after butt implant surgery is 2 weeks, but “many surgeons will have patients avoid sitting for 2 to 6 weeks after the surgery, to help the incisions heal as well as possible,” notes Dr. Franco. You can expect some bruising, swelling, and pain during this time, and the discomfort may spread from your glutes to your thighs. Plan to take at least 2 weeks off from work and normal activities to rest and heal.

“It feels like deep muscle soreness after a long workout,” says Atlanta board-certified plastic surgeon Dr. Stanley Okoro.

The first two weeks are the most uncomfortable, though most patients are able to manage the pain with over-the-counter options after a few days of prescription pain medications.

“Tenderness, burning, or other sensations at the surgical or incision site are typical,” says Dr. Jon Ver Halen, a board-certified plastic surgeon in Colleyville, Texas. “I would be concerned if the pain worsens, the skin becomes inflamed [if it’s red or warm to the touch], or you start running a temperature.” In that case, you may need antibiotics to combat an infection.

Your provider should give you detailed recovery instructions, which may include tips like these.

If your surgeon placed temporary surgical drains, you’ll have to empty the fluid a few times a day (to prevent build-up) until they’re removed at a follow-up appointment, usually a week later.
You may also need to wear a compression garment for two to three weeks, to help reduce swelling and keep you more comfortable.
According to Dr. Stanton, patients can sleep on their back, stand, walk, and kneel facing forward in a chair during those first two weeks. The only time you should be sitting is to use the restroom.
You’ll need to avoid sitting on your butt for up to six weeks, to let the incision heal before you put significant pressure on it. This also helps the implants “settle,” so they’ll be less likely to move around.
When it comes to the bathroom, your doctor may recommend a squatting position as well as using stool softeners to prevent straining (often, patients are constipated for the first few days of recovery from the general anesthesia and pain medication). After each bowel movement, wipe with unscented baby wipes, avoiding your incisions.
Your doctor will give you instructions to gently clean your incisions when you bathe.
Hold off on driving for the first few weeks; in fact, some doctors recommend waiting up to six weeks to get back behind the wheel.
When you return to work, you still may need to sit on a pillow or two (every surgeon has their preference for the best type of pillow, so make sure to follow your surgeon’s recommendation). After six weeks, you should feel more comfortable sitting normally on a chair.

According to Dr. Stanton, “things typically get better each and every week up until six months, even a full year, until [they’re] completely softened.”

Question 11

When will you see your final results?

Accepted Answer

Your butt will look rounder immediately, but the middle and lower third may not look too perky right away.

Your new shape will slowly expand and reveal itself over the next six months as the swelling goes down and the tissues relax over the implants. That's when you'll see your final results.

You will have scars from the surgical incisions, but if they’ve been placed within the butt crack, they will be less conspicuous once you’ve healed.

“Buttock augmentation with implants is performed with an incision in the gluteal crease [the cleft between your two butt cheeks],” explains Dr. Franco. “There are two ways that it is commonly performed—with a single midline incision or with two curved incisions, along each buttock. Both incisions are well-hidden in the crease and covered in underwear or a bikini bottom.”

The two-incision technique has far fewer wound separation complications than the single midline incision, according to Dr. Stanton.

Question 12

How long do butt implants last?

Accepted Answer

Buttock implants are permanent, but patients may want a secondary surgery in the future to change the shape or size, or to “freshen their appearance,” notes Dr. Franco.

You might also need revision surgery if complications arise. But if your implants are placed properly, you shouldn’t have problems with displacement, says Dr. Pat Pazmino, a board-certified plastic surgeon in Miami. “If done appropriately, your implants shouldn’t need to be replaced.”

Question 13

Do butt implants look real?

Accepted Answer

Appropriately sized implants can look natural and even jiggle, says Dr. Shlomo Widder, a board-certified plastic surgeon in Vienna, Virginia. “The butt softness depends on the thickness of the skin. On a very thin person, even though the implants are made from ultrasoft silicone, the butt may feel a little tighter, like when you tighten your muscles.”

Size also plays a big role in how natural your results will look. As you go bigger, your implant may become more noticeable, says Dr. Michael Nykiel, a board-certified plastic surgeon in Newport Beach, California. “It looks less ‘real,’ and you can feel it.”

It takes six months for buttock implants to settle into their final position and fullness, and a full year for them to completely soften.

“I tell patients that in the end, they will feel similar to an Olympian sprinter’s athletic buttocks,” says Dr. Stanton. On the RealSelf website, he says, you’ll see videos of patients twerking with buttock implants. “So yes, they can really ‘jiggle’ as well.”

Question 14

Are buttock implants uncomfortable?

Accepted Answer

At first, sitting on your implants can be uncomfortable—like sitting on a large, hard bubble.

After you’ve healed completely and the tissue around the implant has softened, it should become more comfortable and less noticeable. Just like with breast implants, there will be an adjustment period, and you’ll get used to the new sensation.

“If they’re done correctly, you shouldn’t be able to feel the buttock implants when you sit down, after the initial recovery period,” says Dr. Senderoff.

“My patients have said that they get used to the implants, and they just become part of them,” says Dr. Franco. “After the initial period of not sitting to allow the implants to heal, they can sit and do activities as they did before the surgery.”

Implant placement is an important factor in how natural they feel. “If done properly, butt implants should not harden. Patients can experience a hardening if it’s placed on top of the muscle,” says Dr. Pazmino. “Superficial butt implants can cause a significant reaction in your body, which creates a tight scar contracture around the implant that may alter the appearance and cause discomfort. If this occurs, the implants must be removed and placed into a deeper, safer area within the buttocks.”

Question 15

Are butt implants safe?

Accepted Answer

Buttock implants are considered safer than BBL surgery, but they still come with risks.

A 2013 study in the journal Plastic and Reconstructive Surgery showed that out of 2,226 butt implant patients, 38% experienced some form of complication. By 2016, that number had dropped to 21.6%, mainly due to doctors gaining more experience in the procedure.

The most common issue was incision separation during healing.
Other possible complications included infection, seroma (fluid buildup), and pain that lasted longer than the typical two-week recovery period.
There’s also a small risk of implant displacement, which can cause pain and fever as the first symptoms.

About 5% of the patients in the 2016 study required implant revision surgery, while implant removal was performed in 3.8% of cases due to infection, pain, or seroma.

That’s higher than usual for cosmetic surgery—but if you’re choosing between butt implants and a Brazilian butt lift, the risks from implants are far less serious.

Another factor to consider: reported complications may be higher after revision surgery, especially if the implants are replaced. A 2017 study of revision buttock implantation surgery patients cites a complication rate of 17.8%, noting that “complications were highest after unilateral implant replacement.”

Most butt implant complications can be traced back to inexperienced surgeons or poor techniques. By choosing a board-certified plastic surgeon with years of experience performing buttock implant surgery (and a track record of positive patient reviews), you’re more likely to have a safe experience with good results.

Dr. Stanton says that when the surgery is performed by a reputable specialist who places the implants into an intramuscular pocket, the risk of complications is no higher than that of breast implants. “In more than 2,000 cases, my personal infection rate is only 0.5%, and the wound-healing complication rate is only 1.5%,” he says.

Related: The 5 Biggest Butt Implant Risks

RealSelf Tip: In 2019, Aesthetics Surgery Journal reported the first known case of gluteal-implant associated anaplastic large cell lymphoma (GIA-ALCL). The patient was treated swiftly, but the cancer was aggressive, and she did not survive.

Like similar cases of ALCL related to breast implants that have spurred recalls and implant warning requirements from the FDA, this GIA-ALCL case involved implants with a textured surface.

Some experts, however, don’t give much credence to the study. “Because this single research article failed to note the exact implant used in this patient—it [may have been] a textured breast implant and not an actual textured buttock implant—this can and should be regarded as misinformation until further evidence is revealed,” Dr. Stanton says. In his opinion, “failing to remove the implant from this patient, examine it, and note its exact nature is a major flaw in this study.”

No further reports of GIA-ALCL have been made public, but you may still want to talk with your plastic surgeon about gluteal implant options that have a very lightly textured or smooth surface, to help reduce your risk.

Question 16

What are the alternatives to butt implants?

Accepted Answer

If you’re on the fence about implants, you may also want to consider one of these buttock enhancement options.

A Sculptra butt lift uses an injectable filler that’s FDA-approved to treat facial wrinkles off-label (beyond its approval) for butt augmentation. Made of poly-L-lactic acid, a biocompatible material that’s been used medically for years. Sculptra both adds volume and stimulates the body's natural production of collagen over time. A Sculptra butt lift can be extremely expensive because it requires so much product, and the results are temporary. “Patients tend to need more product than they think for their buttock enhancement,” says Dr. Franco. “It is important to discuss your goals with your provider to make sure Sculptra butt enhancement is a good option for you.”
Emsculpt is a nonsurgical treatment that tones the muscles in the butt (and other areas) using high-intensity electromagnetic energy. It creates muscle definition and strength, but it won’t give you the same rounded shape as implants or add significant volume. “If you are truly seeking buttock augmentation, the results from Emsculpt will likely be disappointing,” says Dr. Stanton.
A butt lift removes excess skin from above the buttock and lifts sagging skin. It’s usually done after major weight loss to create a smoother, tighter appearance. Keep in mind, however, that a butt lift doesn’t add volume. “Most potential patients don’t know this, but a ‘butt lift’ actually tends to flatten the buttocks even more,” explains Dr. Stanton. On the other hand, a lower buttock tuck lifts sagging skin from the back of the thighs and tucks it up into the lower buttock crease (a.k.a. infragluteal fold), creating a more defined junction between the buttock and hamstrings.

Related: 4 Alternatives to a BBL That Can Give You a Bigger, Perkier Butt

RealSelf Tip: Doctors definitely do not recommend silicone liquid, PMMA, Bio-polymer, acrylic, or hydrogel injections for butt enhancement. Inexperienced or untrained injectors often use industrial-grade silicone (sometimes even in their home, hotel rooms, nail salons, etc.) in a procedure they call butt shots.

None of these injections are FDA-approved for body contouring, and they can cause serious, permanent side effects, including tissue death or even patient mortality. For patients with complications, silicone removal is painful, wildly expensive, and sometimes impossible. See the FDA’s safety warning.

Question 17

Sources & studies

Accepted Answer

Rueda, Juan Dario Alviar, et al. “A Rare Case of Implant Displacement to the Contralateral Side after Gluteal Augmentation.” Archives of Plastic Surgery, U.S. National Library of Medicine, 10 Apr. 2020.

Tijerina, Jonathan D, et al. “Celebrity Influence Affecting Public Interest in Plastic Surgery Procedures: Google Trends Analysis.” Aesthetic Plastic Surgery, U.S. National Library of Medicine, Dec. 2019.

Royer, et al. “Post-Bariatric Buttock Contouring With Gluteal Implants During Circumferential Body Lift: Step-By-Step Video Description and 1-Year Results.” OUP Academic, Oxford University Press, 25 Aug. 2018.

Commissioner, Office of the. “FDA Warns about Illegal Use of Injectable Silicone for Body Contouring and Associated Health Risks.” U.S. Food and Drug Administration, FDA, Nov. 2017.

Senderoff DM. Revision Buttock Implantation: Indications, Procedures, and Recommendations. Plast Reconstr Surg. Feb. 2017.

Sinno, Sammy, et al. “Determining the Safety and Efficacy of Gluteal Augmentation: A Systematic Review of Outcomes and Complications.” Plastic and Reconstructive Surgery, U.S. National Library of Medicine, Apr. 2016.

Mofid, M. Mark. “Buttock Augmentation with Silicone Implants: A Multicenter Survey Review of 2226 Patients.” M. Mark Mofid Plastic & Reconstructive Surgery, Apr. 2013 .

BUTT IMPLANTS

Johnny Franco, MD, FACS

Karyn Repinski

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	Butt Implants surgical	Sculptra nonsurgical	Emsculpt & Emsculpt Neo nonsurgical	Butt Lift surgical	Brazilian Butt Lift surgical
Worth It Rating	72%	83%	79%	86%	84%
Average Cost	$13824	$1744	$3017	$12898	$9955
Downtime	2 weeks of downtime	Minimal downtime	No downtime	2–3 weeks of downtime	2–6 weeks of downtime
Anesthesia	General anesthesia	Topical anesthesia	No anesthesia	Local anesthesia with IV sedation or general anesthesia	General anesthesia

Johnny Franco, MD, FACS

Karyn Repinski

Johnny Franco, MD, FACS

Karyn Repinski

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