Dr. Kenneth Hughes: Hello. I'm Dr. Kenneth Hughes, in Los Angeles, California. I'm a plastic surgeon. I do about 1500 total procedures each year. A large portion of those in the last two years have become Brazilian butt lifts. This procedure involves basically transferring fat from any area in which you have excess, and sort of skinning those parts down, and then building up your buttock or your hips or any other area that you feel needs to be built up. It's an extremely effective technique. I probably do about 500 variations of the Brazilian butt lift a year. Today, we're going to take you into the OR and show you a few of these butt lifts. I usually do about two a day or so.

So, revisions are particularly difficult. In the past, this lady had gotten . . . She was a very thin woman. So, she had about 300 CCs or so, per buttock transfer. As you can see, I let the gravity sedimentation take effect. They're a little bit over 1200 of fat, but if you look, that's about 1000 CCs of pure fat in each canister. Gravity sedimentation causes the least amount of damage to the fat cells, unlike centrifugation. So, that's why I do it that way. So, we will then take the fat off of the top and inject 1000 CCs per buttock. So, she's going to fix that now. Go ahead and do it, and then we'll inject.

So, basically, I only use one port to inject everything. These were my hidden incisions for the posterior and lateral thigh liposuctions. So, basically, what I do is I basically start sort of to increase the projection, and you basically have to pass this through multiple plains to see which of the tissues will expand the most to give you the look that you want to achieve. I try to put a good bit in the muscle, but you have to remember the muscle's only about that thick. So, when you're putting in 1000 or 2000 CCs per buttock, putting it all on the muscle doesn't make a lot of sense because you need vascularized tissue all around. That little bit of muscle is not enough to do it.

So, I inject it into the muscle, above the muscle, into the fat, and sometimes superficially underneath the skin to improve dimpling. This is really just a finesse game, placing it at exactly the right place each time you inject to get exactly what you want.

I just massage this, so that it gets distributed evenly superficially, to help with all of the lumps. This is a good treatment for her skin dimpling that a lot of women have. So, as you can see, there's a pretty dramatic difference here in the two sides. And like I said, I'll come back and inject some more here at the end, but the key is to get symmetry. So, you kind of inject a little bit in each one at a time. So, once again, I inject . . . find a place that gives me the most amount of projection per infiltration.

So, there I'm putting some into the muscle. The muscle is relatively easy to locate. It's easy to feel when you reach the fascia, and then you just push slightly in, and you get into the various aspects of the muscle. It's important to realize the muscle is not just . . . It is one continuous thing, but where you inject in the muscle achieves a different shape for a lot of people. So, maybe I'll go over here and give a little bit more projection out laterally, which helps too.

This lady in particular has an area here on her sides where there's a dent. And so, that's why I'm filling it more laterally, and then I basically am placing that fat to kind of take up that space, so that the buttock and the hip have a nice transition. Some people don't want that. Some people want the butt perfectly sculpted and to have that, you know, that dent, that natural dent there. Some people want fat there. So, I do whatever people want, but she wanted a little wider, thicker look. And so, that's what I'm giving her.

I'm just checking from the side to make sure it's nice and round. I think you can see that that really brings out the buttocks a little bit better. These final things are advanced techniques. So, I'm trying to [inaudible:00:09:22]. So now, I'm performing a final massage to see if there's anything else I want to change.

A Brazilian Butt Lift Is Performed Using a Patient's Own Thigh Fat

Dr. Kenneth Hughes walks us through a Brazilian butt lift, which was performed immediately following the liposuction of the same patient's thighs.