BUTTOCK AUGMENTATION FAQs
Brazilian Butt Lift (BBL)
Fat Transfer to Buttocks FAQs
Is it possible to perform a BBL using a local anaesthetic.
However, there are some downsides:
- The patient will likely experience significant pain, regardless of the amount of local anaesthetic used.
- The surgeon may not be able to access the areas they would like to, due to patient discomfort.
- Lidocaine (local anaesthetic) is toxic to fat cells and stem cells and will reduce the amount of fat that survives, meaning multiple sessions of fat transfer may be required if performed under local anaesthetic.
A Brazilian Butt Lift is an operation to restore or reshape the buttocks to provide fuller, firmer buttocks, or correct deformities and asymmetry, by grafting your own body fat into the tissues of the buttocks.
Fat is harvested from areas where excess fat is of concern, commonly the love handles, abdomen and thighs. The fat is carefully handled to protect the fat cells, before being injected into the buttocks through one or two very small incisions using a thin cannula.
The procedure should be fairly atraumatic, reducing the incidence of complications and maximising the healing of the fat cells.
Restricted activities are advised for 2 weeks following a Brazilian Butt Lift.
Wearing a support garment is recommended for the first 3 weeks day and night, then during the day for a further 3 weeks.
The Brazilian Buttock Lift (BBL) is a procedure in which fat is taken from another part of the body, then injected into the buttocks. However, surgeons today warn it has the highest death rate (thought to be as high as 1 in 3,000 operations) of all cosmetic surgery procedures, due to the risk of injecting fat into large veins that can travel to the heart or brain and cause severe illness and death.
Mild discomfort, swelling and bruising can occur.
Some irregularity may occur at the site of fat harvest requiring additional treatment(s), such as Velashape or additional fat sculpting.
Infection is rare (<0.1%) following fat transfer to the buttocks. A course of antibiotics will be given at the time of your treatment.
Some altered sensation around the treatment area and the site of fat harvest is common which is expected to resolve in 6 – 8 weeks.
A Brazilian Bum Lift provides a long-lasting or permanent improvement.
However, anywhere from 20 – 40% of the grafted fat may fail to survive, requiring an additional treatment after approximately 3 months in order to achieve the optimum results.
Improvement in fullness and shape will be seen immediately following treatment. Any swelling will resolve in 2 weeks but return to normal feeling from 4 – 6 weeks.
It will take 3 months for the grafted fat to stabilise in the area(s) treated.
Minimal discomfort is expected following the treatment and no bruising should occur with the careful techniques used. Any mild bruising will usually resolve after 1 to 2 weeks.
The treated area(s) may feel tender – moderate discomfort for the first 3 – 5 days.
Mild discomfort is expected for 2 weeks.
The initial consultation will determine the goals of treatment, and make note of any associated abnormalities or asymmetry, in order to develop the optimum treatment for an ideal result in each patient.
The treatment is carried out under local or general anaesthetic, as a day case.
Fat grafting can be enhanced by using your our platelets from your blood in the form of Platelet Rich Plasma PRP, to enhance fat cell healing and survival.
This is performed at the same time as the fat grafting.
If you would like to improve your buttocks using your own fat, and gain by removing fat from area(s) which concern you, then a Brazilian Butt Lift or buttock fat transfer is likely to be beneficial for you.
A detailed assessment to determine your goals and options can only be carried out at the time of a consultation. If you do not have sufficient fat for harvesting, Macrolane buttock injections, or buttock implants may be a more suitable option.
Fat grafting uses your own fat cells (autologous fat) to enhance your buttocks. Since the fat cells are your own, there is almost no risk of rejection or adverse reactions.
The fat transferred to the buttocks will feel and behave naturally and there is no risk of implant failure or damage as with buttock implants.
Although 1 or 2 treatments with fat transfer may be required to achieve the optimum shape or fullness, the results of fat transfer to the buttocks are permanent.
In cases in which the patient does not have sufficient fat, it may not be possible to locate enough fat on the body to transfer.
In this instance, we recommend either silicone gel buttock implants or the use of Hyaluronic Acid based dermal fillers such as HYAcorp or Macrolane.
Fat transfer is advisable if the patient has sufficient free fat on the body that can be liposuctioned out and transferred to the buttocks.
The advantage of this method is that it is possible to move fat from areas on the body on which it isn’t wanted (the belly for example) to areas on which you would rather have it (the buttocks).
In effect, you have two surgical procedures, a liposuction and a buttock augmentation using your own body fat. It is also important to note that fat transfers are only a semi-permanent solution, not all of the fat transferred to the body will last permanently, and the patient may need to return in a few years time for an additional fat transfer.
Buttock Injections FAQs
Collagen Stimulators based on poly-L-lactic acid are designed to stimulate the production of new tissue in the body. When a foreign substance is injected into the buttocks the body seeks to repair the damage and encapsulate the substance which creates the additional volume.
Adjustable / Safety
A downside of using poly-L-lactic acid is the inability to dissolve or alter the result if something goes wrong, or needs to be adjusted. Poly-L-lactic acid is a form of plastic and once it is in the body it can not be altered. The patient must wait for the substance to break down on its own. With Hyaluronic acid filler the result can be altered following the procedure, if necessary, with the injection of Hyaluronidase enzyme.
Volume / Cost
To achieve the same results as with Hyaluronic acid, a patient would need to spend considerably more money if using injectable poly-L-lactic acid collagen stimulator. On the plus side, the filler will last a little longer than Hyaluronic acid (typically 2 years, versus Hyaluronic acid 9-18 months).
Method of Injection
It is important to inject either of the fillers using a cannula, rather than the needle supplied with the filler (which in the case of the collagen stimulator is only designed for injection in the face). A cannula will allow the filler to be injected deeper into the correct layer of tissue, which improves the result and lowers the risk of any lumps forming.
Mild discomfort including swelling and bruising can occur for up to 2 weeks. Some activities are restricted for 2-3 weeks following buttock filler injections.
A support garment (lycra cycle shorts or similar) is optional for the first week, day and night, and can be purchased by the patient in advance of the procedure.
The maximum increase is around 600 ml in each buttock. This will likely require 2 or more visits to the clinic spaced over a 4 week period.
This will depend upon your physical capacity to carry additional volume, tissue elasticity and the degree of augmentation desired.
Generally, more filler can be injected in one session if the patient is under sedation (asleep during the procedure).
The type of filler being injected and the expertise of the surgeon.
It is preferable to have a specialist buttock surgeon inject buttock filler, rather than a general doctor who is not a cosmetic surgeon.
The volume of filler required. Some patients underestimate the amount of filler required and the cost of this expensive procedure.
If you have the procedure under local anaesthetic (in other words you were awake during the procedure), then you can usually drive home afterwards.
If you have the procedure under sedation (asleep at the hospital), then you are not able to drive home after the procedure and you can not, by law, drive for a period afterwards.
The filler is still malleable (able to be moved under significant pressure) for the first few days after the procedure.
It would be better to sit on a soft chair or couch, or if possible lay on your front or side for at least the first few days.
After 5-7 days the filler is almost fully integrated and can’t be moved anymore.
– If you are having the filler injected at the hospital while asleep, you will feel no pain at all during the procedure.
If the filler is injected while you are awake (with local anaesthetic), the pain will vary from patient to patient.
First, the buttocks are injected with a local anaesthetic. The surgeon will not start injecting filler until the area has gone numb. However, the patient can still experience pain despite having had local anaesthetic, and in exceptional cases, the pain can be significant.
Patients that have a low pain threshold may request the filler to be injected under sedation, at a private hospital on Harley Street, at additional cost.
In the first few days following the injections, the buttock area will feel heavy and there may be some swelling.
The patient may require some mild pain relief of the type typically available over the counter at a pharmacy without a prescription.
A course of antibiotics will be required to be taken following the buttock injections to minimise the risk of infection.
The procedure is usually performed under local anaesthetic and you will be awake during the procedure.
The area to be treated will be completely numbed using a local anaesthetic, and the entire procedure takes around 30 to 45 minutes to complete.
Injections are made through tiny incision points that are usually invisible once healed. The filler is injected using a thin cannula above the muscle.
The amount of filler injected depends on the degree of augmentation desired.
You can increase the volume of filler in 10 ml steps, depending on how much volume you wish to add to your buttocks.
The rate of metabolism of Hyaluronic acid filler varies from person to person.
Premium fillers such as HYAcorp will tend to last longer than Economy fillers.
The results of bum injections are immediate, with the results usually fading from 9 to 18 months following the procedure.
The procedure will need to be repeated again in 9-18 months’ time, possibly requiring less filler on subsequent visits.
Patients returning for injections after 9-18 months typically require around half, or more, of the volume they received in their original procedure, to maintain their increased buttock volume.
Natural weight loss, or weight gain, may add to, or subtract from, the amount of filler required to stay the same size.
* Individual results may vary from person to person.
The use of Hyaluronic acid in buttock reshaping has been driven by the desire to find a less risky, non-invasive method of buttock reshaping that does not need to be performed under general anaesthetic.
By performing the procedure using a local anaesthetic, there are considerably fewer risks compared to buttock implant surgery.
There are also no incisions made, so there is little risk of scarring, and the downtime is usually minimal.
Hyaluronic acid based fillers can be dissolved away using Hyaluronidase enzyme injections; instantly reversing the procedure if necessary.
This provides an additional safety net.
Your surgeon will discuss with you the full range of risks at your consultation.
This depends on the volume of filler you require. Someone who is slim, to begin with, will get a noticeable increase in buttock volume with a small number of buttock injections.
If the patient already has a large bottom, or, wishes to achieve a more dramatic increase in volume, they will require a high volume of filler to be injected.
As a rough guide:
A slim patient wanting a subtle, natural increase in buttock volume may require at least 100 ml of filler to each side, a total 200 ml, or more.
200 ml = £3,960
A patient with a medium build may require 150 ml, or more, to each side, a total of 300 ml, or more.
300 ml = £4,960
A larger patient or a patient requiring a significant increase in volume may require more than 300 ml to each side, a total of 600 ml or more.
600 ml = £9,600
Your surgeon will be able to advise you on the quantity of filler you are likely to require during your consultation.
*Individual results may vary from person to person.
Treatment of shape irregularity, or indents from trauma or scarring: 10 – 100 ml, approximately £1,500 – £2,500.
A consultation with a buttock surgeon is required in order to get a more accurate estimate of the volume of filler required.
Hyaluronic acid is a substance which is produced naturally in the body (however the Hyaluronic acid used for buttock injections is manufactured).
Extensive trials since 2002 have shown no long-term serious side effects and have been clinically proven to be safe and effective.
HA-based fillers have been used in cosmetic surgery for over 20 years.
The Hyaluronic acid used in cosmetic dermal fillers undergoes a process to form links between the molecules, making the HA more durable.
As the body recognises the HA, there is minimal risk of allergic reaction or infection. HA is a natural component of skin and plays an important part in skin health.
You have Hyaluronic acid throughout your body right now.
Hyaluronic acid or ‘HA’ is a component of the skin that is made naturally by the body.
HA is a naturally occurring polysaccharide and is known for its superb capacity to retain moisture. An abundance of Hyaluronic acid resides in the spaces between the skin cells, where it contributes to the plumpness, moistness, firmness, and suppleness of the skin.
Large amounts of HA are produced in the skin, but its levels dwindle as a person ages.
Hyaluronic acid is the basis for many cosmetic fillers such as for the lips and cheeks due to its volumising effect.
Buttock Implant FAQs
Harley Buttock Clinic lead surgeon Dr Gary Horn
This is a common question among many patients.
It will feel normal as when sitting down most of the weight is actually on the underside of the thighs and on the bony part of the buttocks.
Buttock implants are placed higher up, inside the gluteal muscles at the back.
- The expertise of the surgeon and the quality of the implants used are important factors in a successful augmentation.
- The implants need to look and feel natural for life, and when done well will be indistinguishable from someone who spent months at the gym, or who was born with the shape of buttocks most desired by men and women.
Site Author / Lead Surgeon
Dr Gary Horn is a highly acclaimed Consultant Plastic and Reconstructive Surgeon with over 25 years of experience in buttock augmentation and reshaping with buttock implants and fat transfer. Dr Horn is a registered Plastic Surgeon in the UK (GMC 4267803) and Belgium.
SPECIALITIES: General Plastic Surgery, Cosmetic Plastic Surgery
LANGUAGES: English, French
GENERAL MEDICAL COUNCIL NUMBER: 4267803
Dr Horn is qualified to perform a large range of procedures, including:
Buttock Implant Surgery (Gluteoplasty), Fat Transfer to Buttocks (Brazilian Butt Lift), Gluteal Sculpting (Brazilian Butt Lift without fat transfer), Buttock Injections (using Hyaluronic Acid)
For a comprehensive list of publications please see Dr Horn’s Linkedin Profile.