Butt Augmentation

Tummy tuck and BBL (acronym for Brazilian buttock lift, which is essentially buttock augmentation via fat transfer) can be performed under one surgical setting, provided that the patient is physically fit and is committed to healthy lifestyle.


It is important to note that healthy lifestyle, particularly relating to weight management, is the most important factor to maintain the results of tummy tuck and BBL or any other types of body contouring plastic surgery.


Leading Los Angeles plastic surgeon Dr. Tarick Smiley has recently posted a series of videos to illustrate one patient who have had tummy tuck and BBL performed together.


Dr. Smiley first required the patient to undergo a comprehensive lab screening to ensure that she could handle the extent of surgery and its ensuing recovery. To further guarantee her safety, her operation was performed at an accredited surgical facility under the supervision of board-certified anesthesiologist and licensed/highly trained medical staff.


tummy tuck and bbl

The celebrity plastic surgeon started off the “combo surgery” with liposuction in which the goal was to collect adequate amounts of fat from the bra rolls, flanks, and lower back. Then, the fat was purified—all the red blood cells and oil were discarded—before it was injected into the buttocks.


Basically, BBL is a reversed liposuction. Instead of discarding the fat, it is later utilized to improve the shape and projection of the patient’s backside with the use of the most natural material.


After BBL, Dr. Smiley and his staff moved the patient into supine position to begin the tummy tuck operation.


The patient required the standard or hip-to-hip incision tummy tuck technique, which allowed Dr. Smiley to remove most of her stretch marks (including those above her navel), repair the loose abdominal muscle, correct the herniation above her belly button, and give a cinching effect on her waist.

tummy tuck and bbl

Despite the length of her tummy tuck incision, it is expected to fade into a thin, barely detectable line after 1-2 year. Moreover, the scar is positioned very low that her underwear or bikini bottom can easily conceal it.


While multiple-surgeries procedure typically entails a “tougher recovery,” it offers benefits such as lower cost and one-time healing period. Nonetheless, Dr. Smiley only reserves this for patients who have achieved their optimal health prior to surgery.

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The plastic surgeon’s Brazilian buttock lift photos (before-and-after images) can illustrate his “eye for detail” and level of artistic skills. Of course, his education, board certifications, training, experience, and bed side manner will also matter when selecting a doctor.


Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has shown a recent patient whose buttock lift photos depict natural-looking, proportionate results.


The patient has enjoyed a certain advantage—her pre-existing skin has good elasticity, meaning it can “take” more fat volume without predisposing her to increased risk of skin irregularities such as dents and cellulites.


Nonetheless, Dr. Smiley has ensured that the fat volume would not cause enormous weight and strain, which is the main culprit behind sagging and other signs of botched Brazilian buttock lift.

Brazilian buttock lift photos


The profile view of the patient’s new buttocks reveals great projection, particularly in their upper half. The idea, according to Dr. Smiley, is to create an illusion of perkiness and to prevent sagging, which could happen when the lower half receives most of the fat volume (along with its additional weight).


In his previous educational videos posted on Snapchat, Dr. Smiley said the “most critical aspect of Brazilian butt lift is to respect the patient’s underlying anatomy, particularly her skin, septa (membrane that connects the muscle to the skin), and body frame.”


Meanwhile, the posterior view now reveals the appearance of curvier and fuller hips, which Dr. Smiley has created by allocating about one-third of the purified fat into the lateral aspect of the butt.


Brazilian buttock lift photos

Having good skin elasticity offers another benefit: the liposuction sites where the donor fats are collected will appear tight and smooth.


Dr. Smiley said that during liposuction, some fats beneath the skin are removed with a straw-like device called cannula. It is important for the skin to shrink-wrap smoothly around the new contour lest the results will look disastrous (visible bumps and dents).


The celebrity plastic surgeon collected “unwanted” fats from the bra rolls, flanks, and lower back; these were later purified in which the oil and red blood cells were discarded to come up with the “pure, golden” fat that was later injected into the patient’s buttocks.


Dr. Smiley was able to collect a large amount of fat without predisposing her to surface irregularities due to her good skin elasticity.


In almost all Dr. Smiley’s patients, he treats the lower back and flank as liposuction-donor sites to further highlight the buttock’s shape and projection.

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The Brazilian butt lift or BBL results will primarily depend on the surgeon’s qualifications, which include his education, training, experience, and arguably the most critical variable: board certification.


Inland Empire plastic surgery expert Dr. Tarick Smiley says the general rule of thumb is to choose a surgeon who is a member of the American Board of Plastic Surgery, which is the only board certifying body recognized by health authorities.


Apart from the surgeon’s qualification, BBL results will also depend on his “tools” and surgical techniques, Dr. Smiley said in his recent Snapchat video.


The celebrity plastic surgeon has explained the tools that help him achieve smooth and proportionate BBL results.

bbl results

  • Surgical fork


One female patient had large lateral indentation on her buttocks. This “depression” is typically caused fascia or thread-like anatomy that is pulling the skin inward. Hence, her surgery required the use of a “fork.”


A surgical “fork” is a long slender tube whose tip has two prongs to “release” the skin tethering through a small round incision. Dr. Smiley said it is important not to “overdo the process” to prevent “herniation” and skin asymmetries.


  • Liposuction microcannula (hollowed steel tube attached to a vacuum pump)


All BBL surgeries start with liposuction in which large amounts of unwanted fats are collected from two or more donor sites. Doctors may choose large or standard cannula, or microcannula during this process.


Microcannula removes smaller bits of fat; therefore the process of fat extraction (i.e., liposuction) becomes longer although at least they give surgeons greater precision compared to large cannulas.


Large cannulas (4-5 mm outside diameter), meanwhile, remove large masses of fat and so the perceived risk of skin asymmetries and other untoward side effects of over-correction is higher.


The use of microcannula is also ideal when treating the back area (bra rolls, flanks, and lower back), which is notorious for its fibrous fat.


  • Laser light


The use of laser light allows Dr. Smiley to achieve the highest level of symmetry in terms of forward projection and overall shape of the buttocks.

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Brazilian buttock lift is basically liposuction with fat transfer to the buttocks. Instead of discarding the “unwanted” fats, these are injected into the patient’s backside and hips to achieve a more feminine figure.


Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says a good result should present high symmetry between the left and right side, not just of the buttock, but also of the entire torso of the patient when viewed from the back.

brazilian buttock lift

After and before photos of a patient who have had Brazilian buttock lift. Hers was a special case due to her scoliosis.

In one of his recent Snapchat videos, Dr. Smiley has presented a rather special case of Brazilian buttock lift.


The female patient has scoliosis that her torso slightly “curves” to the right. Hence, her fat rolls and skin fold along this side were more prominent compared to the left side of her back.


In the video, Dr. Tarick Smiley said he almost always treats the lower back and flanks as donor/liposuction sites because of the areas propensity to accumulate “unwanted” fats that can show through tight clothing.


However, performing liposuction on the lower back and flanks of the patient with scoliosis could “highlight” the asymmetry between the left and right side of her torso unless “appropriate adjustments are made” during surgery, he explained.


To achieve a more symmetric result, Dr. Smiley removed more fat volume from the right side of the torso than its left side.


“It is important for any surgeon performing Brazilian buttock lift to have an eye for detail. Essentially, this is a combination of science and art,” he said.


After removing sufficient fat volume from the donor sites, Dr. Smiley purified it with the use of a centrifuge, a device that separates biomaterials based on their weight.


For instance, the lightest material is the oil, which floats above the fluid after centrifugation; this is discarded to achieve a high survival rate of fat graft (at least 70 percent).


Then, Dr. Smiley injected the purified fat into the patient’s backside, allocating about a third of the volume to reshape the hips and the remaining amount was used to improve the buttock’s shape and projection.


Moreover, Dr. Smiley smoothed out the visible indentations on the buttocks with meticulous fat injection techniques.

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BBL surgery results should appear smooth—i.e., the skin surface must show uniformity and there should be a smooth transition between the buttocks and the “adjacent areas” such as the posterior thigh, hips, flanks, and lower back.


BBL, which is an acronym for Brazilian buttock lift, is basically a combination of two procedures: liposuction and fat transfer/injection.


bbl surgery results

Liposuction is the process of removing the “unwanted” fat, which is then re-used to augment and reshape the buttocks and hips to achieve a more feminine figure.


Fat injection, meanwhile, is the process in which the buttocks and hips are reshaped in a way that they look natural and proportionate to the patient’s underlying anatomy. The final results should also reflect the individual’s cosmetic goals and expectations, which she must be able to describe in details during the preoperative consultation.


Inland Empire plastic surgery expert Dr. Tarick Smiley, who performs over a hundred BBL surgeries every year, says that fat transfer is a meticulous process. Instead of dumping the fats all out once, the use of microdroplet injection technique is critical to achieve smooth results and high survival rate of fat grafts.


Any amount that survives after a few months of fat injection is expected to last a lifetime, he says in one of his recent Snapchat videos.


Dr. Smiley warns that incorrect fat injection and over-filling the buttocks can lead to a gamut of aesthetic-related problems such as cellulites, dents, and sagging appearance.


Cellulites and other skin surface irregularities are generally caused by “disturbing” the fascia system, which resembles a cluster of threads connecting the muscle into the skin.


When too much fat volume has been injected into the buttocks, the extra weight causes the fascia to weaken and the butt cheek to sag. This “problem” can be further aggravated by aging and large weight fluctuations.


To avoid skin irregularities and sagging appearance, Dr. Smiley says he never injects “fat volume that goes beyond the capacity of the patient’s fascia system and other relevant anatomies.”


“The key to achieve natural, proportionate BBL surgery results is to respect and acknowledge the anatomical limits. This core principle has also helped me avoid most known complications,” he says.


To further avoid “unnecessary weight” that could make the buttocks susceptible to sagging, Dr. Smiley says he avoids or at least minimizes fat injection into the lower aspect of the butt cheek, focusing more on the upper half portion and the lateral side (hips) instead.

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Preventing buttock augmentation risks should be the main objective of any prudent surgeon, said leading Beverly Hills plastic surgery expert Dr. Tarick Smiley on his recent Snapchat post.


To demonstrate a poorly done buttock augmentation surgery, Dr. Smiley has posted photos of singer Nikki Minaj clad in a scanty two-piece bikini.


buttock augmentation risks

Dr. Smiley said the star’s backside clearly shows buttock implants that are too big for her underlying anatomy, particularly relating to her soft tissue coverage, skin elasticity, and body frame.


The hugely disproportionate buttock implants, he said, are clearly visible beneath the skin that they have also caused the tissue to become thin and over stretched, inevitably causing her “derriere” to droop, a complication medically referred to as ptosis.


Whether buttock augmentation surgery is performed through butt implants or fat transfer, Dr. Smiley said the patient’s anatomy, particularly the “elasticity and resiliency of the skin,” must always be respected to achieve natural-looking results and to avoid most known complications.


“The loss or weakness of the fascia system, which holds the skin and the overall shape of the buttocks, can cause ptosis,” he further explained.


“We should not overdo it. The weight of the implants or the amount of fat injected into the buttocks must always respect the anatomy lest the results will look terrible,” he warned.


To further minimize buttock augmentation risks, Dr. Smiley said he now prefers butt augmentation via fat transfer (or Brazilian buttock lift in layman’s term) to the use of implants, which he only reserves for a very small percentage of patients.


Brazilian buttock lift uses the most natural material—i.e., the patient’s own fat—to reshape and augment not just her backside, but her hips as well, leading to a more proportionate, feminine figure.


Despite the perceived benefits of Brazilian buttock lift, Dr. Smiley said it remains important to avoid over-filling the backside since too much weight can cause ptosis, which can happen right after surgery or years down the road.


To further prevent ptosis, Dr. Smiley said most of the fat volume should go to the hips and the upper half aspect of the buttocks (as opposed to its lower aspect). This fat volume “allocation” results in a heart-shaped backside, especially when the unwanted fats from the lower back and flanks are removed as well.


Liposuction is the surgical technique that allows the surgeon to harvest the “unwanted” fats from two or more donor sites; the fats are then purified and re-injected into the patient’s buttocks, said Dr. Smiley.

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