Dr. Chad Deal is an expert in the Southeast who performs the Brazilian Butt Augmentation (BBA). Because of the misconceptions presented to potential patients, Dr. Deal presents in this article the options and also provides both advantages and disadvantages of each buttock enhancement procedure. Dr. Deal teaches surgeons from around the world how to perform the Brazilian Butt Lift while stressing techniques for the safety of the patient above all else.
A Brazilian Butt Lift patient (fat transfer to her buttock)
Buttock enhancement’s popularity is growing. Today women and men are seeking a more lifted, projected, and shaped buttock that reflects youth and physical fitness. In some ways the U.S. is just now catching up to the rest of the world, as surgeons from around the globe and particularly in South America have been addressing this trend for decades.
What is all of the Bad Press?
There has been a host of patient stories with horrific results from both an aesthetic and health standpoint. Unqualified practitioners performing “buttock augmentation” in inappropriate facilities with unconventional techniques have resulted in distorted buttock figures, at the least, and life threatening illnesses in some cases. Recently in the news was the story of the fake doctor in Florida who was injecting a mixture of industrial grade silicone and fix-a-flat glue directly into the buttock. This story and others like it should make patients have caution when selecting their surgeon and surgical procedure. Questions like:
What is your background training?
Are you board certified in the specialty he or she was trained?
Did you receive training in this exact procedure during your fellowship?
How many of these procedures have you done?
Do you have hospital privileges to perform this procedure?
Do you operate in an accredited surgical facility where this can be performed?
Beyond this, a prospective patient should look to other patients of the surgeon for reviews, particularly if they have had the same procedure. Finally, as in life, “The proof is in the pudding.” Ask your surgeon to see several before and after photos of his/her work.
Understand Your Options For Buttock Augmentation
The questions still exist:
Is it safe?
What is the best method?
Who is the best candidate?
What is all of this talk about Butt Injections?
To address many of these concerns, here are the five ways to lift or augment the buttock, along with the pros and cons.
1. Buttock Implants
Pros: Immediate results, consistent sizing, longevity
Cons: Infection, Wound Dehiscense (break-down), Implant Step-off, Implant rotation or
Malposition, Capsular Contracture, Hematoma, Seroma (fluid collection), Large scars
2. Brazilian Buttock Augmentation (BBA/BBL)
Pros: Low complication rate (Low chance of hematoma, Seroma (fluid collection),
Infection, Smooth Contour, Natural Appearing, Essentially no scars
Cons: 3 months for final result, Potentially underwhelming results, Uncertain long-term
3. Liposculpting only
Pros: Very low complication rate, Smooth contour, Natural appearing, No scars
Cons: 3 months for final result, Highest chance for potentially underwhelming results
4. Fillers “Butt Injections"
Pros: Mostly unknown, No scars, No anesthesia needed
Cons: Off-label and in some cases Illegal use of substances not intended for buttock
augmentation, Unknown infection rates, Uncertain scars, Uncertain long-term results
5. Surgical Buttock Lift/Tuck “True lifting procedure”
Pros: Great option for massive weight loss patients, Lifts the buttocks vs. augmenting
alone, Reliable results, Immediate results
Cons: Very large scars, Need for drains, Wound dehiscence (break-down)
Dr. Deal’s Choice: Brazilian Buttock Augmentation
A “Brazilian Butt Augmentation or Lift” (BBA or BBL) is the coined name for large-volume fat transfer to the buttock area. It is a two-in-one surgical procedure where fat is removed through liposculpture from the abdomen, flanks and back areas, then harvested and transferred to the gluteal region of the body (buttock) resulting in a more round, full and lifted buttocks. Recovery is typically about 5-7 days. There is essentially no scarring and no sutures required. There are several advantages and only a few disadvantages to choosing fat over the other options -- particularly gluteal implants. The main advantage is that it is you use your own fat without chance for the fat to be rejected. The complication rates are exceedingly lower than from silicone buttock implants, and the scarring is the size of a pencil eraser vs. 5-inch long scar(s) in the gluteal crease with implants. An extra benefit to the Brazilian Buttock Augmentation is the substantial liposuctioning of the abdomen, flanks, mid-back, low-back area, and often the thighs. Liposuction from these areas usually results in a significant shape change for the patient. Liposuction is either tailored to an hourglass figure for a woman or streamlined shape for a man. The only disadvantage over implants is that the amount of fat that survives the transfer is variable, but studies point to around 50% or more survival rate. This can sometimes mean that a patient will desire a 2nd transfer to ultimately achieve their desired end goal. Regardless of the amount of fat survival, the patient is still left with a more contoured waist, abdomen, and thighs while the buttock will remain natural looking. In essence, the BBA provides the best chance for the most appealing and natural results while maintaining a low complication rate and the forgivibility to re- attempt a second transfer without aesthetic harm to the patient.
When are the other options a good choice?
When a person is a “massive weight loss” patient, he or she most likely needs excess skin removed throughout the body, which result in long scars to meet individual goals. This makes the surgical buttock lift the best choice. These patients have severe drooping of their buttocks. Any fat, implant, or other augmentations alone will most likely not look aesthetically pleasing in these patients because of the significant skin laxity. Implants can be combined with the surgical buttock lift if the patient needs both profound lifting and volumizing. Conversely, when a woman is already in shape or on the thinner side, it is difficult to get enough fat to enhance the buttock with fat alone. However, in this case, careful and meticulous liposculpting alone around the buttocks may give her the appearance of a more round and projected result. When the patient lacks enough fat to transfer, buttock implants may be recommended to meet goals.
So what about buttock injections? “I would NEVER at this point recommend them unless it is under the guise of a study,” says Dr. Deal. Currently silicone and hydrogel injections are becoming increasingly popular on a very unregulated black market. BEWARE of practitioners that perform this procedure. The products have not been studied for this use. It is considered off-label and is illegal to perform. Once large volume fillers are studied and approved, it may become a viable choice. For now, avoid these types of buttock injections.
Is the Procedure Right for You?
As you can see there is no “one size fits all” answer for every person. This is why it is important to be evaluated by a trained surgeon who can provide an artistic result to meet your goals. Do your homework. See several physicians. And when it comes to butt injections, remember, it’s either Fat…or Fiction.