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Image: Bradley Gordon, Licensed under Creative Commons Cropped from original photo

by Joshua Zuckerman, MD, FACS

Unless you haven’t watched TV or online videos or haven’t seen a magazine or read a Huffington Post story lately, you know that all of a sudden it seems that buttocks are the new bottom line in beauty.

The Hollywood Reporter’s headline says it all: “From Jennifer Lopez to Kim Kardashian: How Butts Stole The Spotlight From Breasts.” The article cites the fact that the American Society of Plastic Surgeons reports buttock enhancement (or Brazilian Butt Lifts, as they are commonly known) as the fastest growing plastic surgical procedure. The ASPS, in fact, says that buttock lifts (as opposed to buttock implants) have risen 158% in the years between 2000 (long before the “twerking phenomenon” broke) and 2014.

Companies like “Booty Pop” have arisen and are making millions on padded panties. Award shows like the Academy Awards and the Grammys focus on the stars’ rear view. Well-rounded buttocks sloping down from a slender, well-defined waist are now the culturally desired shape for women (and also for men).

This may all seem new, but I can assure you, it’s not. Apart from differences in size and focus, there has not been a time in recent memory where a firm and well-rounded derriere was not considered fashionable or attractive–think of Marilyn Monroe and much earlier, of the Victorian bustle. The difference is, perhaps, in prominence and in society’s new freedom in discussing the beauty of a firm and fit rear view.

There is also the fact that plastic surgical solutions now offer a wide range of safe and effective options for patients who want more prominent, firmer or fitter buttocks.

Buttock augmentation (also called the Brazilian Butt Lift because of its popularity in a culture used to baring buttock cheeks in “dental floss”-like bathing suits) is the procedure of choice for many patients. The procedure involves fat harvesting (usually from the lower back and flanks) which is then grafted into the patient’s buttocks. The fat harvesting is done via liposuction. Grafting uses about four or five tiny incisions, through which a 2 millimeter grafting cannula is inserted. We usually hide these in the crease of the bottom so there is no problem with scarring.

We prefer fat grafting over implants because it’s always better to use a patient’s own fat stores for sculpting. If a patient is particularly thin and fat grafting is an issue, we can also consider implants as a solution.

Recovery time involves a period of about two weeks where you can’t sit at all and you must sleep on your stomach. Patients interested in undergoing this procedure should be prepared to comply with this restriction.

The result is a firmer, higher and more prominent butt. The lift usually results in firmer, better looking skin in the region, too. A lift using fat grafting looks and feels like real buttock tissue (it is the patient’s own fat and is indistinguishable from the tissue that was there before surgery) and can last about ten years. There is some predictable loss of grafted fat over the first several months to one year after surgery, but at least 50 to 75 percent remains at one year and then potentially for 10 years or more. After the natural lifetime of the surgical effect (about 10 years), the patient can repeat the procedure if they have sufficient donor fat for grafting (from the back, flanks, abdomen, thighs or even arms).

The popularity of buttock augmentation has also risen among men. Men may choose the surgery because it gives an overall more youthful appearance. Your suit will hang better–both in the pants and over the pants–and you’ll avoid the “old man’s butt” profile that is so distinctly associated with age.

For both women and men, society’s new love affair with the buttocks doesn’t show any sign of fading. Buttock enhancement is one of our most requested surgeries. It is also one of the surgeries we do that has the highest rate of patient satisfaction.

If you have any questions or thoughts on buttock enhancement, Dr. Zuckerman would be happy to hear from you. Send an email to


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