In my practice, 2015 could be called “The Year of the Rear” because buttock procedures have exploded in popularity. Both men and women are having procedures done in higher numbers than ever before.

The most commonly requested procedure is known as the Brazilian butt lift. There are a handful of high profile celebrities that deny having it done, while clear photographic evidence shows that they have. Luckily for them and the rest of us, the butt lift operation has undergone a transformation in recent years resulting in a much improved, more reliable end result (pun intended). A desired booty is now within reach for everyone – literally.

A little history of the buttock lift is helpful. Buttock enhancements have been done in a number of ways for many years. Many of these methods included an implant of some sort. It is important to understand that buttock implants can be troublesome, especially because, by necessity, they come in pairs. It always comes down to whether the pair is even. Symmetry is a beautiful thing, and never more so than with the buttocks. And that’s where the Brazilian technique comes in.

Brazilian butt lifts were a popular procedure in 2015. New technology provides more options and better outcomes.

The reason symmetry issues rarely occur with the Brazilian butt lift is the fact that the buttocks are sculpted with no implants. As with all plastic surgery procedures, this is where the artistic intuition of the surgeon comes into play. Sculpting is the ultimate expression of art. This is especially true with buttocks. Many patients I see in consultation demonstrate the butt they want by holding their hands in a certain shape. My technique of buttocks shaping moves the fat around, much like what my patients do with their own hands. I take fat from some areas and move it elsewhere in the buttocks. This is sculpting at its best.

The major change or innovation in this area has to do with the way the fat is extracted. The fat taken out is called a graft. It is living tissue that is removed from the body (like a kidney transplant) and replaced (transplanted) into another spot. The problem we used to encounter was due to the heartiness of fat cells. Fat is very fragile and the easily broken cells did not survive the removal and refinement process very well. Some experts say that nearly 50% of the fat we used to take out died before we got it back in. This made buttocks sculpting a little ‘hit or miss.’

Medical advances have now created a new way to remove and refine the fat that ensures that almost all the fat survives the short trip back into the body. First, the fat is removed through teflon coated instruments. This way, the fragile cells slide smoothly through a polished pathway. Second, the fat is concentrated with a low speed centrifuge, which spins the fat and increases the force of gravity to have the heaviest clumps settle into a concentrated area. Third, the fluids, oils and fat cells that didn’t make it are skimmed away, leaving only concentrated, dense, healthy fat cells for insertion. Finally, the fat is injected through a teflon coated instrument, just like the one with which it was extracted. All this is done without exposing the fat to the air, which would ruin many of the cells in the process. The good news is there is also less bruising and swelling with the newer technique.

What about implants? I do them regularly and there is a place for them in creating butt lifts. When a very thin person wants more butt, implants are the only option (other than working out, of course). Also, if a person has literally no butt and desires substantial buttocks, a radical change cannot be done with fat alone. But with implants the incision is bigger, risks are higher and we lose that fine tuning ability of the Brazilian procedure. Nine out of ten patients would do better by moving the fat around.

So now you can better understand how newer techniques for modern buttocks lifting can produce bigger, better, rounder and more reliable results. In the end, you get a fantastic looking backside that both men and women love.

Dr. Chopra is medical director of The Plastic Surgery Institute in Rancho Mirage and can be reached at (760) 568.2211. Please send your ideas and recommended topics for his column via email to [email protected].