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While the overall number of plastic surgery procedures continue to slowly rise each year, some procedures have increased more than others. One such procedure is buttock augmentation, up nearly 40% last year.  Plumping procedures have always been popular in plastic surgery and the buttocks represents the biggest body part to plump of them all.  Whether it is higher, rounder or just smoother, there is a growing number of people who want a better one.

While increasing buttock size has been around for some time, the use of implants to do it limited the number of people who wanted to undergo it. One should not confuse the surgery and the recovery process of buttock implants with that of breast implants. While very effective and permanent, it is a harder procedure to go through with more discomfort and a longer recovery.  After all, having to sit on your implants after surgery is much different than having them merely placed onto the front part of your chest.

What has led to a dramatic increase in buttock augmentation is two main factors. In an ever increasing multi-cultural society, the buttocks is a greater focus of body aesthetics and shaping. Amongst Black, Latino, gay and transgender people, the size and shape of the buttocks takes on increased emphasis. Add to that the exposure that certain Hollywood stars, such as Kim Kardashian and Jennifer Lopez, have placed on a shapely derriere and the public is sure to follow. The second factor for the procedure increase is the method now most commonly used to do it, fat injections.

Fat injections offer a more appealing alternative to the use of implants for buttock augmentation, not only because it is a more natural material but also because of the concomitant benefit of fat reduction and body contouring achieved at the same time. Getting fat for the injections requires a liposuction harvest and a generous amount to do it since the fat must be concentrated for injection. This always results in a significant body contouring effect, usually on the abdomen, flanks and along the upper back. This alone can make the buttocks look bigger or more shapely because the body is reduced around them. In essence, buttock augmentation with fat is a redistribution effort.

While buttock fat injections is an obvious plumping procedure, it has gotten a more commonly known name that is really a misnomer  and even a bit misleading.  Called the Brazilian Butt Lift and other such lifting names, it is not really a lift at all. It is no more of a lift than one would consider a breast implant as a breast lift. To some degree, there is a mild lifting effect from filling out the skin but it is primarily a volumizing effect.

It is also the one operation where being a little overweight is beneficial providing more donor fat to harvest. There are even some patients who gain weight for the procedure although I do not advocate that approach. At the least, it is not an operation like a tummy tuck or liposuction where you want the patient to have done everything beforehand to be as lean as possible to get the maximum benefit.

For those patients who do not have enough fat, however, buttock implants are the only way to do it. The good news is that buttock implants today are far more advanced with gel-like softness and a large number of sizes and shapes to use. Employing an intra-muscular plane of insertion, results are better and the risk of implant-related complications such as infections and fluid collections much reduced.

Dr. Barry Eppley

Indianapolis, Indiana

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