Is your derriere letting you down? See the options to to give it a lift

Dr A Bolin

A curvaceous behind is in high demand as celebrities tout their booty – but what exactly is involved. Dr A Bolin finds out from plastic surgeon Naveen Cavale.


It may not have made it into the top ten list of most performed procedures in the UK but the popularity of a ‘butt lift’ is rising. The likes of Nicki Minaj, Kim Kardashian,  Beyonce and J. Lo, have put curves back in fashion. Some celebrities openly discuss what nips and tucks they have undergone while others mysteriously become more voluptuous vowing they have not had any work done.

Either way, their shapely forms have stuck a cord even if many women are opting for a more subtle way to reverse the effects of gravity.  So what are the options available to maintain or even gain the curves we so desire?

As it turns out, there is a myriad of choices for cosmetic procedures and plastic surgery, as plastic surgeon, Naveen Cavale, has helped explain.

Options for our derrières?

There are various treatments for what is known as gluteal augmentation:

  1. Brazilian Butt Lift: liposuction of available fat in abdomen, thighs, hips, etc. which is purified then injected to the buttocks (fat grafting technique). This is no longer recommended as there is a high risk of death from this type of procedure.
  2. Buttock implants: similar to silicone breast implants that need to be replaced over time
  3. Butt Lift (surgical): surgical nip and tuck to lift buttocks. This is done mostly in cases of dramatic weight loss or aging where there is excess skin)
  4. Buttock fillers: hyaluronic acid fillers. (*beware of cement or non-medical silicone. Always have these done by a professional who will use a medical grade and appropriate fillers.)



What is a Brazilian butt lift?

It is liposculpting or fat grafting. Basically, the procedure involves taking your own excess fat from areas where you don’t want it (usually from abdomen, hips or thighs) by liposuction, processing it and then injecting it into the buttock region.  As they are your own fat cells, the goal is for them to fuse into the existing tissue in the buttocks (with new blood vessels forming in order for the fat to survive) for a permanent sculpt that achieves the most optimally achieved shape.

The plus side of this is that there is less of a chance of rejection since the fat is from your own body.


How many treatments would I need?

According to Naveen Cavale, 2 to 3 treatments which are spaced about 3-6 months apart are usually necessary to achieve the final result.  The reason for this is that a certain amount of fat transferred will not survive, so further treatments will work cumulatively towards the final results.


How much volume should I go for?

As opposed to saying ‘the biggest possible’, the goal should be safety first and then to consider a few treatments in order to achieve a reasonable volume. Due to the potential medical complications (see below), Mr. Naveen Cavale recommends no more than 200 cc’s injected into each buttock per treatment.

He advises being wary of surgeons offering too much volume as there is a significantly higher risk of fat necrosis (when the fat dies, turns to liquid, and needs to be drained with the added risk of infection).


What are potential complications?

As with any procedure, there is a risk of bleeding, infection, scarring, sepsis and very rarely a fat embolus (if injected into a blood vessel) – which can be fatal. For this reason this procedure is no

An adequate blood supply is necessary to keep the transplanted fat alive, and this will take a little time to form. This is while not all the cells transplanted survive. And a problem related to symmetry can arise if different amounts of fat survive on each side. This will mean the sides don’t quite match is size or shape.


Are there any reasons why I shouldn’t have a procedure?

In general, it is not recommended to undergo a cosmetic or aesthetic surgical procedure if you are a smoker, have diabetes, are on systemic steroids, have chronic illnesses involving cardiac (heart) or respiratory systems (lungs). Pregnant woman cannot have the procedure.

If you are very slim with lack of sufficient fat, this procedure may not be possible.


Maybe I could get the same job done abroad for cheaper?

Mr Naveen Cavale has seen botched jobs from nip tuck vacations to countries including the Dominican Republic, Turkey and Tunisia. There are numerous countries and companies that advertise medical tourism procedures for cheaper.

However, “quality control as well as appropriate post-operative follow-up care is often not optimal”.  There are many cases of patients being left with infection, scarring and complications (and the occasional death!) after having a cosmetic procedure abroad.

What if something goes wrong after the procedure?

Many cosmetic surgeons, clinics and hospitals are insured, which covers any medical complications in the two year period after having a treatment. In addition, all surgeons in the UK are required to have medical indemnity insurance with run-off cover – this provides cover for legal expenses for many years after surgery. The surgeon who did the treatment should always been open (within a certain window of time) to assess you and deal with any medical problems that arise after the procedure.


What about buttock implants?

Unlike breast implants buttock implants have to deal with quite a lot of wear and tear since you sit on them.

As a cosmetic procedure, there is a large incision to insert the implant (which is hidden as much as possible in naturally occurring folds of the skin).

There is a risk of the implant rupturing or becoming displaced, nerve damage, areas of the buttock being firmer than others, needing replacement, infection and scarring.

Due to these complications, many people are opting for the less invasive options such as the Brazilian butt lift (lipofilling or lipografting). In certain cases, implants might be the best choice for you, but the procedure is becoming less popular.


What is a surgical butt lift and when would it be a good idea?

If you have a flat bottom and have sagging excess skin in the buttock region due to significant weight loss or aging, this might be the right match for you. With the extra skin, no amount of crossfit or squats are going to give you more volume to fill out the skin but this type of surgery, which doesn’t add fillers, cleverly removes the excess and shapes the remaining skin to give a firmer, lifted effect.

If excess skin is making you feel embarrassed and you are at a stable weight, this would be an option to consider.

The benefit is a permanent procedure that sculpts, defines and lifts the buttocks. As it is a surgery, the recovery could take a few months. But remember, if you lose more weight, the result could be compromised.

What about fillers for buttocks?

Hyaluronic acid fillers are used sometimes to enhance the buttocks, but the procedure is not permanent and needs to be repeated. Depending on the resilience of the type of filler used the results could last 12-18 months. On the upside it’s an immediate result but there can be problems with symmetry and it needs to be repeated. Is it also quite expensive with come clinics charging £2000-4000 depeinding on how much filler is used.

*There are many illegal substances that have been injected, causing pain and even resulting in death. In the UK the trend is very much heading away from fillers in the buttocks.


Keeping it real: managing expectations?

Remember that your derriere is only one part of you.  Your wellbeing, confidence and personality should be enhanced, not defined by it.  When considering your shape and image, work toward the best match for you, as opposed to wanting to look like someone else.

The idea of any aesthetic or cosmetic procedure is to be as good of a match as possible to your shape and form.

Also, cosmetic and aesthetic surgery are medical procedures with risks and benefits. Be aware of this and consider strongly which option and risks are the right match for what you are looking to achieve.

How do I choose my surgeon?

Your surgeon and you are going to have a medical and professional relationship.  Choose wisely.

Check that your surgeon is registered on the GMC Specialist register, that they are a member of professional bodies such as BAAPS or BAPRAS.

Ask to see before and after picture and what their after care procedure is. You need to feel comfortable with your surgeon and vice versa.  If something doesn’t seem right, remember that you can always seek a second or third opinion.

Special thanks to Mr Naveen Cavale, BSc(Hons) MBBS MSc FRCSEd(Plast), Consultant Plastic & Cosmetic Surgeon at Real Plastic Surgery London for contributing to the content of this article.


Part II: Plastic Surgeon, Nora Nugent gives her pro’s and cons on the treatments available.


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