The Brazilian Butt Lift
Win Pound, M.D.
Some people are simply born without much shape to their butt, others lose volume as they age or lose weight. The Brazilian butt lift restores volume to the butt but also shapes the butt by removing fat from the surrounding tissues.
Early attempts at enhancing the buttocks depended on the insertion of large silicone rubber implants beneath the muscle of the buttocks. The risks involved malposition of the implants, migration of the implants over time, infections, or fluid around the implants. It also left a pretty nasty scar where the implants were inserted. Fat transfer was not popular at this time because fat was unpredictable as far as its ability to survive. It has very poor blood supply. If it didn’t survive, it could liquify and go away or harden, forming firm, tender knots and irregularities that could be felt or seen. Many years ago, I walked out of a course given on buttock augmentation when the experts stated that they had a sixty percent complication rate with this operation. That was simply too high for me.
Over the years, the process of harvesting and transferring fat has improved immensely. This has resulted in greater viability of the transferred fat. Much of it will still re-absorb, however, so we still need to transfer a lot of fat in order to make a significant difference in the appearance of the butt. Nevertheless, fat transfer has replaced implants as the procedure of choice for augmenting buttocks these days.
Fat has to be harvested from somewhere in order to use it. The more fat we can harvest, the more we can transfer and the more noticeable the result. For most women, this means removing fat from the hips, thighs, and abdomen, places where fat tends to accumulate the most and where it is least susceptible to changes from diet and exercise. These are hardy fat cells. Removing fat from the hips and thighs has the additional advantage of sculpting these areas which also allows us to shape the butt.
Once fat is harvested in a sterile fashion, it can be washed and then re-injected through small incisions. The incisions are closed with dissolvable stitches and the patient is placed in a compression garment to wear for several weeks. Because fat is so fragile, it is best if the patient can keep pressure off of the buttocks while the fat is growing new blood supply. This may mean sleeping on the stomach or putting cushions under the thighs while sitting to that the patient’s weight is not directly on the buttocks.