What is Buttock Augmentation?

Enlarged buttocks are, in modern society, equivalent to female sexuality, mostly due to social influencers such as Kim Kardashian, Jennifer Lopez etc. Many transgender patients seek to achieve these results, no matter the cost, however the cost can sometimes be devastating. There are safe and well accepted methods to enhance the buttocks, and there are others, sketchier and with dire complications.


The most common technique for buttock augmentation is fat grafting, also known as Brazilian butt lift. This procedure, when performed properly, is very safe and with very pleasing results. The fat is harvested from the abdomen, flanks, back, arms and other areas and then injected in multiple layers in the buttocks, both augmenting them and creating a most desired round or A-shape. Over 500ml of fat can be injected per buttock, mostly in the upper and outer pole, which, in combination with an aggressive liposuction of the flanks, creates a very feminine curve of the area. The downsides of fat grafting are that a portion of the fat will be absorbed (around 20-40%), which makes it less reliable, and the fact that it is not applicable on very skinny patients with no harvestable fat deposits.

Other Option

Buttock implants can also be an option, when fat grafting is inadequate or bigger gluteal projection is desired. Silicon implants for the buttocks are similar with breast implants, however the differ in shape. Round or anatomical implants can be used, depending on the anatomy and the result trying to achieve. The implants are inserted through small incisions near the midline and an intramuscular plane is selected. Although the result is very pleasing, buttock implants are prone to complications, such as dislocation, rupture, capsular contracture, infection etc. For this reason, silicone buttock implants are the second choice, when fat grafting is not applicable.

Injectables in the buttocks can be a third option, however care is advised when choosing such a method. The safest injectables are hyaluronic acid or polylactic acid based, such as Sculptra. Dermal fillers are very easy to inject, have minimal downtime, require no surgery and can be performed in the office with local anesthesia. However, the downsides are that the can prove to be very pricey because they have to be repeated every 1-2 years and due to the high cost of the materials, and the fact that they can lead to lumps and imperfections which can be visible after some months. Permanent injectables, such as liquid silicone, acrylic based ones and others must be avoided, because the risk of complications such as granuloma are very high and can prove devastating, creating a permanent deformity which is very difficult to correct, even surgically.