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.

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 reducing 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 of 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 Fat Transfer or Brazilian Butt Lift (BBL)

A Brazilian butt lift (BBL) is a surgery where a doctor transfers fat from your belly, hips, lower back, or thighs to your buttocks. The result is more of an hourglass-shaped figure, with larger buttocks. It's not an actual "lift" because it doesn't try to raise your buttocks. Instead, it increases volume. A BBL can give you a smaller-looking waist if the fat comes from your belly or lower back. It's a two-step procedure. Doctors remove the fat using liposuction. This is a cosmetic procedure that sucks out fat with a small plastic tube called a cannula. Then the fat is injected into the buttock area. You might hear your doctor call this operation gluteal fat grafting, buttock augmentation with fat grafting, and safe subcutaneous buttock augmentation (SSBA).