Buttock Augmentation

What is a Buttock Augmentation?

Buttock or gluteal augmentation is a procedure used to improve the volume, shape, and contour of the buttocks. Buttock augmentation can be achieved through fat grafting, (famously referred to as a Brazilian Butt Lift or BBL), silicone implants, or sometimes a combination of these two techniques.

Due to public demand for BBLs, there has also been a huge increase in the number of non-board-certified plastic surgeons performing this procedure. Gluteal augmentation surgery, including BBLs are technically demanding procedures which require appropriate training to be executed safely. Your surgeon must have an in-depth understanding of the different anatomic planes and the neurovasculature within the gluteal region. This procedure is performed through tiny incisions where a blunt metal cannula is inserted to deliver the harvested fat. The 1:3,000 mortality rate for this procedure is alarming, which is why we encourage you to verify any of your prospective plastic surgeon’s board certification status through www.plasticsurgery.org courtesy of the American Society of Plastic Surgeons.

Why Buttock Augmentation May Be Right for You

  • At a stable and healthy weight without excess sagging skin.
  • If you do have excess skin laxity, you may require a buttock lift and/or tuck in conjunction with buttock augmentation to attain optimal results.

If you are unhappy with the shape of your buttocks and believe the contour is asymmetrical or flat and lacking volume, a buttock augmentation procedure may be right for you.

The Procedure

Gluteal Implant

Silicone implants are inserted into the subfascial (below the fascia) plane of the gluteus muscle or inserted intramuscularly (within the muscle). Implants in the subfascial plane have the benefits of obviating the need for muscle dissection and significantly reduces the risk of injuring the sciatic nerve, (which can cause neuropathic pain, and dysfunction of muscles located on the back of the thigh and lower leg). The disadvantage to this method is that the subfascial plane is not as deep as the intramuscular plane, making the contour of the implant more prominent.

The benefits of the intramuscular plane include the thick muscular covering that the bisected (dissected in half) gluteus maximus muscle provides over the silicone implant, conferring a natural contour. The con to this method is that the intramuscular plane requires the surgeon to bisect the gluteus maximus muscle, which lengthens recovery and increases the risk of permanently severing nerves that innervate this muscle. Nerve injury can cause paralysis of the gluteus maximus muscle and subsequent atrophy (muscle shrinkage), creating asymmetry and muscle dysfunction. Implants are silicone and are either round or oval. They also come in different sizes ranging from 200-500 mL. The ideal size and shape will be selected according to the size of your pelvis, your height, and your desired degree of augmentation. All options will be discussed with your plastic surgeon and a customized surgical plan will be created to match your existing anatomy and your aesthetic goals.

Gluteal Implant

Gluteal Fat Transfer or Brazilian Butt Lift (BBL)

Liposuction is performed in areas where fat removal will improve the contour of your body. Typically, fat is harvested two or more regions to obtain an adequate amount. These areas include the flanks (love handles), abdomen, and back. The harvested fat is purified to optimize the viability of your fat cells and stem cells which will be injected into the subcutaneous layer (below the skin, but above the muscle) of your buttocks. About 50-75% of the injected fat will survive. Occasionally, a patient may want an additional BBL to add more volume.

Gluteal Fat Transfer


  • Moderate pain is typical. Pain is well controlled with over the counter and prescription medications.
  • You may have surgical drains which you will have to empty several times a day. These will be removed in clinic during one of your follow-up visits.
  • You are required to wear the compression garments around the clock following your surgery. Strict adherence to the timeline and detailed instructions will be provided to you during your pre-op appointment. Noncompliance with these instructions significantly increase the risk of developing complications.
  • Stool softeners for the first 1-2 weeks.
  • Avoid sitting or sleeping on your buttocks for a minimum of 2 weeks after gluteal implant surgery and 8 weeks for BBL.
  • Do not shower for 48 hours after surgery.
  • Avoid strenuous activity for at least 4 weeks. Most patients resume their normal level of activity at 6-8 weeks.
  • Return to work 2-4 weeks after, depending on comfort and ability to accommodate sitting restrictions.
  • You can appreciate the final results at approximately 3 months.

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