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Buttock Augmentation or Gluteal augmentation

The concept of buttock or gluteal augmentation has evolved over decades. Earlier buttock augmentation meant just increasing n the size of buttock like in breast augmentation using silicone filler implants. The modern concept is based on buttock sculpting or gluteal sculpting to enhance the shape rather than size only. We do both, we augment and contour the buttock to ensure the result is simply the best.

Buttock in men and women behaves differently. In women either some are born with small underdeveloped buttock muscles and fat or the shape changes with time due to weight fluctuation and aging.

The problems in gluteal / buttock region can be basically classified into-

  1. Underdeveloped or hypoplastic or “flat” buttocks
  2. Contour loss or altered shape of buttocks
      • Underdeveloped buttocks may be due to lack of adequate gluteal muscles or lack of gluteal fat pads. It may also be due to altered shape of lower spine i.e. lack of Lordosis ( curvature of spine and pelvis that gives shape to the buttock region). People who are born with exaggerated lordosis of lower spine have naturally round buttocks.
      • Buttock undergoes a lot of volume and aging changes. Loss of weight due to pregnancy or excessive dieting may resort the fat in the buttock region causing sagging of buttocks. In some people abnormal deposits of fat around the buttock changes the shape of the buttock.

There are three basic shapes of buttock

  • A shaped – with narrow upper part of buttock and wider lower part
  • V shaped buttock- is wider upper part and narrow lower part of buttocks
  • Square shaped – as name suggested it is squarish in shape with wider upper and lower part and a narrow midpart
  • Round shaped

A- shape tends to be the most attractive and desired buttock shape and it occurs in about 30% of the population.

Round shape globally is second most popular shape of buttock, but in modern days and mostly in the Central Asia, Latin America, round shape is the most sort after shape for all women.


  • Gluteal implants- this remains the first choice for women with very small and flat buttocks and particularly if they lack significant amount of body fat i.e. BMI lower than 18-20.
  • Fat grafting- adding fat to increase the size has become the number one procedure in gluteal enhancement. It is suitable in all patients with adequate fat available to harvest I.e BMI more than 20.
  • Buttock contouring or gluteal reshaping is an entirely new concept considering the altered shape of the buttocks. It is a scientific fact that abnormal distribution of fat around the buttock region is the cause of dissatisfaction in women. The excess fat in the love handles, on the sacral region, saddle bag region are primary cause of unaesthetic shape of buttock. Removal of fat from this region in itself is good enough to improve the shape of the buttocks. Adding the fat to buttock projection enhances the shape of the breasts.
  • Composite buttock augmentation – this is also a new concept where combination of implants and gluteal reshaping is performed to improve the shape of the buttocks. This is for patients who are expecting dramatic improvement in the buttock size and shape. Just adding a silicone implant to buttock may only increase the projection, but to alter the shape to a more favored shape requires additional fat removal and addition to key areas.

Changing the shape of buttock from v- shaped or square shaped to more aesthetic A – shaped or Round shaped is the basics of Brazilian butt augmentation.

It is performed to improve the following aspects of lower body

  • Buttock projection
  • Aesthetic waist- buttock proportion
  • Favorable shape of the buttocks
  • And classical ” coke bottle ” figure to the body

It is important to visit your plastic surgeon and address your issues. Your surgeon with thoroughly evaluate your body. He/ she will assess the gluteal muscles, fat distribution, bony shape, overall framework of your buttocks and general figure of your body. Along with this a medical evaluation is done to ensure medical fitness. He or she then would explain to you regarding your buttock shape either by taking photographs or drawing free hand. This is followed by various options suitable to your needs will be offered. On detail discussion with your surgeon, you will be able to understand the correct procedure that best fits your body.

  • Buttock or gluteal implants- this procedure is performed under general anaesthesia in hospital. Two incisions are made in each gluteal fold, a plane is created either ” Intramuscular” inside the gluteal muscles or ” subfacial” above the muscles based in the requirement. The selected size of implant is then inserted in the pocket and wounds sutured. A drain is left in place for 3-4 days.
  • Brazilian buttock augmentation- this procedure can be performed either under general anaesthesia or local anaesthesia with IV sedation. The areas of excess fat is marked in the abdomen, waistline, bra rolls, flanks, trochanter etc. the fat is removed by using ultrasonic device that allows gentle and nontraumatic liposuction.

The fat is collected in a special disposable device where it is washed and filtered to separate pure fat cells. The collected fat is then distributed in the buttock region in multiple planes such as intramuscular, subfacial and subcutaneous region. Typically 600-1500 ml of fat is injected depending upon the need and availability of fat to achieve the desired result.

Some of the wounds are sutured to prevent fat leak. A special dressing is applied to the areas.

  • Buttock implant procedure involves 2-3 days of hospitalization where they sleep in their tummy. They are ambulated on a daily basis. At home patent continues to lie in tummy for 2-3 weeks. They are allowed to walk and stand but not to sit for first 3 weeks. Alternatively they can sit on a ” donought” pillow that distributes pressure on the rim of the buttocks. Antibiotics and analgesics are required for 1 week followed by normal pain killers on as necessary basis. Patients can start exercise after 4-6 weeks under the surgeons supervision.
  • After Brazilian butt augmentation a dressing is applied that allows discharge for the first 24-48 hours. The dressing is then replaced with a special pressure garment that has a window for the buttocks. Patients are up and about the next day, but need to sleep on their tummy for 3-4 weeks. After 10 days they are allowed to sit in a soft cushion to avoid excessive pressure. Exercise can only be resumed after 6-8 weeks for favorable outcome.

Buttock implant carries risks of haematoma, infection, wound dehiscence, implant displacement etc. the complications can be minimized by a proper preoperative evaluation and postoperative care. The key factors to prevent complications include discontinuing smoking, blood thinners such as aspirin, vitamins and maintaining healthy lifestyle. A regular visit to surgeons office for evaluation is also important to prevent and treat complications early.

Brazilian butt augmentation risks are very low but may include bleeding, infection, contour deformities, asymmetry, fat resorption etc.