The procedure of increasing the size of the buttocks and re-shaping them using the patient’s own fat is now referred to, in the United States, as the “Brazilian Butt Lift.” This name evolved because the procedure was primarily performed by surgeons in Brazil, and they were the first to report results in the universal medical literature. The true medical term would be “autologous [i.e. your own] fat grafting to the gluteal area.”
Originally, surgeons were grafting (injecting) small amounts of fat into the buttocks or gluteal areas. Over time, as physicians felt confident and saw no complications with this procedure, the amounts of fat being injected were larger. Fat grafting not only allowed for correction of some deficiencies in the area, but also increased the size of the buttocks, and lifted them to a greater extent.
The “ideal” female has full buttocks that are 1.4 times the circumference of the waist. Removing excess fat from around the buttocks (i.e. from the lower back, and even from the lateral aspects of the thighs) and afterwards injecting the fat into the gluteal areas, allows the surgeon to improve the patient’s æsthetics by reaching the above-mentioned “ideal” proportion.
The “Brazilian Butt Lift procedure is performed in conjunction with liposuction, which will be carried out to a greater or lesser extent, as needed, in order to harvest the appropriate amount of fat to be injected in the buttocks. The typical procedure involves liposuction of the abdomen and back (upper back, lower back, or both), which usually supplies enough fat to perform the grafting.
Depending on the physician, the harvested fat is processed and refined in different ways. In our practice, in order to ensure the maximum “take” (i.e. persistence and non-reabsorption) of the fat graft, the tissue is carefully harvested in sterile containers, and then placed in a centrifuge in order to separate the fat cells from any other material that is not needed. The refined fatty tissue is loaded into small syringes, and then injected in layers in the buttocks using a small cannula that allows performance of micro-grafts, which have greater chance of survival. It is the general consensus, and our experience as well, that most of the fat survives with this technique. We have not had any major complications related to this procedure of fat-grafting to the buttocks, and patients report no pain related to the procedure.
The procedure can be done under general anesthesia or even with sedation plus local anesthesia. In our practice, either way the procedure is performed, we have an anesthetist providing anesthesia services to ensure the safety of our patients, and to ensure a relaxed and pleasant surgical experience. Most patients can undergo this surgery and be discharged home the same day. Small incisions, like the ones performed for routine liposuction, are made, and these are also used to insert the cannula for the injections. The recovery time varies depending on the extent of the liposuction. Usually we advise the patients to wait 7 days before they go back to their regular activities. Considering the fact that the patient is also undergoing (and benefiting from) liposuction, the increased cost of the surgery is very reasonable.
As is well known, the first attempts at increasing the size of the buttocks were performed with implants. Different kinds of implants in different anatomical locations have been described over time. Even though this kind of surgery has been successful, it involves a long and fairly painful postoperative recovery time of about 2-3 weeks, and a variety of complications that could lead to the need for postoperative wound care, which might extend from 1 to 3 months. Even though the complications from this type of implant surgery can be managed, they always create additional expenses, not to mention anxiety, for the patient. For that reason, these days the procedure is commonly reserved for patients who do not have sufficient amounts of excess fat to undergo fat-grafting of the buttocks.
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