Buttock Enhancement

Wanting a fuller booty?

Most buttock enhancement is done using Brazilian Buttock Lifts (BBLs) where fat is taken from liposuction and injected into the buttocks. We talk about what to look out for when making decisions about your BBL, and cover some of the risks and complications. Buttocks can also be filled with Sculptra or PRP bio fillers, and we touch on that as well as silicone buttock implants.

At Pulsar Health, we always prioritize your safety as well as aesthetic goals, so if you want to be as safe as possible, have your BBL done with us - find out more by calling for an appointment.

South Florida is the mecca for buttock enhancements in the United States. 

The Brazilian Buttock Lift (BBL) is the most commonly done buttock procedure these days, where fat is transferred into the buttocks, called fat grafting. It needs to be combined with liposuction to obtain your own fat for the fat grafting. This section gives you further information about this procedure and some things to look out for.

BBLs are done to create a more curvaceous look. There are many ideals in buttock aesthetics, so brining photos of the kind of look you are going for, and think you can achieve with your underlying body structure, is helpful. The top portion of the buttock can be sloped in (more natural) or create a more dramatic "shelf". The roundness on the sides of the buttocks can vary in position and fullness, as can the prominence facing the back. Hip dips may need to be "released" prior to being filled in. The amount of fat that can be placed is limited by the amount that can be removed from you, as well as on the size that you are seeking to be. About half the fat "takes" or survives. Overfilling places too much pressure on the fat and more of it does not make it, so it is better to do a second procedure if you want a very full look. If fat does not survive, it can become quite lumpy, called "fat necrosis", another reason to not overfill. Fat grafting does not cure cellulite and dimpling may look more accenuated, unless you specifically request certain portions to be "released", which isn't part of the usual fat grafting process. 

BBL procedures need to be done carefully under ultrasound image guidance to make sure that the fat is injected into the layer between the muscle and the skin. Injecting the fat into muscle is no longer recommended, as there is a much higher risk of getting a "fat embolus" where fat can lodge in the blood supply to the lungs and can cause a fatality. Several young women have died in Florida before use of ultrasound became a mandatory requirement and the number of BBLs done daily was limited to 3/day. Whether the "Miami chopshops" are following guidelines remains unknown. At Pulsar Health, we don't treat people like a number, and we make sure that we deliver the safest and best experience we can for each of our clients. Dr. Gill was using ultrasound for BBLs long before it was required by law, as she always seeks to maximize safety as well as aesthetics.

The fat for fat grafting in the BBL usually comes from liposuction of the abdomen, but can also come from the thighs or arms. The liposuction is priced separately because the goal is to provide a cosmetically pleasing result for the "donor" area, rather than just take fat. The term "Lipo 360" refers to taking fat from the front and sides of the abdomen. It is used a lot in marketing, so be sure to clarify what areas are included. You don't want to have bulky back bra roll and heavy hips left, unless that is the aesthetic you like. In some cases, there is an area of fat on the lower back, just above the cleft of the buttocks, which is important to remove to enhance the appearance of the buttocks, so check whether you have that issue and if it is being addressed in the liposuction portion. 

To get great results from liposuction, use of garments is essential, so please review the website section on Liposuction: Love handles & more. Some garments are designed with a BBL in mind, having a looser mesh in that area. If you are doing a BBL, we need to avoid any pressure on the buttocks so that the fat can "take", which means to survive by developing its own blood supply over the course of a few weeks. Too much pressure can reduce the blood flow to the area, causing more loss of fat. For that reason, it is recommended that you not sit or lie on the buttocks for a protracted period of time for four to six weeks. Special cushions are available that take pressure off the buttocks for driving, but use even these with caution, avoiding long drives in the first two weeks. The garments are very important for shaping your buttocks in your desired shape, and look into custom garments for more precision shaping. 

Complications from BBLs include fat necrosis, where a part of the fat does not make it and becomes a hard lump. This may not be significant enough to warrant any further intervention, or it could be severe enough to require excision. There are also risks of infection, bleeding, healing with irregularities and not getting the shape that you were going for. Complications from the liposuction can be lumpiness or creases during healing as well as occasional scar issues, which is why great care needs to be taken during the healing journey with the appropriate positioning, garments and boards. Use of lymphatic drainage massage can be helpful but is only recommended for liposculpting cases immediately following surgery. Waiting a few days after surgery is a better option for most people after normal liposuction and BBL, to reduce discomfort from lymphatic drainage massage and any risk of bleeding. 

Buttock enhancement can also be done without fat using fillers. Sculptra is a filler that is used many times for buttocks, but it is quite expensive (far more than fat grafting in the long term) and will require repeated treatments. The filler in Sculptra is made of poly-L-lactic acid. It is placed under the skin to produce an immediate filling effect and longer term production of collagen. Following placement, the area should be massaged for five minutes five times daily for five days. The next set of injections are done about five weeks later.

We don't use dilute Radiesse, a popular filler, at Pulsar Health as this is a "bony substitute" even when diluted, and we prefer not to place that in a soft tissue area. The only other filler we do use is PRP with or without hyaluronic acid. This has a temporary filling effect but a longer term regenerative effect.

Unfortunately, some people have had other substances injected into the buttocks. We have seen massive skin death as well as long term problems with lumps and flabby skin from use of these types of fillers. We can help you deal with the problems, but stress that prevention is best. 

Implants placed in the buttock area tend to cause discomfort or get mispositioned, so we do not place buttock implants but will remove them if needed.