The Surgeon Minute

Buttock Augmentation Is The New Rage

Buttock Augmentation Is The New Rage

It’s not just the media who are suddenly obsessed with the derriere. Buttock augmentation procedures as a whole were the fastest growing procedures in 2015, according to the American Society of Plastic Surgeons. Why are buttock enhancements suddenly so popular? “I think it’s a cultural thing based on a handful of celebrities,” says Dr. Richard Restifo of Orange, CT.  Women such as Jennifer Lopez, Kim Kardashian, and Nikki Minaj have transformed our vision of what makes a buttock attractive. Dr. Restifo discusses this trend that seems here to stay.

by Katherine Stuart
and Richard Restifo, MD

The Challenge Is Finding the Fat

Buttock augmentation with fat transfer, or the Brazilian Butt Lift, has grown in immense popularity. “Everyone wants the big round booty,” explains Restifo. “It’s a phenomenon.” The challenge with the BBL is the surgeon has to be able to find enough fat on the patient’s body in order to deliver the results that he or she wants. Most BBL patients are not heavy, so the fat often needs to be taken from multiple donor sites.

The best place to harvest the fat is from the lower back, just above the buttocks, because it creates a concavity above the buttocks which improves the patient’s overall shape, making the butt look bigger on it’s own. The importance of contour paired with volume cannot be overstated.

Another good donor site is the abdomen, although this can sometimes be problematic with patients who’ve had pregnancies because the skin in that area may already be loose. If you remove more volume from the area, it could make the skin even more loose. With these patients, Restifo will often suggest that a tummy tuck be performed in addition to the BBL.


The second challenge with the BBL procedure is that it takes more fat than you think. Since 1/3 – 1/2 of the transferred fat won’t take, it doesn’t really matter where the fat comes from on the body as much as it matter how much can be harvested. It also means that a patient’s initial results will be larger than their final results. This requires a very honest conversation with the patient during their initial consultation so that they understand what to expect. The recovery from BBL surgery is not particularly difficult, although Restifo does advise patients to avoid sitting for prolonged periods in order to allow the transferred fat to establish itself. The final results will appear in anywhere from 3-6 months.

Other Buttock Enhancement Options

Sometimes a thin patient will come in wanting Jennifer Lopez’s fanny but they may not have enough fat to deliver those results with a BBL. What are their options? Buttock implants do exist and are used routinely in South America and certain parts of the United States. Restifo doesn’t believe in utilizing buttock implants as they are too problematic given the fact that you sit on them.

For Restifo, buttock enhancement takes one of three forms. The first is the BBL, or fat transfer. The second is skin removal. This is ideal for patients where the situation is not a lack of fullness, but where there is too much hanging skin due to age, gravity and weight loss. The procedure involves removing the excess skin and pulling up the skin on the lower buttock for a higher, tighter booty.


The third option is what is called auto augmentation. In this procedure, the surgeon removes the extra skin, but instead of throwing it out,  he or she moves it down to fill in the lower buttock area. The most common donor site for this is the skin right above the buttocks. It not only tightens the skin, but the patients gets that curvy, “shelf” appearance.

“Buttock enhancement is a definite growth area,” says Restifo. Whether it was a celebrity or unknown cultural shift, enhancing the buttock is on the rise with a great array of options to craft incredible results.

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