Butt Augmentation

Brazilian buttock lift not just focuses on augmenting the butt with the patient’s own fat. An equally important aesthetic goal is to improve the shape of the backside based on the established aesthetic guidelines, leading Beverly Hills plastic surgeon Dr. Tarick Smiley said in his recent Snapchat video.


But what constitutes the ideal butt shape? And are there some Brazilian buttock lift guidelines to achieve it?


While the standard of beauty varies greatly among different cultures and ethnicities, which is further complicated by the patient’s preference and aesthetic goals, the inverted heart shaped buttocks are deemed to be the most attractive, followed by the round buttocks.


brazilian buttock lift guidelines

The inverted heart shape and round buttocks are perceived to be the ideal shape, while the square and V-shaped buttocks are the least attractive because these are tied to poor waist-to-hip ratio.


These two buttock shapes have always been depicted in artworks throughout history as visual cues for female sexuality and fecundity.


Dr. Smiley said the inverted heart shape buttocks can be achieved by Brazilian buttock lift when volume distribution follows the 40:60 ratio on profile view, meaning the upper half of the buttocks should possess 40 percent of the total volume, and the rest goes to the lower half.


Brazilian buttock lift inverted heart shape

This volume distribution on profile view results in the much coveted inverted heart shape buttocks.

Nonetheless, some women ask that most of prominence should be allocated to the upper half of the buttocks, ultimately creating a “round” or bubble-shaped buttock appearance. Hence, during consultation the patient must be able to describe her goals in detail to achieve results that will satisfy her long term.


Dr. Smiley said that these two buttock shapes are closely tied to the ideal waist-to-hip ratio of 0.7, which means that the hip circumference is 30 percent wider than the waistline.


To create a smaller waistline and enhance the buttock shape and projection, Dr. Smiley said the flanks and lower back are always treated as “fat donors” or liposuction sites.


“There should be a Smiley scoop or an inward slope of the lower back,” the celebrity plastic surgeon said.


Meanwhile, the two least desirable butt shapes—i.e., the V and square buttocks—can be improved by reshaping the hips through more fat injection. To further highlight the lateral curves and forward projection, Dr. Smiley said the waistline typically entails aggressive liposuction.

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Brazilian buttock lift starts with liposuction to collect “troublesome” fats usually along the waist line, which are then purified and re-injected into the buttocks and hips. The results are often dramatic—i.e., smaller waist and curvier derriere, which ultimately improves the waist to hip ratio.


Across cultures and geography, there is a strong preference for a female physique with a WHR of 0.7 or at least near this ratio in which the waist accounts for 70 percent of the hips circumference. Scientists have found a strong correlation between this much-coveted figure and fecundity and good health and genes.


brazilian buttock lift


One of the keys to achieve high satisfaction rate is to listen to the patient’s input, focusing more on her aesthetic goals and the ideals of beauty, many of which vary drastically by region and ethnicity. For instance, African-American women generally love their full-bodied curves and rarely desire for the lithe and petite figure, which then appeals to Caucasian women. Nonetheless, making a sweeping generalization does not do justice to each patient and thus a prudent surgeon conducts extensive consultation prior to surgery.


To achieve more prominent curves in all the right places, African-American women seeking Brazilian buttock lift often ask for larger augmentation and more projection, which of course entails more aggressive liposuction in order to collect large volume of fat. Caucasian and Asian patients, meanwhile, are usually more concerned about the butt shape than its size and so they may need less fat volume injection. Again, each patient has specific aesthetic goals and a unique set of anatomies and so the ideal approach is a highly customized one.


If there is a desire for larger augmentation, a 360-degree liposuction is almost always warranted. This means that the donor fats are collected from the patient’s anterior abdomen, flanks, and lower back. Occasionally, the “bra rolls” and upper arms are treated as well to collect additional amount of fat.


Round buttocks in which the maximum prominence is found at the mid and upper region are deemed as the most attractive butt shape in women. A multitude of cultures and artworks seem to agree on this beauty standard; hence, leading Beverly Hills plastic surgeon Dr. Tarick Smiley adheres to this template to deliver a more natural, proportionate result.


To further achieve a more feminine physique, Dr. Smiley says that during fat injection he allocates about one-third of the purified fat to the hips, which are basically the outer lateral aspect of the buttocks.

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Brazilian buttock lift is basically a reversed liposuction procedure. Instead of throwing away the excess fat typically collected from the waist line, this is purified and re-injected into the patient’s backside and hips, thus improving her waist to hip ratio.


While BBL is primarily performed to reshape and augment the buttocks, a good number of patients have also noticed some improvements in the appearance of their cellulites. Nonetheless, there is no guaranty that the cottage-cheese appearance will disappear completely after surgery.


brazilian buttock lift

The “before” photo shows mild to medium depth depressions, which BBL has significantly improved as seen in the “after” photo.


Celebrity Beverly Hills plastic surgeon Dr. Tarick Smiley, who has performed more than 5,000 fat transfer surgeries, says the amount of improvement depends on the degree of skin puckering and its elasticity.


Cellulites occur when the fat protrudes through the skin because of the weakened connective tissue. Hence, patients with mild to moderate orange-peel skin may expect some level improvement in their surface, provided that their surgeon performs meticulous fat injection.


Some patients, meanwhile, have dents along the lateral aspect of their buttocks because of the “tethered” fascia or connective tissue; this needs to be released from the skin with the use of a “surgical fork.”


Releasing the skin not just corrects the dents but also allows the area to take the fat and thus expand. Nonetheless, he says in a previous Snapchat video that it should be done “meticulously since even the slightest error could aggravate skin asymmetries and herniation.”


To further promote smoother skin and prevent surface irregularities, Dr. Smiley says the patient’s skin quality should also be taken into account, as it determines the viable amount of fat injection.


He warns that over-injection, i.e., the volume is too much for the skin and other soft tissue to handle, can result in cellulites or aggravate any pre-existing surface irregularities, as well as increase the risk of sagging or lopsided appearance.


Aside from knowing the fat volume the patient’s anatomy can permit, Dr. Smiley says the honeycomb injection technique further promotes smooth results from BBL surgery. This involves gradual creation of new fat layers, with minute spaces between the grafts, allowing the amalgamation of fats with the blood supply.

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Brazilian buttock lift is perceived to be safer than butt implant. Instead of synthetic prosthesis, doctors reshape and augment the backside with the most natural material—i.e., the patient’s own fat derived from other areas of the body, typically the abdomen, flanks, and lower back.


Despite the impressive safety record of Brazilian buttock lift, news of fatal complication due to fat embolism has been circulating the Internet recently.


safety of brazilian buttock lift

Dr. Smiley uses a blunt cannula to perform microdroplet fat injection, a technique known to deliver natural results and to improve safety.

Fat embolism happens when fat particle or droplet is inadvertently injected into the blood vessels. In mild cases it simply causes low oxygen level in blood, but in serious conditions it leads to lung and brain impairment. According to medical literature, the risk of death is 10-20 percent.


However, fat embolism can be prevented with proper injection of fat. Hence, a prudent patient always ensures that her surgery is performed by a board-certified plastic surgeon—i.e., certified by the American Board of Plastic Surgery.


The list below explains the basic guidelines known to improve the safety of Brazilian buttock lift.


  • Avoiding the deeper muscle during injection


A US study has suggested that fat embolism generally happens when fat injection is performed deep into the gluteas muscle, which has large blood vessels. To prevent this complication, fat grafts are ideally injected into the existing buttock fat (more superficial layer than muscle).


Simply put, doctors with deep understand and respect of the anatomy can avoid fat embolism and other serious complications.


  • Honeycomb or microdroplet injection technique


Beverly Hills plastic surgeon Dr. Tarick Smiley says the honeycomb or microdroplet fat injection (inoculation of less than 0.1 cc of fat at a time) increases the survival rate and helps achieve near permanent results from Brazilian buttock lift.


Furthermore, the injection technique, which also entails continuously moving the cannula (hollowed steel probe), prevents fat embolism that happens when fat is inadvertently injected into the blood vessels.


  • Use of the most innovative liposuction devices


The use of blunt cannulas not just prevents accidental injection of fat into the blood vessel; studies have also suggested that it promotes higher survival rate of fat grafts (70 percent and higher).


  • Accredited surgical facility


Dr. Smiley has previously posted a video on Snapchat explaining the importance of having one’s surgery in an accredited ambulatory center, which means that it has passed the rigorous patient safety standards imposed by health authorities.


Accredited surgical facilities are staffed by board-certified anesthesiologists and emergency personnel who can treat patient should an untoward event occur.

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Brazilian buttock lift reshapes the buttocks with the use of fat grafting or injection. The patient undergoes liposuction to remove unwanted fats from the abdomen, back, etc., which are then processed and re-implanted into the “backside.”


During surgery, leading Beverly Hills plastic surgeon Dr. Tarick Smiley says the hips, or the laterally projecting region of the buttocks, must also receive some fat volume to complement the increased projection or profile of the backside.


Notice the curvier hips of the “after” photo, leading to siginificant improvement of the patient’s waist to hip ratio.


Essentially, the surgery improves body shape by changing the volume or fat distribution. According to studies, a waist to hip ratio of 0.7, or at least near this proportion, is the most attractive female figure due its strong correlation with fertility and health.


Dr. Smiley has recently posted a series of videos on Snaphcat to demonstrate one female patient with a markedly poor WHR due to her thick waist, flat buttocks, and narrow hips.


The patient had no curves on her hips; its width was almost the same as her flanks. Furthermore, she had thick waist and “back rolls” caused by excess superficial fat beneath the skin (this is different from the deeper visceral fat linked to obesity).


In most cases, Brazilian buttock lift allocates most of the fat to improve the projection of the buttocks. But for this particular patient, Dr. Smiley said he injected more volume into the hips to achieve a more hourglass effect.

Laser light guides Dr. Smiley during liposuction.

To further highlight the curves of the hips and the projection of the buttocks, Dr. Smiley treated the flanks and lower back as a donor or liposuction site. He also removed fats from the anterior abdomen to further ensure more proportionate and smoother results.


During liposuction of the flanks and back, Dr. Smiley used a laser light that helped him distinguish the “root” or “start” of the buttocks and thus avoid the area. The device also allowed him to deliver more symmetric results during fat injection.


Almost all cultures and ethnicities seem to agree on what constitute an attractive looking derriere: Most of the prominence is found between the mid and upper buttock, while the hip width adheres to the 0.7 “beauty ratio.”

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Brazilian buttocks lift is a colloquial term for buttock augmentation via fat injection. This combines liposuction, which is the method to harvest the donor fats, and structural fat grafting wherein the patient’s own fat is injected to reshape and augment her “derriere.”


Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos demonstrating a female patient with markedly flat buttocks and narrow hips, leading to poor waist-to-hip ratio.

brazilian buttocks lift

The before photo shows flat buttocks and narrow hips, leading to poor waist to hip ratio.

Studies have suggested that the ideal WHR ratio is 0.7, or at least near this proportion. This means that the waist, which is the narrowest part of the midsection, accounts for 70 percent of the hips circumference, which is measured around the apex or most prominent aspect of the buttocks.


Across different cultures, generations, and socio-economic backgrounds, the preference for 0.7 WHR remains constant, as suggested by several studies.


Further aggravating the patient’s poor WHR was her thick waist. Hence, Dr. Smiley performed 360-degree liposuction, meaning the flanks, lower back, and anterior abdomen were all addressed.


To further achieve a smooth transition between the torso and buttocks, Dr. Smiley also performed liposuction in the upper back to eliminate the “bra rolls” that tend to become more recognizable in tight clothing.

The after photo shows fuller and curvier buttocks juxtaposing the slender flanks and lower back.

Performing liposuction on a larger surface area is the key to harvest sufficient donor fats to reshape and augment the buttocks. Nonetheless, the tightness and elasticity of butt skin would still determine the ideal fat volume.


A skin that is too tight may not allow large volume injection because it will resist expansion. On the other end of the spectrum, a skin that is too loose may lead to sagging buttocks and surface irregularities such as dents and cellulites after surgery. Hence, Dr. Smiley said “respecting and recognizing the quality of skin” is one of the keys to achieve great results.


Fortunately, the patient’s skin has the right amount of tightness and elasticity, allowing him to inject a relatively large fat volume. In general, women reuire more than 800 cc on each side to achieve noticeable improvements in the shape and projection of their buttocks.


Because the patient also had narrow hips, which are basically the lateral aspect of the buttocks, Dr. Smiley allocated about one-third of the fat volume into the area before injecting the remaining amount into the butt profile or “forward projection.”


To further promote a good WHR, Dr. Smiley focused on reshaping the upper half of the buttocks, which should carry most of the prominence if the goal is to deliver more natural-looking results. Furthermore, this “allocation” prevents or at least minimizes risk of sagging because no excessive weight is placed in the lower half cheek of the butt, which serves as a “foundation.”


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