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Lifting and supporting the buttock with supplemental fat grafting is sometimes called a Brazilian butt lift. I’m not really a fan of that terminology as it usually associated with excessive volumes of injected fat, popularised on reality TV shows but that’s what most people call it, like it or not. I’m going to cover this in three parts. We’ll start with the bad news, follow that with the good news and finish up with a summary of the best surgical options so you’ll be an expert by the time you read the whole piece.
If your time is short and you want to cut to the chase here it is- In my opinion, there is definitely a surgical role for improved shaped buttocks and volume through lifting and/or filling procedures and these can be safely achieved without the ridiculous and sensationalist images seen on social media. We should probably be doing a milder version of this with most of our tummy tucks (two birds one stone) so that we’re treating the entirety of you from a 360-degree perspective, ensuring your desired areas compliment your body and lifestyle.
Let’s start with the bad:
The last few years have been like the wild west characterised by hugely exaggerated results, terrible complications, purified fat and even some deaths. At the recent international plastic surgeons and plastic surgery conference in Miami, the safety issues related to these procedures were discussed and there is even an urgent taskforce being performed by some of my American (board certified plastic surgeons) colleagues looking at recommendations to improve safety. The deaths have arisen from fat being injected into the buttock muscle, from other areas of the body, and then inadvertently into the large veins that can be found there. When fat cells are injected into the vein it ends up getting trapped in the lung and this is called a fat embolus. It has a very high mortality rate that is almost unsalvageable i.e. you suddenly die. Other complications include skin loss, fat death, rippling, cellulite, scarring, pain, infections, excess fat etc.
This procedure is popular in some societies where a fuller curvier buttock is culturally desirable such as in South America. Until now, that kind of larger buttock shape in places like Australia has been the opposite of what we’ve always aspired to. As with all procedures- go for the classic looks that are timeless. A fit and athletic you will always be in style no matter what age you are and if it is done so that it is in harmony with your physique then it will look great.
I worry for younger patients who are wanting to have huge amounts of fat placed in their bums, often through a fat transfer procedure. It may look good for a while but when age and time set in- the problem will be almost unfixable with terrible cellulite. You need only to remember what your parent’s bums look like. Your butt will be just like this only much bigger, heavier and with much more cellulite. Is that something you really want in the long term? You can’t just have the fat removed again when you get older.
So should we abandon this procedure?
The answer here is no but it needs to be done in a safe way and not to the ridiculous way it has been promoted in the past. You should always try to improve you buttock shape with exercises such as squats and lunges first but sometimes, particularly if you’ve lost a lot of weight, no amount of filling will help and surgery might be an option.
The buttock area ages just like the rest of the body and changes with weight loss, pregnancy etc. If we value improving your shape at the front with abdominoplasties why shouldn’t we consider the backside as well! The key message here is the same as for any plastic surgical procedure you are considering. The goal is to Improving shape and volume and giving you a harmonious result that fits with the rest of your body.
Newer techniques involving smaller volumes have really helped to lower both the side effect profile and mortality of these procedures. Fat grafting is commonly one of the commonest procedures I do, usually in conjunction with breast procedures to really tailor, define and shape the breast. The same principles can be applied to the buttock.
This is achieved with your own fat with or without some skin excision. If only a small amount of lifting is required then fat alone can be a great tool to help you restore your shape through buttock augmentation. About 2/3 of the fat injected will survive in the long term. If you’re going for a curvier look this is also okay but I don’t offer enormous Brazilian butt lift surgeries- you’re going to need to go to someone else if you want this. Why? Well, I just couldn’t, in good conscience, do this to you knowing the problems ia brazilian butt lift procedure is going to cause you in the future (which will, by extension, also be my problems when they happen).
As the fat is a biological structure derived from your body (liposction of another body part), you may require another round of fat grafting at a later date but the fat that does survive will look, feel and behave your fat normally would.
Resection techniques are usually done as part of a circumferential lift – sometimes called a body lift. Whilst this used to be the domain of the massive weight loss patient, increasing numbers of men and women are requesting the lift at the back to change their buttock shape at the same time as flattening their abdomen. As you can expect- there is always a trade-off. The main issue is the scar. This fades with time and can be hidden in the most revealing underwear or swimwear but it is still there.
The final thing to mention for completeness would be buttock implants. There is a very high complication rate with these implants as they sit in a heavy use area so I don’t offer this procedure.
Remember to always try gym/exercise first and if that fails, you can see a plastic surgeon like myself (take a look at my personal profile) who can help you with achieving a buttock shape that compliments the rest of your figure.
If what I have written resonates with you, please don’t hesitate to get in touch!
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Choosing the right procedure and surgeon is important. I believe that helping my clients make informed decisions is key to a great result so if you have a question or would like to know more about something specific, please let me know – Regards, Alex.