Orginialy this was called Buttock surgery update but after 6 years…

Buttock shapes

We all know these classification for buttock shapes. It turns out there are pear, apple, mandarin and tomato buttock shapes if you are a vegetarian type and other shapes to describe buttock if you are a mathematician etc…  Funny but no one told me that during my training. It also appears that the citrus fruit among these, mandarin /Round, is the shape most want: two round balls for buttocks. Buttocks plastic surgery keeps on evolving and its time for a buttocks plastic surgery update!

From a cosmetic plastic surgeon’s perspective, there are three types of buttocks plastic surgery that can be performed: patients want their buttocks larger, smaller or just lifted.


Making buttocks bigger

The options for making buttocks larger are:

1. Silicone implants

In this outpatient cosmetic procedure, a 2-3 inch incision is made between the buttock cheeks and a solid silicone implant is placed under the buttock (gluteus) muscles.

  • Silicone implants used are different from ones used in breast augmentation and are firmer to touch
  • Implant have to be placed higher in buttocks, as you cannot sit on implants for fear of rupture; we all sit on the bone under our buttocks
  • Healing takes about 10 days and full recovery 1-2 months
  • I rarely perform these unless the patient really has no fat at all that can be used for a Brazilian buttock lift  or enlargement. The complication rate is just too high.

2. Fat injections – Brazilian buttock lift

  •  Even though the Brazilian buttock lift has “lift” in its name, it’s a plastic surgery procedure that both enlarges and lifts buttocks
  • Liposuction of abdomen and hips is performed, and harvested fat is injected into buttocks after mixing with antibiotics.
  • I typically inject about 1000 cc into each buttock at one surgery for maximum effect
  • This is an outpatient cosmetic surgery requiring 3-4 days for recovery and 1 month for full healing
  • About 20% of  fat injections will naturally disappear, but some will remain permanently; everyone is different
  • Recently we have learned that if a BBl is done by in-experienced surgeons who place the fat below the muscles of buttocks there is a high risk of complication. That fat is placed only in the skin area above the muscle.


Making the buttocks smaller

There is really only one cosmetic procedure to make buttocks smaller, and that is liposuction. In this procedure, three to four small incisions are made around either cheek and fat is removed, leaving behind a smaller buttock. The cosmetic danger is in removing too much fat and turning a plump cheek into a flat and droopy one—not a good idea.

I have not had a patient ask me to make their num smaller in 10 years- It is just not in style to have small buttocks- Everyone wants them big these days.


Lifting the buttocks

There are two options for this cosmetic procedure, buttock lift surgery and, again, Brazilian buttock lift.

Buttock lift surgery

In this surgery, a scar is placed in a crease under the cheeks and the skin is turned in to give a modest lift.

The problem is that the plastic surgeon is trying to push and hold your skin and fat tissues in a high position against gravity’s force; given the weight of skin and fat, gravity wins. The scars are not great from this surgery, and I try hard not to perform it!

Brazilian buttock lift 
As above, fat injection will not only make a buttock larger but will also lift it, in the same way an empty bag is “lifted“ when full. With liposuction I can actually change the shape of the buttocks to to make them larger and lifted or smaller and lifted!

The concept to keep in mind with all these surgeries is that by changing the shape of the skin and fat around an area I can change the apparent shape of the area itself! So yes, it is possible to get wider hips for example.

The update

I first wrote this blog in 2010. 10 years later not much has changed other than…

I now perform a lot more Brazilian buttock lifts than before; it is a routine procedure now. Specially in combination with abdominoplasty tummy tuck.

I do very few silicone implants these days

I have not done a simple lift with cutting of the skin in 4 years! – It is just not a good surgery.

We still do not know how come much more fat survives in some areas like the buttocks and not in others such as the breast!

Morad Tavallali, M.D., FACS

Tavallali Plastic Surgery LLC