It’s final! Nowadays the derriere is a main beauty attribute and many people, especially women, feel that nature has not been generous with them.

One of the solutions devised for this problem is transplanting patient’s own fat to the butt.

Some claim Brazilian surgeon Ivo Pitanguy invented the technique, other says it’s was invented in the USA; whatever it may be, there’s the belief that fat, as an autologous tissue, can be considered an ideal filler because of its biocompatibility.

Many colleagues think that if fat grafts are manipulated correctly, fat grafting represents a safe and natural looking buttocks augmentation method even if results aren’t long lasting.

However things should be taken with a grain of salt because all that hype around Brazilian Butt Lift (BBL) tends to raise unreasonable expectations, finally ending up in great frustration and dissatisfaction when patients realize that the procedure was not what they thought it’d be.

We put an effort in making an objective analysis of the Fat Transfer/Grafting procedure on Buttocks, based on studies and medical articles published in recognized scientific journals but without all those technical details that are difficult to understand by the general public.

We believe the result is a very digestible piece of information which clearly illustrates what you really could expect from a Brazilian Butt Lift procedure, what BBL is and what’s not.

The idea of this work is helping to understand what the pioneers in the subject have said in the past and nowadays, according to their experience as well as adding our own vision based on many years of practice.

The crucial point we would like you to think about, is evaluating how true is the fact that with your own fat you can get a significant, long-lasting and complication-free buttock volume, regardless of whether or not you are a good fat donor or if you have the quantity and/or the quality of adipose tissues required for this procedure.

An excessive media exposure of BBL along with compelling campaigns against dermal fillers of unknown origin, had the effect that many people turned to BBL having irrational expectations about a procedure which is marketed with lot of promises and without  questionings of any kind.

After all, when one is told that BBL utilizes an autologous material, 100% biocompatible since it’s performed with your own fat, one tends to believe that the procedure has no contraindications of any kind but only great results, being reality rather different.

A bit of history

Fat transfer a.k.a fat grafting had been used over the last five decades for body and face contouring and reconstruction, even though the first attempts to transplant fat date back to the very first decades of the 20th century when Holländer, Lexer and Gillies among others, showed in their papers and  books, patients treated with fat grafting after diseases or injuries.

Many controversies have arisen about the efficacy of fat transfer as a mean of contouring, enhancing and augmenting areas of body and face or simply restoring tissue lack of volume after fat loss due to aging, diets or diseases.

Such differences in opinions cover topics such as the percentage of fat cells that survive after transplantation (i.e. fat grafts lifespan) as well as the best methods for harvesting fat, processing it and transplanting it.

The survival of fat cells (adipocytes) has been a great concern for plastic surgeons, especially from the invention of liposuction by Fischer in 1974 and its subsequent improvement in 1978 when the French physicians Illouz and Fournier further developed the procedure utilizing blunt cannulas that made the process of fat extraction more reliable.

By the early eighties, liposuction became quite popular in the United States when Klein, a dermatologist, invented the tumescent technique for liposuction that allowed patients to have it performed totally under local anaesthesia with less bleeding and traumatism.

In the nineties, Dr. Sydney Coleman set a milestone when he described standardized techniques for fat extraction, processing and injection of fat grafting which are used up to now with minor modifications.

Despite all the efforts made by surgeons, it is a fact that life expectancy of fat grafts tends to be quite low; soon after fat transplantation, some cells called macrophages start eliminating the new adipocytes causing what is called fat resorption.

Some authors estimate fat resorption rate at around 40-60% after six months of the procedure; some say that up to 90% of the injected fat will have disappeared after a year.

How Fat Transfer Works

Until recently there was no good understanding of the mechanism of survival of implanted fat cells but some research is shedding light about it, revealing that there are three different zones that demarcate the survival rate of the adipocytes or fat cells.

  1. The outermost superficial zone where the adipocytes tend to have a high survival rate in a process quite similar to the physiology of skin grafts. The theory suggests that donor adipocytes survive by oxygen diffusion at the recipient site during the initial days after grafting.
  2. The intermediate zone which shows both surviving adipocytes along with dead ones. In this zone fat cells do not succeed to survive, however adipose-derived stem cells, 4 to 12 weeks after procedure, experience some level of adipogenesis (creation of new adipocytes)
  3. Finally, the deepest inner zone where transplanted fat cells are not bound to survive, instead lot of fibrosis is created (thickening and scarring of the tissues). Practically all of the transplanted fat into this inner zone will be reabsorbed quickly and often developing fibrous tissue, cysts, lumps as well as other complications such as infections, necrosis and seroma.

In theory, fat grafting success could be improved in all of the three phases of the process, namely, fat harvesting, fat processing and fat grafting.

Specialists will perform each of these three phases under their own criteria and experience always committed to achieving the best possible results.

Now, summing up and getting back to the initial question:
What could you realistically expect out of Brazilian Butt Lift?

Well, the answer is that there are bad news and good news. If what you expected was a butt like Nicki Minaj’s one, let us say, no, it’s not feasible.

Good news are that, even though you won’t achieve the kind of booties you see in Hip Hop videos, still you could highly benefit from a BBL performed under the right parameters.

First of all, a superb lipo contouring procedure thoroughly performed on all of your body instead of on a by-the-area-basis will make your derriere to stand out on its own.

To achieve this goal, in our practice we apply a dual technique approach: in those areas aimed to harvest fat for transplantation purposes, we use the tumescent technique for maximum adipocytes survival rate, whereas the rest of the body is treated with advanced vaser technology maximizing shaping and contouring whilst minimizing traumatism.

This optimal contouring procedure guarantees bringing out the best of your buttocks by molding and shaping the areas that were causing distortion of glutes shape besides outshining them with all that accumulated fat in the wrong places.

Moreover, taking advantage of the liposuction procedure that’s been performed during BBL, surgeon can add that final touch, sculpting patient’s abs for a gorgeous look being that well defined abs are a much coveted beauty feature nowadays, both in men and women. In the case of women, no need to go to extremes such as chocolate abs, just beautiful and demarcated abdominal muscles work perfect.

And lastly, the cherry on the cake will be given by the fat grafting process; no need to have augmentation as such in mind but rather a conservative view in which your overall appearance is what matters.

This article has been written in collaboration with our team of specialists Dr. Hernando Larios, Dr. Jesus Garcia and Dr. Ignacio Lemarquis.

Bibliography

Fat Grafting in Body Contouring
(https://www.researchgate.net/publication/311694736_Fat_Grafting_in_Body_Contouring)

Adipose-derived Stem Cells: Isolation, Expansion and Differentiation.
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668445/)

Adipose Tissue-Derived Stem Cells in Regenerative Medicine
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040903/)