One of the most common Brazilian buttock lift risks involves having a poor shape and projection, which can be avoided by creating a strong foundation, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
Dr. Smiley, who performs over a hundred Brazilian buttock lifts every year, has recently posted Snapchat videos to demonstrate how he achieves natural, long-lasting results from the procedure by following the most basic principle: Always respect the patient’s underlying anatomies.
The celebrity plastic surgeon says that a poorly done Brazilian buttock lift can lead to sagging and cellulites (dents and dimpling), citing the poor results (dimpling and sagging) of reality TV star Kim Kardashian.
Photo of a Brazilian buttock lift patient one week postop (she is wearing a compression garment). Dr. Smiley has created wider hips and fuller, rounder buttocks without compromising the underlying foundation of the butt cheek. Hence, the patient can expect great results that are not susceptible to gravity and aging.
To prevent the sagging appearance after surgery, he highlights the importance of creating a strong foundation and avoiding too much volume (or overdoing fat injection) because the additional weight makes the buttocks susceptible to the effects of gravity, aging, and weight fluctuations.
Dr. Smiley says the buttock skin is supported by vertical septae, which look like small threads attached to the muscle and bone. They also serve as a compartment for fat globules.
However, the vertical septae can lost their strength and elasticity, which can lead to cellulites and sagging, when too much fat has been injected into the buttock—particularly the lower half aspect. To prevent these complications, he avoids over-injection of fat near the gluteal fold (the crease between the butt cheek and the posterior thigh).
Too much volume and weight on the lower half of the butt cheek, just like in the case of Kim, is the most common cause of poor shape and dimpling, says Dr. Smiley.
The celebrity plastic surgeon has also surmised that Kim’s poor results might also stem from liposuction of the posterior thigh, which has further weakened the “foundation” of the buttocks and thus contributed to the sagging appearance.
Kim Kardashian’s backside has visible dents and sagging, which could be a result from over-filling the lower half aspect of the butt cheek, and liposuction near the gluteal fold.
Dr. Smiley says he generally avoids liposuction of the posterior thigh due to risk of saggy buttocks and surface irregularities.
Nevertheless, liposuction remains an integral part of Brazilian buttock lift because it allows surgeons to collect “unwanted” fats from two or more donor sites; the fats are later re-injected into the buttocks.
Dr. Smiley says he almost always treats the lower back and flanks as a viable donor site of fats because contouring these “adjacent” areas further improve the profile and shape of the buttocks, and so there is no need to perform over-aggressive fat injection in an attempt to achieve great projection.
He believes that having a deep understanding of the buttock anatomy can prevent most, if not all, Brazilian buttock lift risks.
Brazilian booty lift, also referred to as buttock augmentation via fat transfer, is one of the most commonly sought after procedures in Beverly Hills plastic surgery.
Instead of implants, patients can achieve fuller, shapelier backside with the use of their own fat, which is derived from two or more areas.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a Snapchat video explaining how Brazilian booty lift can achieve the “Kylie effect.”
Posterior View of the Patient. The left photo shows the results of Brazilian booty lift with a “Kylie effect” in mind.
Over the past several months, Dr. Smiley’s patients have been citing reality TV star Kylie Jenner’s voluptuous body to describe their cosmetic goal.
“Basically, the Kylie effect is achieved by creating a narrow and high waist and the fullness of the hips,” he explained in the Snapchat video.
One female patient had requested for this “effect,” although she is naturally thin (weighing just 115 lbs. at the time of surgery) and so Dr. Smiley used multiple donor fats/liposuction sites to collect enough fats to be injected into her buttocks.
Dr. Smiley used the inner thigh, flanks, lower back, and arms as donor sites. He performed liposuction via microcannula, a suction probe with a very narrow body to dislodge and suction the fats in the most accurate and gentlest manner.
The use of microcannula, Dr. Smiley said, is particularly critical when treating the inner thigh because the area is susceptible to surface irregularities and so he avoids the use of large cannulas, which remove fats in bigger chunks and thus with less precision.
Moreover, Dr. Smiley had focused on reshaping the lower back and flanks through meticulous liposuction in order to replicate the reality TV star’s sultry silhouette.
Afterwards, the collected fats were processed with the centrifuge to separate and discard impurities such as the oil and blood cells.
Dr. Smiley injected more fats into the hips to make them appear fuller and curvier.
The celebrity plastic surgeon said that achieving high level of symmetry on both sides is one of the challenges of Brazilian booty lift; hence, he always uses laser light to guide him during the actual injection of fat.
Buttock implants under the muscle or at least within this anatomical layer has been known to provide softer, more natural results compared to a placement technique in which the prostheses lie above the muscle.
Placing the buttock implants above the muscle, with only the skin and fat “supporting” their weight, is known to increase the risk of sagging (inadvertent displacement) and palpability.
Leading Inland Empire plastic surgeon Dr. Tarick Smiley warns that the skin’s elasticity means it may stretch over time and lead to implant displacement and other surgical stigmata; hence, he always places buttock implants under the muscle or at least within this layer.
Furthermore, the under the muscle is known to minimize risk of infection especially in the event of poor healing since the muscle itself can serve as a protective barrier.
From the aesthetic point of view, buttock implants under the muscle technique can provide a more natural appearance—i.e., an S-shaped “behind” when viewed from the side.
Nonetheless, achieving natural and proportionate results also entails careful examination of the patient’s buttock dimension. The goal is to use implants that are within the anatomical boundaries, which in turn can also prevent skin thinning, implant malposition, and poor wound healing.
(Note: Patients of average frame are generally advised to stick to buttock implants whose size range is not more than 400 cc to prevent excessive tension on skin. It is important to note that too much tension is closely linked to poor healing and increased palpability.)
All buttock implants are positioned above the “sitting” area and so only the upper half of the butt is actually augmented, while its side (hips) and lower aspect receive no or very little improvement. For this reason, some patients may need a simultaneous fat transfer or fat grafting.
Incorporating fat transfer (which always starts with liposuction to collect fats) also allows the surgeon to “carve out” a more feminine contour by removing the excess fats along the flanks and lower back, says Dr. Smiley.
Liposuction uses a small hollowed tube inserted into tiny round incisions to remove the excess fat adjacent to the buttocks, further improving the contour and profile of the butt cheeks, he adds.
The collected fats from liposuction could be used to reshape the hips and lower aspect of the buttocks for a more proportionate, curvier silhouette, says Dr. Smiley.
The Brazilian butt lift results can be more impressive when the hips, which in essence are the lateral aspect of the buttocks, are included as well. For this reason, leading Beverly Hills plastic surgeon Dr. Tarick Smiley almost always includes the area to create a nice curvature.
Improving the hips contour at the same time will also give an illusion of a rounder, fuller backside, says the celebrity surgeon. As a result, he allocates about a third of the donor fats collected through liposuction to the hip area, while the remaining is injected into the actual buttocks.
In his recent Snapchat video post, he has shown a female patient with noticeable side indentations and flat hips that further worsened the appearance of her flat buttocks.
The female patient required liposuction of the lower back and flanks not just to remove the appearance of “fat rolls” but also to “curve out a more feminine silhouette” in which the hips and buttock profile are further “emphasized.”
In the video, the celebrity plastic surgeon is seen filling out the lateral depressions along the hips to create a smoother transition between them and the buttocks. Also by improving the hip contour, the butt’s posterior view is further enhanced.
Aside from liposuction of the lower back and flanks, Dr. Smiley also collected donor fats from the “bra rolls” for a more holistic improvement of the feminine curvature.
To achieve high survival rate of fat grafts, Dr. Smiley uses centrifuge to separate and remove biomaterials (e.g., blood) and “broken” fat cells so that only the purest and healthiest fats are transferred to the buttocks.
Structural fat grafting injection further ensures high survival rate and smooth results. This technique involves “micro-injection” of fat (less than 0.1 cc) to gradually build up new soft tissue and ensure blood vessel ingrowth.
Without blood vessel ingrowth, the fats will simply die and become absorbed by the surrounding tissue.
Aside from meticulous handling of fat, Dr. Smiley says the survival rate will also depend on patient cooperation. A good rule of thumb is to avoid direct sitting (i.e., the patient should make every effort to sit on her posterior thigh with the use of boppy pillow or U-shaped cushion) for at least three weeks.
And during sleep, the patient must assume a fetal position in which she must lean more toward her stomach to prevent inadvertent shifting of fats along her hips.
The ideal liposuction sites in patients seeking buttock augmentation via fat injection, or more commonly referred to as Brazilian butt lift, are usually the regions of the trunk because they contain most of the bulk of “unwanted” fats.
Instead of throwing away the fats collected from liposuction surgery, they are purified and injected into the patient’s backside, precluding the need for butt implants. For this reason, Brazilian butt lift is perceived to be safer because no synthetic prostheses are used to contour the body.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says he almost always treats the lower back as one of the best liposuction sites because of its propensity to hold on to excess superficial fat (i.e., type of fat right beneath the skin that can be removed with a flexible hollowed tube called cannula).
Furthermore, “carving out” the lower back will allow the buttocks to stick out more, leading to a better shape when viewed laterally and posteriorly, explains the celebrity plastic surgeon.
A many patient can also benefit from liposuction of her flanks to further improve the buttock’s profile and shape.
The liposuction sites may also include the entire circumference of the lower torso, sometimes referred to as 360 degrees liposuction, which is particularly ideal for creating the quintessential hourglass figure. According to studies in which men were asked to rate the attractiveness of female bodies, a hip-to-waist ratio near 0.70 is perceived to be the most attractive.
But as the hip-to-waist ratios climb higher toward 0.80 the feminine curves become less apparent, as suggested by the studies.
Aside from the torso, other viable liposuction sites are the patient’s “areas of concerns.” For instance, women with flabby arms caused by the excess fat can benefit from fat removal surgery in the area.
While the vast majority of patients seeking Brazilian butt lift are women, some men with markedly flat buttocks can also benefit from the procedure, although the “aesthetic guidelines” may slightly differ to achieve a gender appropriate result.
Moreover, many liposuction sites commonly treated in women are rarely considered as viable donor areas in men. This is particularly true for liposuction of the upper arms and hips, which are almost an exclusive procedure for female patients.
From the standpoint of aesthetic improvement, the right candidate for Brazilian butt lift typically wants to address the problems stated below:
* Flat buttocks when viewed posteriorly and laterally
* The appearance of buttocks and hips that “disappear” from the midsection, which is made worse by the unsightly fat rolls along the flanks and/or lower back
* Visible dents
* Asymmetry between the two sides
* Less than optimal shape due to aging or weight loss
Despite its name, the Brazilian butt lift does not actually lift the sagging buttocks, which often ensue after massive weight loss. For this reason, MWL patients will need an excision-based surgery that typically results in a linear scar above their buttocks, which could be extended around the entire circumference of their lower torso, a procedure referred to as lower body lift. In essence, it combines three major surgeries, namely buttock lift, outer thigh lift, and tummy tuck.
Going back to the topic of the “ideal” candidate for Brazilian butt lift, the patient must have sufficient “unwanted” fat. Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says that it is not uncommon to inject more than 1,000 cc of purified fat into each side to achieve the desired results.
Dr. Smiley further explains that less than 800 cc fat on each side may not give a noticeable amount of augmentation particularly in large-framed patients unless they are only seeking minor improvement or they just want to smooth out dents and other small irregularities.
Sometimes, Dr. Smiley requires his thin patients to gain a bit of weight so he can collect more “unwanted” fats. To further compensate for the “seeming” fat deficiency, he recommends large surface areas or multiple donor sites treated by liposuction.
Liposuction surgery uses a flexible hollowed tube to remove the unwanted fat beneath the skin. The celebrity plastic surgeon almost always treats the flanks and lower back as viable donor sites to further improve the profile and contour of the buttocks.
As with any elective plastic surgery, the ideal candidate for Brazilian butt lift must possess “general” requirements to achieve optimal results from the procedure:
* Someone who has achieved her optimal health and weight through “sustainable” healthy lifestyle, as opposed to yoyo dieting and other hardcore regimen.
* Someone who has realistic goals and expectations that can be improved by surgery.
* Someone with good skin shrinkage or elasticity. After liposuction, the skin must be able to shrink-wrap around the new contour to achieve smooth, natural-looking results.