The qualification of buttock augmentation surgeons is the most critical factor affecting patient satisfaction rate, according to California Surgical Institute website.
As of this writing, there are two reasonably safe and effective methods used by buttock augmentation surgeons:
- Brazilian butt lift. In essence, this is buttock augmentation via fat transfer in which the patient’s own fat harvested through liposuction surgery is used to reshape her backside.
- Buttock implants. Solid silicone implants, which do not pose risk of leakage, are positioned above the patient’s sitting area, ideally beneath the muscle for additional soft tissue coverage.
While most patients feel that the technique is the most important factor, the truth is the surgeon’s skill set is the one that largely determines the success rate. Nonetheless, some doctors have their own personal preference based on their experience and “educated” judgment.
For instance, leading Beverly Hills plastic surgeon Dr. Tarick Smiley prefers Brazilian butt lift to buttock implants since the former provides additional contouring thanks to the simultaneous liposuction; it also eliminates implant-related risks such as inadvertent shifting and palpability.
Dr. Tarick Smiley explains the qualifications you should look for in buttock augmentation surgeons:
The proliferation of professional-sounding boards might leave you confuse. Nevertheless, the general rule of thumb is to select a plastic surgeon who has passed the rigorous oral and written exams of the American Board of Plastic Surgery.
Take note that ABPS members must adhere to the strictest standards: they are required to take the board exam every 10 years and continue their education; and they should only operate in an accredited surgical facility.
Plastic surgery is a very broad practice; some surgeons focus only on facial surgeries, others dedicate most of their time perfecting rhinoplasty (nose-reshaping), while others have a preference to body contouring surgeries.
A good rule of thumb is to choose a board-certified plastic surgeon who performs buttock augmentation on a weekly basis. It is important to note that experience will help doctors make educated judgment and minimize or avoid risk of complications.
Even the surgeon with the best clinical skills may not be the right one for you if he has poor bedside manner. It is important that you choose a doctor that you trust completely.
Simply put, your surgeon must have good interpersonal skills, i.e., he must be caring and friendly.
Buttock implants or fat transfer? This is one of the most common dilemmas of patients seeking butt augmentation surgery.
Dr. Tarick Smiley, a leading Beverly Hills plastic surgeon who devotes much of his time to body contouring surgery, says he prefers fat transfer to buttock implants provided that the patient has adequate donor fats, which are collected through liposuction surgery.
Buttock augmentation via fat transfer, or more commonly referred to as Brazilian butt lift, uses the patients’ own [excess] fat to reshape and add volume to their backside. Using one’s own tissue, as opposed to synthetic implants, it provides a wide range of benefits such as more natural results and feel.
In addition, Brazilian butt lift eliminates most implant-related complications such as adverse reaction, protrusion, and visibility, says Dr. Smiley.
The celebrity plastic surgeon, who regularly posts Snapchat videos as part of his educational and awareness campaign, says the Brazilian butt lift gives him more “freedom” when it comes to the final shape not just of the buttocks but the rest of the torso or waistline as well.
Buttock implants, because they are positioned above the patient’s sitting area, can only reshape and augment the upper mid and uppermost aspect of the buttocks. Meanwhile, the hips and lower buttocks will remain the same after surgery, explains Dr. Smiley.
On the other hand, Brazilian butt lift in which fat grafts are injected can “widen” the hips and reshape all the aspects of the buttocks, says Dr. Smiley. For this reason, the surgeon has more control over the final contour of the backside; this is particularly important in patients with a specific “shape goal” in mind—e.g., heart-shaped derriere, “bubble” butt look, large “C,” etc.—he adds.
Under most circumstances, Brazilian butt lift is superior to buttock implants; hence, Dr. Smiley says he sometimes requires “thin” patients to gain a bit of weight to make fat transfer a viable option.
However, the results and the overall viability of Brazilian butt lift are highly dependent on the patient’s donor fats. This might be an issue for some men (naturally, they have a lower body fat percentage than women) and patients who want large augmentations but have limited fats.
To determine whether buttock implants or fat transfer technique is a more viable approach, Dr. Smiley says the patient’s underlying anatomies and cosmetic goals are always taken into account.
A good number of secondary liposuction aims to eliminate the indentations caused by the initial surgery. While this goal is often achievable, leading Los Angeles plastic surgeon Dr. Tarick Smiley says the patient must have good skin elasticity or shrinkage to achieve good results.
Dr. Smiley has recently posted a Snapchat video involving a patient who had a poorly done abdominal liposuction, i.e., her tummy had visible indentations.
Aside from a secondary liposuction, the patient also requested for Brazilian butt lift or BBL in which the backside is augmented and reshaped using one’s own [unwanted] fat. Fortunately, she was a good candidate for both procedures, says Dr. Smiley.
Dr. Smiley started off the surgery by treating the abdomen. He corrected the indentations by removing the residual fats that contributed to the skin irregularities with the use of a liposuction microcannula (flexible hollowed tube).
Microcannula delivers smooth results because it removes tiny bits of fat, as opposed to large chunks of fatty tissue when large cannulas are used.
Aside from the abdomen, Dr. Smiley also performed liposuction of the flanks, lower back, and bra roll. The goal was to collect more donor fats, which were later used to reshape the patient’s backside.
Despite the proliferation of different liposuction techniques, Dr. Smiley prefers the tumescent approach because it minimizes bleeding. This requires the injection of fluids containing saline, lidocaine (local anesthesia), and epinephrine (blood vessel-constricting drug) into the fatty area.
After liposuction, he was able to collect about 5 liters of fat, which was purified prior to re-injection to achieve a high survival rate and ultimately near permanent results.
To create smooth and symmetric results from liposuction, Dr. Smiley says that the surgeon’s experience plays a critical role since he must know these guidelines:
- There should be enough fat layer beneath the skin to prevent indentations and other surface irregularities.
- There should be symmetry between the left and right side of the body.
- The natural curves and contours of the body must be preserved.
At the end of liposuction, Dr. Smiley says he always pinch and “feel” the skin to make sure that both sides are symmetric. If one of the sides has a “thicker feel,” he would remove additional fat in the area to achieve a more balanced result.
Aside from removing just the right amount of fat, Dr. Smiley also ensures that he creates an “S” profile, which is the epitome of a beautiful feminine physique; hence, he always removes all the unwanted fat in the lower back (or outer-upper buttocks) and flanks.
Buttock augmentation procedure is either accomplished through fat grafting (or more commonly referred to as Brazilian butt lift) or gluteal implants. Occasionally, these two methods are combined to deliver the patient’s desired look, as suggested by leading Los Angeles plastic surgeon Dr. Tarick Smiley.
Dr. Smiley says it is not uncommon to hear patients request for a “natural-looking” result, although each person has her own unique interpretation. Hence, a good surgeon focuses on building good communications to deliver results that would satisfy both parties, he adds.
Meanwhile, he explains the markers of a successful buttock augmentation procedure and the “tools” to make this a possibility.
* The overall result should meet most if not all of the patient’s aesthetic goals and personal preference. For this reason, anyone with unrealistic expectations is discouraged to have surgery.
A good plastic surgeon knows how to listen to his patient’s input, particularly the amount of projection she wants to achieve, the shape (e.g., heart, large C, or “bubble butt”), and the hip width.
It is important to note that each buttock augmentation procedure has its limits. For instance, the gluteal implants can only reshape the upper half of the butt cheek due to the way they are positioned; hence, it is difficult to achieve the large “bubble butt” look. Another ramification of using this technique is that the hips will receive no or very little improvement.
Brazilian butt lift, meanwhile, allows to the surgeon to reshape the hips and the lower and upper buttock cheeks because the fat grafts can be injected anywhere. Nonetheless, the overall results are primarily determined by the amount of the donor fats.
* The results are gender appropriate. While the vast majority of patients are women, men are slowly catching up. But due to the nuances in male anatomy and their different beauty ideals and cosmetic goals, they need a different set of approach.
For instance, male patients who are bodybuilders ask for gluteal implants to make their backside look proportionate to the rest of their muscular body. Due to their low body fat percentage, they are generally poor candidates for Brazilian butt lift.
In general, men ask for a conservative amount of projection. Women, on the other hand, are more particular about the shape and hip width improvement.
* There is no visible reminder of plastic surgery. When gluteal implants are used, there should be no inadvertent displacement, palpability, and visible scars. Oftentimes, these complications are avoided by selecting the right implant size based on the patient’s soft tissue coverage and other relevant anatomies.
In Brazilian butt lift surgery, the stigmata that must be avoided include asymmetry (which happens when one of the butt cheeks has lower fat survival rate), and skin asymmetries in the donor/liposuction sites.
Buttock implants with fat grafting are used to augment and reshape the patient’s “behind” to produce a more feminine silhouette. However, it is best to perform each surgery separately to achieve a more predictable result.
According to California Surgical Institute website, the implants could affect blood vessel regrowth within and around the fat grafts, leading to their low survival rate and overall unpredictable outcome.
Fat grafts are donor fats typically collected from the waistline through a gentle liposuction, although any part of the body with excess fatty tissue can serve as a donor site. Once harvested, they are purified so that only the healthiest cells are injected back into the body.
Buttock implants, meanwhile, are made of solid silicone implants thus they pose no risk of leak unlike the traditional silicone breast implants. For this reason, they are expected to last a lifetime provided the patient does not experience infection, displacement, and cosmetic-related issues.
Leading Los Angeles plastic surgery expert Dr. Tarick Smiley says that fat grafting is often seen as the first option due to its perceived benefits and impressive safety profile. However, some patients have insufficient donor fats to produce their desired appearance, particularly the amount of augmentation they are after.
Should the patient choose buttock implants with fat grafting “method,” the prostheses will provide most of the projection and augmentation particularly in the upper half of the butt cheek.
The fat grafts, meanwhile, are used to reshape the lateral buttock (outer thigh) and hips, areas that are barely improved by implants due to their inherent position—i.e., above the patient’s sitting area.
Oftentimes, the donor fats are collected from the waistline, particularly the lower back and flanks to achieve a smoother and more feminine waist-butt junction.
Most surgeons perform fat grafting first to augment and reshape the patient’s derriere, a procedure more commonly referred to as Brazilian butt lift. Should any revision or ancillary procedure is warranted (such as buttock implants), it is best performed after 4-6 months to make sure all the residual swelling is gone, the skin has redraped to the final contour, and the grafts have formed their new blood supply.
Because the implants can only augment the upper half of the buttock cheek, they often produce an “O” shaped derriere, which is also referred to as “bubble butt,” says Dr. Smiley.