• Wish you had a smaller waistline and a rounder derriere?
• Has gravity deflated your buttocks? wish they were rounder and more perky?
• Have you had breast augmentation—and now want more shapely buttocks to complement your new look?

Ever wish you could take your unwanted “muffin top” fat and transfer it to your derriere for a curvier shape? You should know about buttock augmentation.

Dr. Parungao answers questions about
buttock augmentation

What is buttock augmentation?

Buttock augmentation—sometimes called a Brazilian butt lift or gluteal enhancement—is a surgical procedure that uses your own fat cells to round out the buttocks. The clinical term for this procedure is lipoaugmentation of the buttocks

Are you actually lifting the buttocks during butt augmentation surgery?

Butt augmentation surgery by fat grafting produces the appearance of a lifted derriere because we're adding volume to enhance the curve in the upper half of the buttocks.

Technically, a buttock lift is a complicated procedure that amounts to a tummy tuck on the reverse side of the body—which we certainly can do, but we don't do it that often.

Actual buttock lift surgery increases risks of complications, including seroma formation, poor scarring and wound breakdown due to the extent of the dissection or cutting. We will do this type of procedure only if it is necessary and the patient is well-informed of all the risks involved.

How is butt augmentation surgery done?

Our butt augmentation procedure is twofold:

1. We liposuction unwanted fat from the love handles or the ‘muffin top’—the area starting right above the buttocks in the small of your back and curving around to the sides. Many women have diet- and exercise-resistant fat in that area. In some cases, we may also take unwanted fat from the tummy or upper thighs as well.
2. We process the liposuctioned fat and inject it into the upper part of the buttocks to create more fullness.

How is the liposuctioned fat processed?

We gently separate the fat from the tumescent solution—saline (salt water) with lidocaine and epinephrine—using gravity.

Lidocaine is a local anesthetic. Epinephrine—also known as adrenaline—constricts the blood vessels in the liposuctioned area to minimize bleeding and bruising.

What do you think has made butt augmentation so popular?

People have been asking me about butt augmentation for several years now. As our society becomes more diverse, and shapely celebrities such as Jennifer Lopez and Beyoncé Knowles have become more prominent, people are starting to notice the shape down there more.

This trend is encouraging women to look for ways to make their rear ends look more curvy. Not everybody wants to be waif-thin.

Who is a good candidate for butt augmentation?

I typically perform butt augmentation on women in their 20s to 40s—but a woman can be a good candidate if she meets these criteria:

• Be at or near ideal weight
• Be in good cardiovascular condition

I advise women considering butt augmentation to do squats and lunges to help define the muscles in the posterior part of their body. If these techniques don't do enough to enhance the curve of the buttocks, butt augmentation surgery can be a good option.

What is your approach to butt augmentation surgery?

More often than not, I prefer:

• Sculpting above the buttocks in the love handles to make that area more concave
• Sculpting below the buttocks in the posterior thigh area
• Augmenting the middle—the upper buttocks themselves—with the transferred fat

How do you correct sagging buttocks?

Women who complain of sagging buttocks may need some liposuction in the lower half of the buttocks to create better contours. In extreme cases, we might have to remove extra skin on the lower half of the buttocks.

How long does butt augmentation surgery take?

Butt augmentation surgery takes an average of two hours, depending on the number of areas being treated with liposuction. The procedure can be done under the patient's choice of general anesthesia or IV sedation.

Does fat transfer work better than butt implants?

In general, plastic surgeons find fat transfer to be a more acceptable method of butt augmentation than buttock implants. Silicone butt implants have a high risk of seroma, infection and extrusion—meaning that the implant pops out through the skin. The implant would be under enough stresses that you can have problems.

Are the effects of butt augmentation surgery permanent?

The literature shows that about 50% of the transferred fat can be expected to be reabsorbed by the body after a year. At that point, you might want to repeat the procedure.

Often, the body's natural response is to maintain at least some of the transferred fat due to a combination of scar tissue, the ongoing viability of the transferred fat cells and collagen formation that may be encouraged in that area.

How much bigger will my buttocks be after butt augmentation?

That's a difficult question. I tell my patients there will be a modest improvement in the shape. It varies by how much fat I'm able to harvest from other parts of the body. Another factor is how the body reacts to the transplanted fat—how much is reabsorbed, and how much stays. The increase in size is not as definitive as with a breast implant, for example.

How long should I expect to be off work after butt augmentation?

I typically encourage my patients to take a week off of work after surgery to accommodate the pain in the butt, as it were. It's necessary to sleep on your side or your stomach during the healing period rather than sleeping on your back.

Recovery is not especially painful. The incisions are the same type of tiny incisions you would have for liposuction. I give my patients Vicodin for the pain after surgery.

Can plastic surgeons also use liposuctioned fat to enhance the breasts?

Some people do, but it's still considered an experimental procedure. We're still trying to figure out if transferring fat into the breasts would cause problems with mammograms in the future. The American Society of Plastic Surgeons is having plastic surgeons hold off on that procedure until more studies are done.

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