Butt Augmentation

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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Buttock augmentation via Sculptra injection might be a good alternative to Brazilian butt lift, which always requires patients to have adequate amount of “unwanted” fat to augment and reshape their buttocks.


While Sculptra is an FDA-approved injectable filler to conceal deep folds and depression caused by facial aging, when used to reshape the buttocks the practice is called an off-label use.


buttock augmentation via Sculptra

Dr. Smiley readies several vials of Sculptra to sculpt and “conservatively” enhance a patient’s derriere.

Compared to the results achieved by Brazilian butt lift, Sculptra injection provides a more conservative effect and thus it is more ideal for improving the buttock shape than adding volume (augmentation). Furthermore, it can only last a few years, while fat injection provides near permanent results.


Another issue with Sculptra injection is the cost. Patients who seek significant results will need lots of vials and several sessions (usually 2-3) and so the price is about the same or sometimes even more than the Brazilian butt lift even though the contouring effects are only subtle.


Dr. Tarick Smiley, a prominent Beverly Hills plastic surgeon, says the “holistic” contouring effects of Brazilian butt lift not just rely on fat injection. Because it also involves liposuction that typically treats the lower back and flanks, he is able to produce a more hourglass physique. Meanwhile, the same principle does not apply in Sculptra injection that uses readily available fillers.


Hence, Dr. Smiley only reserves buttock augmentation via Sculptra in patients who are very thin and those who want to avoid surgery and the ensuing three-week recovery (during the first few weeks Brazilian butt lift patients should avoid or at least limit sitting to prevent inadvertent shifting of the fat grafts).


Contrary to popular belief, patients who are thin might still be considered as good candidates for Brazilian buttock lift. Through physical exam and honest discussion, Dr. Smiley says he can find adequate amounts of “unwanted fats” by treating larger surface areas. Occasionally, he requires them to gain a bit of weight prior to surgery.


Meanwhile, he reserves Sculptra for naturally thin patients who only seek subtle results—i.e., they are more concerned about the butt shape than the final size—and do not want to undergo surgery. Oftentimes, Brazilian butt lift entails aggressive or large volume liposuction to achieve the desired results. Of course, this results in longer downtime and more commitment to recovery.

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The plastic surgeon’s Brazilian butt lift transformation pictures can shed light on his eye for detail and core competencies. It should be noted that the surgery is not just about augmenting the buttocks, but more importantly, improving the patient’s body proportions.


Liposuction is an integral component of any successful Brazilian buttock lift. Aside from harvesting the fats from two or more sites, this surgery also allows the surgeon to sculpt the adjacent areas of the buttocks and hips—such as the flanks and lower back—so the patient’s derriere is further enhanced.


Celebrated Beverly Hills plastic surgeon Dr. Tarick Smiley shares some Brazilian butt lift transformation pictures of his actual patients.


Patient 1


The above “before” photo shows that the patient’s hips and buttocks’ convexity was near absent, while her legs were relatively thin prior to surgery. Hence, some people may assume that the ideal results must lean on the conservative side to achieve natural-looking appearance.


But instead of going the conservative route, Dr. Smiley injected large volumes of fat, which he collected from the flanks, lower back, and bra rolls.


He says the patient’s “new” fuller buttocks and wider hips would compensate her broad shoulder, resulting in a more feminine physique from Brazilian butt lift.


Patient 2


The second before-and-after photos show a patient whose “starting anatomy” included boxy, flat buttocks that were lacking of any lateral “bulge.” Hence, Dr. Smiley allocated about one-third of the fat grafts into the hips to give her a more feminine curve; the rest of the volume then went to the buttock’s profile or forward projection.


This patient has specifically asked for the “bubble” effect in which the entire butt cheek has a relatively pronounced roundedness.


Patient 3


The third before-and-after photos, meanwhile, depict a patient who asked for subtler improvements, meaning her primary goal was to enhance the shape of her hips and buttocks, without the “obviously augmented look.”


Just like the rest of Dr. Smiley’s patients, she also received liposuction of the flanks and lower back so her “backside” would appear curvier and fuller.


Dr. Smiley says listening and respecting the patient’s input—instead of assuming that everyone wants the augmented or “bubble butt effect,”—is one of the most critical components of high patient satisfaction.

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Contrary to popular belief, BBL surgery procedure (aka Brazilian buttock lift or butt augmentation through fat injection) is more about the shape and body proportions than the actual size, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley in his recent Snapchat post.


The principle of BBL surgery procedure may seem too simple and straightforward: Harvest the unwanted fats from two or more liposuction sites and later inject them into the patient’s buttocks.


bbl surgery procedure

The new buttocks look proportionate to the upper body. Dr. Smiley believes the shoulder width is one of the factors determining the ideal shape and size of the postop buttocks and hips.

But the truth is, Dr. Smiley says the surgery requires a meticulous set of methods to increase the survival rate of fat and thus make it possible to achieve near permanent results; and deep understanding of beauty and ideal body proportions.


To shed light on the issue of “ideal body proportions,” he recently posted before-and-after photos of a female patient whose “starting buttocks” were markedly flat, an appearance further aggravated by the presence of fat rolls along her flanks and lower back.


Instead of giving her a “conservative” result, Dr. Smiley injected large amounts of fat volume into her buttocks.


“A lot of people would ask me if the new buttocks look too big for her legs. The truth is, one of the most important factors is the shoulder. This patient’s shoulder is big and wide and so we must reshape the buttocks and hips in a way that the latter will almost have the same width as the upper body, leading to the much coveted hourglass physique,” he explains.


To further create a more feminine silhouette, Dr. Smiley says he always treats the lower back and flanks as his donor or liposuction sites, adding that his idea is to “scoop out” this area so the buttocks and hips will have more projection and curvier appearance.


Occasionally, Dr. Smiley says a 360-degree liposuction (i.e., fats from the frontal abdomen, flanks, and back are all removed) is even more ideal in order to achieve a narrower waistline.

In terms of the ideal distance between the “new” buttocks, Dr. Smiley says the V-shape effect [see pictures below] will primarily determine this.

bbl surgery procedure

Dr. Smiley marks the buttocks and draws a V-shaped pattern between the two “cheeks” to guide him during the fat injection process.

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