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.
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.
When doctors mention 360 degree liposuction, they generally refer to a fat reduction surgery that encompasses the entire waistline—i.e., the four quadrants of the abdomen, flanks, and lower back. The idea is to create a cinching effect that is one of the most coveted features of a feminine physique.
When combined with Brazilian butt lift, the contouring effects of 360 degree liposuction are further enhanced. Instead of discarding the “unwanted” fat, doctors “recycle” them in order to enhance the patient’s backside with the most natural material.
Basically, Brazilian butt lift is buttock augmentation via fat injection. With this technique, patients can avoid the risks they would carry if synthetic implants were used instead.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of snapchat videos and images on Snapchat to demonstrate a patient who have had Brazilian butt lift right after her 360 degree liposuction.
Due to the fibrous fat commonly found along the flanks, around the navel area, and back, Dr. Smiley has used the power-assisted liposuction (PAL) technique.
“PAL cannula [straw-like device attached to a vacuum pump] has a vibrating tip, making it ideal for treating tough areas,” he said in one of the Snapchat videos.
(Note: When doctors use the term fibrous or “tough” fat, they refer to fatty areas with more connective tissue that a thick cannula cannot easily penetrate through. Hence, these areas are best treated by a thin PAL cannula.)
The tiny vibrations released by PAL cannula makes fat extraction gentler and more precise, which in turn results in less surgical trauma and bleeding, and minimal postop swelling and bruising. Thus, the recovery is also perceived to be quicker compared to other liposuction techniques.
After collecting adequate amounts of fat, Dr. Smiley placed them in tubes and allowed the red blood cells to settle to the bottom, thanks to gravity. These were discarded so he could only use the purest “golden” fat, and ultimately promote high survival rate of grafts—about 70 percent or even higher.
It will take about three weeks for the fat grafts to re-establish their blood supply and the extracellular matrix holding them together to achieve its full strength, allowing the grafts to endure the pressure from sitting, squatting, and stretching.
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.
Liposuction and fat transfer cost is highly variable due to factors such as the donor and recipient site, amount of transferred fat, clinic location, professional/surgeon fee, among others.
While liposuction and fat transfer has many uses in cosmetic and reconstructive plastic surgery, its application is widely popular in Brazilian butt lift (i.e., buttock augmentation via fat injection) and facial rejuvenation surgery.
According to Realself.com, an online forum dedicated to popular plastic surgery procedures, the average cost of Brazilian butt lift is $6,550. Nonetheless, some patients may have to pay for a hefty price tag (as high as $14,000) if their surgeons cater to high-profile people or their clinic is located at a posh district.
But the truth is, the average cost of Brazilian butt lift may greatly vary even among patients treated by the same doctor because others may require just two liposuction areas, while some entail up to six “donor” sites.
To further shed light on the issue, one Brazilian butt lift patient treated by leading Beverly Hills plastic surgeon Dr. Tarick Smiley paid about $6,000 for liposuction and fat transfer that involved collecting donor fats from the lower back, flanks, inner thighs, and bra rolls.
The vast majority of patients will need at least two liposuction sites to collect an adequate amount that will be injected into their backside. However, women on the thinner side may need more donor sites to harvest enough volume to deliver the desired results.
But in facial rejuvenation via fat transfer, the volume of fat required is no more than a few teaspoons; hence, the viable donor sites are almost always not an issue.
A fat transfer involving the face—i.e., flat cheeks, laugh lines, and deep tear trough—can run as low as $3,500, or as high as $11,000. The hefty price tag almost always comes with simultaneous procedures such as facelift, neck lift, eyelid lift, or brow lift.
The upfront cost when fat transfer for facial rejuvenation is used instead of dermal fillers (Restylane and Juvederm) is higher, although in the long run the patient may actually save more because fat grafts that “survive” in the first 3-6 months are expected to be near permanent.
Traditional fillers, on the other hand, typically require 2-3 touch-ups every year.
Meanwhile, some doctors have also started offering fat transfer to replace breast implants; however, the amount of augmentation is rather limited, i.e., not more than a cup size.
Because of the rather marginal results from breast augmentation via fat transfer, many surgeons view it as just an ancillary procedure of breast implant or breast reconstructive surgery. Its primary use is to add more soft tissue coverage to hide implant rippling and minimize palpability.
Liposuction and fat transfer has a significant impact on how plastic surgery today is performed. The modern approach is to replace likes with likes and make every effort to use the patient’s own tissue, as opposed to synthetic prosthetics. Hence, patients nowadays are not limited to choosing facial, breast, and buttock implants because their very own fat can be used as a “volumizer.”
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley says liposuction and fat transfer is particularly helpful in buttock augmentation. Instead of using solid silicone implants to reshape the patient’s derriere, the procedure has allowed doctors to deliver more natural and softer results.
Liposuction and fat transfer has been used to achieve this more sultry, more feminine “backside.”
Buttock augmentation via fat transfer is more commonly referred to as Brazilian butt lift. (This is a misnomer since the procedure does not actually lift the buttocks; it only reshapes and augments them with the patient’s own fat usually derived from the hip-flank region, abdomen, and lower back.)
While liposuction and fat transfer has also been successfully performed in breast augmentation procedure, the use of implants remains the gold standard because of their more predictable results and they give more control over the size and projection of the postop breasts.
Breast augmentation via fat transfer is less likely to deliver more than a cup size increase. Attempting to inject large amounts of fats without taking into account the “pressure and strain” experienced by grafts—a particular concern in women with a rather tight skin—will result in low survival rate and less than optimal results, warns Dr. Smiley.
Fortunately, the aforementioned risks are less of an issue in Brazilian butt lift, he explains.
Aside from Brazilian butt lift, the celebrity plastic surgeon says that fat transfer is also helpful in facial rejuvenation procedures, particularly in facelift surgery, which can only address sagging skin and tissue laxity and has no or very little effect on facial volume or fat loss.
With fat transfer, Dr. Smiley says he can correct the flat or aging cheeks, deep tear trough, laugh lines, and hollowed eye socket—without using dermal fillers, facial implants, and other synthetic materials.
But even without the intention of correcting facial volume loss or flat buttocks, Dr. Smiley says that liposuction as a stand-alone procedure could also benefit from fat transfer. For instance, after liposuction he always examines the treated area (which includes sweeping his hands over the skin) while the patient is still in the operating table to feel any dents that could be smoothed out by fat transfer.