Brazilian buttock lift is a surgical procedure to augment the buttock region and to enhance an hourglass body figure. It is performed under general anesthetic as out-patient surgery. Fat is first harvested through liposuction of other body regions, most commonly the abdomen, hips, or thighs. The aspirated fat is carefully prepared and then injected into the buttocks to create a full and round contour. The procedure uses the patient’s own fatty tissue exclusively and eliminates the need for implants.
Patients are required to wear a compression garment post-operatively for 6 weeks to reduce swelling and to expedite healing. They may generally return to work within 1-2 weeks. Sitting and lying on one’s back should be minimized over the first 6 weeks following Brazilian buttock lift. Exercise and strenuous activity may also be resumed at that time point.
"The biggest hurdle for a lot of women is coming in for the consultation. Many do not want to appear vain or they feel guilty about finally spending money on themselves."
- DR. STEPHANIE POWER
Patients considering Brazilian buttock lift often express concerns regarding decreased waistline definition and flat buttock contour. The buttocks may lose volume and begin to sag following pregnancies and weight loss. Patients wish to augment their buttocks to create a fuller and more youthful appearance while achieving greater definition of the waistline. This may enhance an hourglass figure. Patients may also present with concerns regarding increased fatty deposition at other body sites, which may be effectively treated with liposuction. Brazilian buttock lift offers the bonus of utilizing this aspirated fatty tissue to augment the buttocks. It eliminates implant-related complications, including capsular contracture, foreign body infection, and unnatural palpability, given that autologous body tissue is used exclusively.
An appropriate candidate for Brazilian buttock lift is of healthy body mass index (BMI) and a non-smoker. Other medical conditions should be appropriately managed and stable prior to undergoing elective cosmetic surgery. Smoking cessation is recommended for at least 1 month before and after surgery to low risk of healing complications. An appropriate candidate must also have adequate fat stores at other body sites to allow fat harvest and later injection into the buttocks. They must understand the risks and benefits as well as potential limitations of surgery. Buttock volume that is achieved depends on availability of fatty tissue at other sites for harvest and also how much fat survives the injection process, which depends on many factors as discussed below.
Comment donor sites for Brazilian buttock lift include the abdomen, flanks, upper back, and thighs. Normal skin elasticity must be found at these donor sites to permit skin retraction following liposuction. If decreased skin elasticity is present, redundant skin and associated contour deformities may result at the donor sites following liposuction. This is an important consideration for the abdomen following history of pregnancies. The skin has often stretched beyond its ability to fully retract, which may lead to aesthetic complications if the abdomen is selected as a donor site for Brazilian buttock lift. In these cases, a tummy tuck may be more appropriate to remove the redundant skin. In most cases, Brazilian buttock lift and tummy tuck are not recommended during the same procedure given increased risk of complications relating to anticipated length and extent of surgery. It may be recommended to stage the Brazilian buttock lift and tummy tuck several months apart to allow further healing in the interim. In these cases Brazilian buttock lift is generally recommended as the first procedure to maximize the available fat for harvest and injections.
The patient is taken to the operating room and placed under general anesthetic when lying supine. In this position, fat is first harvested through gentle liposuction from the pre-selected donor sites on the front of the body. Following sufficient harvest, the patient is then repositioned carefully to lie on the stomach while still asleep. Great care is taken during this repositioning maneuver to ensure that the endotracheal tube is secured and that pressure points are carefully padded. Surgery is then resumed on the back of the body, harvesting further fat from donor sites as needed. Transferring to prone position for Brazilian buttock lift enables complete visualization of both sides of the back and buttocks during the procedure.
It is important for this procedure to be performed in an accredited operating room facility with a board-certified anesthesiologist to ensure patient safety, particularly in prone position. Careful monitoring is performed throughout the surgery during repositioning maneuvers and different stages of surgery to ensure patient safety.
Following completion of liposuction, the fat is prepared and then injected into the buttocks for desired contour improvement. A few small access incisions, 3-4mm in length, are used to harvest and inject the fat. These are carefully placed in concealed sites to lower visibility once healed.
Following surgery, you will awaken in the post-operative recovery room lying on your side. A compression garment will be in place, generally covering the abdomen, buttocks, and thighs. This provides gentle compression of the donor sites and buttocks to decrease discomfort, swelling, and risk of bleeding. It also holds gauze dressings in place as some drainage is expected during early healing from the liposuction sites.
Once ambulating to the washroom with assistance, tolerating fluids and oral pain medication, patients are discharged home. It is important to have a responsible adult stay with you for at least 24 hours following the general anesthetic. A prescription for post-operative pain medication will be provided in advance. This should be filled beforehand to ensure that you are able to return directly home following surgery. Tylenol #3 is generally required for a few days post-operatively and may then be transitioned to Tylenol plain as needed. It is important to lie on your side or stomach during recovery and to minimize time spent lying on your back and sitting. This will reduce the pressure placed on the buttocks during early healing as a new blood supply is established to the injected fat. Walking short distances is encouraged soon after surgery to lower the risk of developing venous thromboembolic complications.
Most patients are able to wean from narcotic pain medication within 2 or 3 days of surgery. It is recommended to minimize time sitting over the first 4-6 weeks. This is important as a new blood supply is established to the injected fat within the buttocks. Reducing pressure on the buttocks during early healing may maximize the percentage of fat that survives the injection process to achieve the best possible cosmetic outcome. Patients may return to work within 1-2 weeks following surgery. If job requirements are physically strenuous, longer recovery time may be recommended. This should be discussed with Dr. Power pre-operatively if any concerns.
As with most elective cosmetic surgeries, it is recommended to achieve a healthy BMI prior to surgery. A body mass index of 30 or less, ideally closer to 25, is recommended before proceeding with surgery. It is important for weight to be stable for approximately 6 months prior to surgery to achieve more predictable results. It is a balance when considering BMI prior to Brazilian buttock lift. A lower BMI is recommended to lower risk of systemic complications prior to undergoing elective surgery. Adequate fat stores are required however to achieve a patient’s aesthetic goals relating to injection volume. The degree of augmentation is limited by the availability of donor sites. A thin patient with inadequate fatty tissue at other sites may be unable to proceed with Brazilian buttock lift given that sufficient tissue would not be available for augmentation. Clinical examination is important pre-operatively to assess donor sites and to determine whether the available donor fat may meet a patient’s goals.
It is recommended to refrain from exercise over 6 weeks post-operatively. Any exercise that increases heart rate or blood pressure may increase risk of bleeding, bruising, and further swelling. The compression garment may be discontinued at 6 weeks post-operatively, which will also facilitate exercise.
You will typically experience localized discomfort of the donor sites and buttocks during early healing. The procedure is generally not as painful as more extensive types of plastic surgery, for example, the muscle repair site following tummy tuck or breast implants placed below the pectoralis muscle. Prescription pain medication is usually required for a few days. Brazilian buttock lift involves surgery on the fatty tissue layers at both donor and injection sites. Fat is not injected into the gluteus (buttock) muscles to lower risk of complications, particularly emboli. It is recommended to discontinue pain medication as soon as possible to lower risk of complications, including constipation and potential for dependency.
The post-operative compression garment is recommended for 6 weeks. It places gentle compression on the donor sites and buttocks, which may reduce discomfort. It also reduces swelling and maintains contour during early healing. It is controversial following Brazilian buttock lift whether the buttocks should be included in the garment or whether cut-outs are recommended to decrease pressure placed on the surgical sites. Within my practice I recommend a garment maintaining gentle compression of the buttocks to minimize swelling and to support shape during early recovery and healing. While the garment applies gentle compression to the buttocks, it is still recommended to refrain from sitting and lying on your back as much as possible over the first 6 weeks as a new blood supply becomes established to the injected fat.
Not all fat that is injected during Brazilian buttock lift will survive the injection process. Results at 6 months should be long-lasting once a blood supply has been restored to the injected fat. Results may fluctuate however with changes in body weight. If a patient gains or loses weight in the future, the buttocks may fluctuate in size accordingly.
There are various techniques employed to maximize fat graft take within the buttocks. The fat is harvested through gentle liposuction, which is more time-consuming but less traumatic to the fat cells than greater suction. The fat is then allowed to settle under gravity to remove the oil and water components. The purified fat is then injected within multiple planes of the buttock soft tissues, avoiding the muscles given risk of emboli. Fat is injected within multiple planes to increase the surface area of fat in contact with the recipient bed tissues. This may result in a more robust blood supply and higher percentage of fat graft take. Local anesthetic is also avoided within the tumescent fluid based on studies that suggest that it may reduce viability of fat cells following injection. Following recommended activity modifications post-operatively may also promote fat graft take. Avoiding excess pressure on the buttocks during early healing is important as the blood supply becomes established. Lying on your back and sitting should be avoided as much as possible over 6 weeks following Brazilian buttock lift.
Brazilian buttock lift poses systemic as well as local risks, relating to both the donor and recipient sites. Donor site risks are similar to those following liposuction alone, including bleeding, hematoma, infection, altered sensation, skin pigmentation changes, contour irregularities, fluid collection, potential injury to surrounding structures, and risk of emboli.
Recipient site complications including similar risks of bleeding, hematoma, delayed wound healing, and infection, as well as incomplete graft take leading to loss of volume, fat necrosis, nodularity, asymmetry, emboli, and dissatisfaction with aesthetic outcome. Risks of fat emboli and serious systemic complications are low. Risk of venous thromboembolism, including DVT or pulmonary embolism, is also reduced by placing compression pumps on the lower extremities during surgery and encouraging early ambulation.
As with any elective cosmetic surgery, risk of complications may be reduced by selecting appropriate candidates. It is important that surgical risks are calculated. Recommendations regarding smoking cessation, weight loss, or other medical conditions may be made pre-operatively before undergoing Brazilian buttock lift. It is imperative for surgery to be performed in an accredited facility with a board-certified plastic surgeon and anesthesiologist to ensure patient safety.