Butt Augmentation

Fat transfer buttock augmentation has made butt implants a passé due to its more natural results and notable safety, provided that it is performed by a board-certified plastic surgeon with “relevant” experience.


Dr. Tarick Smiley, a Beverly Hills plastic surgeon who conducts an average of three butt augmentations via fat every week, says the “holistic contouring effects of the surgery can be attributed to liposuction” wherein unwanted fats from two or more areas of the body are collected and transferred.


fat transfer buttock augmentation


The lower back, flanks, anterior abdomen, and bra rolls are common donor sites, as they typically carry excess fat. Furthermore, carving out the waistline is one of the key elements to improve the female waist to hip ratio, which is perceived to be one of the markers of beauty.


Across all cultures, there is a strong preference for female bodies with WHR of 0.7 or at least close to his proportion. This means that the hip circumference is 30 percent thicker than the waist.


After collecting sufficient amounts of fats, these are washed and sorted; all biomaterials such as the red blood cells and the anesthetic/tumescent fluids are discarded prior to fat injection.


In Dr. Smiley’s recent videos posted on Snapchat, he said that he only uses “good healthy fats rich in stem cells” to achieve permanent results from fat transfer buttock augmentation, which is colloquially called as Brazilian butt lift.


Aside from the quality of fat, the surgeon said the longevity and overall success of the surgery also rely on meticulous injection.


“Fat injection must be must be done in a honeycomb fashion, meaning the fats are injected into a larger surface area,” he explained.


When fats are injected in a way that they resemble tiny compartments within the soft tissue, somewhat resembling a honeycomb, blood vessels can form and bring the much needed oxygen and nutrients. Without this process, the fats eventually die and are resorbed just after a few weeks or months of injection.


Because permanent result is one of the goals of buttock augmentation via fats, all efforts are made to promote blood vessel ingrowth.


The honeycomb injection technique not just ensures long-lasting results, but also softer and better contour because it replicates the natural layered distribution of fats. Furthermore, it prevents fat embolism in which fats enter the blood vessels and interfere with the functions of critical organs like the heart and lungs.


But even with honeycomb injection technique and proper collection and purification of fats, Dr. Smiley said that about 30 percent of the fat volume is resorbed within a year, while 70 percent is expected to persist long term.

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Brazilian buttock lift is a well-established plastic surgery technique in which the patients’ hips and buttocks are reshaped and augmented with their very own fat. Oftentimes, large volume of fat collected through liposuction is needed to deliver noticeable improvements.


Dr. Tarick Smiley, a celebrity Beverly Hills plastic surgery expert, says the patient’s “starting anatomy” affects the results to a varying degree, with certain physical traits making this procedure more challenging. Nonetheless, the use of right surgical maneuvers and tools can counteract these “anatomical roadblocks” and ultimately achieve the desired results.


Dr. Smiley has shared some Brazilian buttock lift before and after photos depicting patients with challenging anatomy. He also explained the corresponding techniques that allowed him to overcome such anatomical roadblocks.


brazilian buttock lift before and after

Before photo of patient no. 1. She has large lateral dent, which needs to be released so her hips can expand after fat injection.

Photo of patient no. 1 right after surgery. Notice the complete elimination of the lateral dent and smoother, fuller buttocks and hips.

Patient no. 1 had lateral depression along her buttocks caused by tethering of the fascia or connective tissue that was pulling the skin inward. Failure to release the skin would not allow the hips to expand after fat injection.


Dr. Smiley released the skin from the fascia or thread-like anatomy so he could expand and sculpt the hips, improving the feminine silhouette. This was done with the use of a surgical fork that resembled a thin two-pronged cylinder inserted into a tiny puncture wound.

He says “the use of surgical fork requires precision” because a slight error can lead to more skin asymmetries and herniation.

Patient no. 2 was thin, weighing only 115 lbs. during surgery and so it was a challenge to collect adequate amounts of fat. Hence, Dr. Smiley performed liposuction on a larger surface area to harvest enough volume to sculpt the hips and augment the buttocks.


Before and after photos of patient no. 2. She is thin and so she requires larger liposuction surface area to harvest sufficient fat volume.


To further create an illusion of fuller buttocks and curvier hips, Dr. Smiley used the flanks and lower back as donor or liposuction sites. By removing the excess fat in the area, even though the volume was relatively small, he was able to carve it out and allow the butt to “stick out more.”



Patient no. 3 had asymmetric fat distribution along her back, with more fats along the right flanks. Hence, she required “an extra meticulous” liposuction to achieve smoother, more symmetric appearance between the left and right side of her torso.

Before and after photos of patient no. 3. The surgery corrects the fat rolls along her armpit, bra line, and flanks. Furthermore, it improves the symmetry between the right and left side of the torso.


Further complicating her case was the extent and distribution of fat that her armpit area—along with her flanks, lower back, and “bra rolls”—was even included during liposuction. The idea is to create a smooth silhouette from the posterior view.


Moreover, her skin buttock prior to surgery had visible dents and so Dr. Smiley filled in these tiny depressions with the use of microdroplets technique (0.1 cc of fat inoculated one at a time). This method of injection not just deliver smooth results, but also high survival rate in which 70-75 percent of the fat volume is expected to be near permanent.

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Brazilian buttock lift is basically a butt augmentation through fat injection. It always starts with liposuction to harvest unwanted fat from two or more donor sites; this critical step contributes to the more holistic contouring effect of this technique compared with butt implant surgery.


Buttocks come in different shapes and sizes, which to some extent affect the results of Brazilian butt lift. Simply put, the right candidates have cosmetic goals that are in line with what the surgery can accomplish.

The patient has square-shaped buttocks and poor waist-to-hip ratio, which Tarick Dr. Smiley improves with meticulous Brazilian butt lift.

The surgery has a certain appeal to women with square-shaped buttocks, which lead to a less feminine figure. Studies have all pointed out the most ideal female physique has a waist-to-hip ratio of 0.7, meaning the waist circumference accounts for 70 percent of the hips measurement.


The preference for 0.7 WHR is seen across all cultures; even the world’s best artworks depict women with this physique, or more commonly referred to as an hourglass figure.


Women with square-shaped buttocks have poor WHR due to their thick waist, narrow hips, and flat buttocks.


Liposuction can reduce the waist circumference, although it is critical to pay closer attention to the flanks and lower back to create a smooth inward slope. Despite the relatively thick waist, a good number of patients with square buttocks have less dispensable fat in the area. Hence, other donor sites might be considered such as the upper arms, bra rolls, and thighs.


For “average built” patients, at least 800 cc of fat on each butt is needed to see a notable improvement.


But even with large fat volume collected by liposuction, the elasticity of butt skin will still determine the degree of augmentation. A skin that is too tight resists large expansion, and too loose the patient runs the risk of sagging appearance and cellulites if over-injection has been performed.


Over-injection must also be avoided because of the increased risk of skin surface irregularities. This applies to every patient, regardless of the “starting” butt shape and size.


Despite the anatomical roadblocks facing patients with square-shaped butt, in the vast majority of cases Brazilian buttock lift can still provide impressive contouring effects provided that the surgeon is meticulous during patient selection and is adept in the surgery, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.

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Brazilian butt lift for older women can still deliver great results provided that the patients possess the “ideal” starting anatomy. For instance, the right candidates possess good skin tone and their weight is within the normal BMI range, says leading Inland Empire plastic surgery expert Dr. Tarick Smiley.


Contrary to popular belief, the patient’s chronological age plays no role in her candidacy for most body contouring surgeries. Doctors consider more pertinent factors such as physical fitness, weight, skin quality, and condition of connective tissue and other soft tissues during patient selection process.


brazilian butt lift for older women

Nonetheless, it remains important to recognize the anatomical traits commonly found in older patients (55 years and above). For instance, the outer skin layer thins with aging, while its blood vessels become more fragile, which leads to more bruising and bleeding beneath the skin following surgery.


Also, certain health conditions are linked to advanced aging, although with healthy lifestyle these can be avoided or at least controlled. Hence, older patients may require more extensive lab screening to ensure that they can handle the surgery and its ensuing recovery.


Because there is a perceived increased risk of bleeding and bruising, older patients are suitable for the tumescent liposuction, which is the preferred technique of Dr. Smiley. This involves infusing the fatty area with tumescent fluids that contain epinephrine, a drug that constricts the blood vessels and thus reducing bleeding by up to 90 percent when compared to the dry technique (no wetting solution is injected into the liposuction site).


The fats collected during liposuction are then processed before these are injected back into the buttocks and hips.


Because older women typically have less skin elasticity and strength due to age-induced changes in its connective tissue, Dr. Smiley says over-injection of fat should be avoided to prevent sagging appearance and cellulites and other skin irregularities.


To further avoid the aforementioned side effects, Dr. Smiley says most of the fat volume should go to the mid and upper butt, while the lower half aspect should not receive too much weight or augmentation. This approach also ensures natural results as scientific studies and artworks throughout history have depicted attractive female buttocks having most of their prominence found in the upper half.


Meanwhile, the celebrity plastic surgeon says that about one-third of the purified fat should go to the hips, or the lateral aspect of the buttocks, in order to achieve a more hourglass figure.

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The patient’s commitment to recovery after Brazilian buttock lift will have a large impact on the long-term success of the surgery. It is important to note that [prolonged] sitting must be avoided for a minimum of three weeks although it remains ideal to minimize “pressure” on the buttocks for a few more weeks to further reduce risk of asymmetry and low survival rate of grafts.


In general, the volume of fat that survives two months after surgery is expected to last a lifetime, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.


recovery after Brazilian buttock lift

donut-shaped inflatable pillow

The first 10 days of recovery is the most critical period and so any pressure that may kill the fat grafts or cause them to inadvertently shift (causing contour irregularities) must be avoided; this includes sitting, squatting, and stretching.


After 10-14 days, Dr. Smiley says that most patients can return to work and social activities without any problem, although the use of “off-loading” pillows remains important when sitting.


The celebrity plastic surgeon shares his tips on how to enjoy a more convenient recovery after Brazilian buttock lift, which is basically buttock augmentation with the use of the patient’s own fat (harvested through liposuction surgery).


  • Ask for help (for house chores and childcare) for at least two weeks.


Brazilian buttock lift is a major surgery as it typically combines large volume liposuction to collect unwanted fats from two or more body areas; followed by fat injection into the butt area (and hips). Hence, the patient will need help for at least two weeks so she can focus more on her recovery.


It is important to avoid rigorous activities, heavy lifting, and squatting for at least 3-4 weeks to allow the body to heal properly.


  • Use off-loading pillow.


In the first few weeks, it is highly ideal to sit in a way that the butt hangs freely to prevent inadvertent shifting of fat (which of course can lead to contour irregularities) and low survival rate. Hence, post-Brazilian buttock lift cushions are all designed to let the patient sit on the back of their thigh area.


Nonetheless, despite the use of off-loading pillows it remains ideal to stand up and walk around after 10-15 minutes of sitting.


  • Know the correct sleeping position.


In the first few weeks, it is highly ideal to sleep on the side (with the body leaning a bit on the belly) or on the stomach. Meanwhile, the supine position—or sleeping on the back—is best avoided for the meantime.


  • Take care of the liposuction sites.


Aside from the buttocks, the liposuction sites also require great care to achieve smooth results and prevent the appearance of ugly scars. The general rule of thumb is to use compression garments for a minimum of one week; avoid sun exposure for at least six months; and never submerge the tiny round incisions for three weeks to prevent infection.

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The initial buttock augmentation consultation typically lasts 30-45 minutes, giving you the chance to share your goals and input, ask your surgeon’s qualifications, scrutinize his before-and-after photos of previous patients, and learn not just the benefits but also the “ramifications” such as the downtime and the possibility of touch-ups.


Touch-ups are rarely indicated when buttock augmentation is performed by a board-certified plastic surgeon who conducts the surgery on a regular basis, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.

buttock augmentation consultation

Dr. Tarick Smiley encourages his patients to be candid during consultation so they can achieve satisfying results.

The initial buttock augmentation consultation is an opportunity for a patient to share her expectations in detail. Hence, you may want to show photos of celebrities that will serve as your “booty goals,” although women whose body frame closely resembles yours are particularly more helpful. Take note that your “starting” anatomy will have a large impact on the final results.


Furthermore, you should disclose your drug and vitamin supplement use and complete medical history such as previous surgery or medical condition, if there is any. You must be very candid during the initial consultation because the information your surgeon will be getting will decide the specifics of your lab test and will help him decide if you’re a good candidate.


Dr. Tarick Smiley prefers buttock augmentation via fat injection, or colloquially known as Brazilian butt lift, due to its more holistic contouring effects compared with butt implants, which can only reshape the upper aspect of the “cheek.”


With butt implants, the lateral aspect of the butt (or hips) and its lower half will have no or very little improvement in terms of shape and “projection” due to the prostheses placement—i.e., above your “sitting area.”


Remember that for prudent patients, consultation is primarily about “doctor shopping.” Hence, you may want to consult with two or more surgeons until you find someone you are comfortable with based on his qualifications. The general rule of thumb is to pick a “bona fide” plastic surgeon (member of the American Board of Plastic Surgery) who performs buttock augmentation surgeries on a regular basis (to shed light on the issue, Dr. Smiley performs an average of three Brazilian buttock lifts per week).


Moreover, you must be equipped with some basic knowledge of the surgery so you can ask the most pertinent questions such as the surgeon’s qualifications, training, experience, and techniques. More often than not, skilled doctors prefer Brazilian butt lift to implants.


Should you choose Brazilian butt lift, ask about the liposuction sites where the unwanted fats will be collected and later purified and injected into your backside. Also, it is important to ask how much fat volume (measured in cc) will be injected into each butt cheek, the purification methods, and the fat injection techniques.


Other topics you must discuss with a surgeon include the recovery (and your responsibility to ensure high survival rate of fat grafts), possible risks and ways to avoid or at least minimize them, itemized list of expenses, and follow-up care.

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