What are the different kinds of plastic surgeons? 

Dr. Schulman: All board certified plastic surgeons are trained in all aspects of cosmetic and reconstructive surgery for the face and body. This usually requires 6-8 years of specialized training after medical school. This is general training and many go on to specialize in specific types of procedures, sometimes requiring additional 1-2 years of training.  For cosmetic surgery, you want a Board Certified Plastic Surgeon who specializes in cosmetic surgery. Be careful and don’t be fooled though, because  there is something called a “cosmetic surgeon.”  This is simply any doctor – radiologists, general surgeon, cardiologist, gynecologist, etc. – who decided that they now want to perform cosmetic surgery and probably took a few weekend courses, and now has the ability to call themselves a “cosmetic surgeon.”  It can be very confusing to the general public and the American Society of Plastic Surgeons is always actively trying to educate the public about the difference between the two.

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What health conditions should be considered before signing on for surgery?

Dr. McKnight-Baron: Patients should stop smoking nicotine-containing products 4 weeks prior to any surgical procedure and 4-6 weeks after to avoid potential wound healing problems. A patient should be healthy enough to undergo general anesthesia. A physical examination with your primary care doctor should reveal most potential issues and determine your perioperative risk.

What are the different kinds of butt enhancement surgeries?

Dr. Schulman: There are only two safe ways to increase the size of your buttocks: injections of your own fat that are obtained through liposuction (this is called fat grafting), or buttock implants that are placed in the buttock, similar to the idea of breast implants.  Injections of other synthetic materials such as silicone are dangerous, potentially life=threatening, and illegal! No board certified plastic surgeon in the US will ever perform buttock injections with material other than your own fat.

Dr. McKnight-Baron: The methods that are FDA approved and performed by specialty-trained plastic surgeons are fat grafting/injections and gluteal silicone implants. The fat injections, also known as the Brazilian Butt Lift, consist of liposuction from the abdomen, flanks, hips, thighs, etc. to harvest the fat and then injection of the fat in small quantities into the gluteal muscle and surrounding tissue for augmentation. Silicone implant gluteal augmentation is when a gluteal implant (very different from a breast implant) is placed either within or on top of the gluteal muscles for enhancement. What is not FDA approved is injection of free/liquid silicone, polymers, PMMA, hydrogel or other synthetic substances in large quantities into the buttocks. These are often the substances that you hear horror stories about.

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Which is the more popular procedure?

Dr. Salzhaeur: The American Society of Asthetic Surgeons noted a 58% increase in the number of BBL’s in 2013. More than 10,000 women underwent this procedure in the US alone, with thousands more opting to do it overseas in Mexico or South America.

Dr. McKnight-Baron: The Brazilian Butt Lift/fat grafting is probably the most popular because in addition to enhancing the gluteal region, the patient is getting contouring in an alternate area that will likely lead to a more pleasing aesthetic result. For example, liposuction of the waist/flanks and abdomen paired with fat grafting to the buttocks will create more of a “Coke bottle” effect than if the gluteal augmentation were to be performed alone. Also the fat injected is the patient’s own tissue and is less prone to warping, infection, or the need for corrective surgery if issues arise, which is not the case with gluteal implants. If an implant becomes infected or develops scar tissue around it (capsular contracture), then it may warrant removal or revision of the implant pocket.

What are the costs of butt injections vs. butt implants?

Dr. McKnight-Baron: Gluteal augmentation has a broad range of prices. Fat injections can range anywhere from $4,000-$20,000 and up depending on the state and on the amount of fat that needs to be harvested and injected. The fat injections can be more costly because the operation is more labor intensive for the physician and it takes more time in the operating room. Gluteal implants can range from $4,500-$8,000 still depending on the state and the patient’s body shape.

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