Brazilian Butt Lift by a Specialist Plastic Surgeon in Toowoomba & the Gold Coast

brazilian butt lift - buttock augmentation - Dr Magnusson

Who would consider a buttock augmentation (Brazilian butt lift)?

After years of experience, Associate Professor Magnusson appreciates that we all come in different shapes and sizes. Some women will feel their breasts don’t match their hips or shoulders, and others may feel that their buttocks don’t match or aren’t in proportion with the rest of their body. Others may feel their bottom is too athletic or masculine without curves.

Fat grafting to the buttocks, once thought to be a simple operation, is emerging as a series of sophisticated manoeuvres which requires proper instrumentation, techniques, and operative strategies, including respect for deep anatomical structures and proper patient positioning.

A/Prof Magnusson offers the Brazilian butt lift or BBL as a standalone procedure or in combination with abdominoplasty and lower body lifts to women from Toowoomba, Brisbane and the Gold Coast.

What is the goal of a Brazilian butt lift?

Certain life events impact the shape of the buttocks and the two most frequent contributors are ageing and significant weight loss. Under these circumstances the buttocks lose their round shape, may develop droop or become flat or empty.

Buttock augmentation is designed to address these concerns.

Methods of the buttock augmentation

The two commonest methods of buttock or gluteal augmentation are with fat grafting or buttock implants. While implants have been around for a long time and have achieved popularity particularly in South America, they are not as common in Brisbane, the Gold Coast and wider Australia. Buttock fat grafting is a more recent evolution of gluteal augmentation over the last 10 years but has achieved a great deal of popularity and is now the commonest procedure for gluteal augmentation and is particularly common in the United States and South America. This procedure is commonly

What is a Buttlift?

What is a Brazilian buttock lift or BBL?

A Brazilian butt lift specifically refers to a procedure that involves the removal of fat from areas such as the thighs, stomach and love handles with liposuction and returning this fat as a fat graft to the buttocks.

A/Prof Magnusson has been observing the increased popularity of Brazilian butt lift overseas and has sought specific learning from colleagues in the United States who have developed and finessed these techniques so that reliable results can be achieved. A/Prof Magnusson’s good friend and colleague, Dr Tino Mendieta from Miami, has been a pioneer in advancing our understanding of buttock anatomy, aesthetics and treatment. A/Prof Magnusson applies these same principles that were defined and perfected by Dr Tino Mendieta and others such as Dr Dan del Vecchio and Dr Simeon Wall Jr.

Dr Magnusson regularly performs buttock fat grafting in isolation and frequently in association with body contouring procedures such as abdominoplasty and body lift procedures.

What are the aesthetic features of the buttock?

It is important to understand that there is no one perfect proportion that creates an attractive buttock. Preferences are influenced by ethnicity, age and personal attitudes. Nevertheless we talk about features that contribute to buttock aesthetics because it allows us to assess individuals and construct a plan that may lead to improvement rather than simply a change. Any single woman will have a different goal and a different outcome when compared with others which is dependent in a large part on what the pre-existing anatomy is and how other factors such as weight fluctuations may contribute.

The initial goal of this procedure is to shape the buttocks and address droop that can occur (particularly with weight loss or simply just ageing).

A noticeable increase in the volume of the buttocks will be part of the goal for some women but still only occurs once the shape has been corrected if required.

Broadly, the shape of the buttock can be defined as A-shaped, round, square or V-shaped.

From the literature and research we know that the most desirable buttock shape is A-haped or an inverted heart.

In addition there are certain elements we would ideally see or consider recreating if they are absent.

  1.  An A-shaped buttock with an even curved shape and seamless transitions in the lateral contour from the waist into the buttock, through the regions of the buttock and from the buttock into the thigh
  2. A well-defined presacral space defining the upper border of the muscle above the gluteal cleft with a triangular V-shaped depression aimed downward at the top of the gluteal cleft
  3. A nicely defined lumbosacral lordosis: the curved transition between the lower spine and sacrum/buttocks when viewed from the side
  4. A smooth transition between gluteus maximus and gluteus medius with no visible demarcation between the upper and lower buttock at the level of the hip joint
  5. An infragluteal crease angled 45° downward and with a smooth curved shape to become more horizontal with a diamond shaped gap between the inner gluteal crease and inner thighs on each side
  6. The junction between the upper thigh and buttock

What are the elements that contribute to buttock shape?

The anatomy that contributes to the buttock shape is strongly interrelated and so all of these features need to be evaluated prior to surgery to ensure that the appropriate plan is created if surgery is considered.

  1. Fat distribution around the buttock in the flank, lower back, outer thigh and back of the thigh
  2. Fat distribution in the buttock particularly in the upper outer buttock over gluteus medius and lower outer buttock below the hip joint
  3. The bony pelvis plays a very strong role in creating buttock shape and in particular its height and the height to width ratio which can’t be altered and needs to be camouflaged
  4. Relationship between the gluteal muscles which and in particular the amount that the gluteus medius extends above the gluteus maximus muscle. The four quadrants of the buttock will need to be separately assessed to determine if they are sufficient or deficient and therefore requiring grafting
  5. The transition areas between the gluteal muscles and the frame at the sacrum, the top of the pelvis/iliac crest, the outer part of the buttock, hip and the fold underneath the buttock at the upper part of the thigh
  6. Skin excess and buttock droop including the intergluteal space below the gluteal crease at the top of the inner thighs and the inferior gluteal crease.

The Surgery

How is Brazilian butt lift surgery planned and performed?

The patient needs a comprehensive evaluation as everyone is different. The aesthetic goals with respect to buttock shape and size and whether or not additional procedures are being performed will define the procedure and also vary from one patient to the next.

Assess the frame:

In general there will be four main elements to the surgery:

  1. Harvesting fat by liposuction
  2. Refining the frame and shape of the buttock
  3. Fat removed by liposuction is processed before being reinjected
  4. Fat grafting the buttock in multiple layers between the skin and superficial muscle according to the preoperative plan

Liposuction component:

If the procedure is combined with other body contouring procedures such as an abdominoplasty or body lift significant amounts of fat will be harvested in association with that procedure beneath the areas of skin excision. if buttock fat grafting is being performed then frequently these procedures are combined with circumferential trunk liposuction where liposuction is performed through the upper abdomen, flank, lower back between the ribs and pelvis and also over the lower chest and shoulder blade including the bra role. This procedure is designed to shape the lower chest and waist in addition to the other elements of the abdominoplasty or body lift which then also controls the abdomen, outer thigh and lifts the buttock if there is significant droop particularly following significant weight loss.

In others, the Brazilian buttock lift is performed as the primary procedure and liposuction is performed for the sole purpose of performing the BBL. In these patients the bodyweight is commonly lower and liposuction frequently has to be quite widespread often involving circumferential trunk liposuction in addition to global thigh liposuction. Additional areas may be treated because of cosmetic concerns in these zones such as the arms, knees and ankles.

Once the fat is removed it requires processing before it is reinjected into the buttocks.

Refining the frame of the buttock and improving its shape:

During this stage liposuction is used to specifically shape areas that frame the buttocks and are interfering with the aesthetic appearance if they have not already been addressed.

  1. The V-shaped presacral space at the top of the gluteal crease defines the upper border of the buttocks
  2. The flanks: properly treating this area defines the transition between the waist into the buttock and is one of the most powerful manoeuvres in shaping the buttocks
  3. The transition zone between gluteus maximus and medius can represent as a bulge requiring liposuction but occasionally will represent a deficiency that requires fat grafting
  4. The lumbar area over the base of the spine and above the sacrum may require liposuction to accentuate the curve between the lower spine and buttocks accentuating the aesthetics is this is one of the goals
  5. The outer thigh is an important area that corresponds to the saddlebag at the lower part of the buttock and can be full and problematic in its own right in a minority of patients. The width of the buttock at this level is important for developing an A shape and is frequently deficient particularly if there is increased with at the top of the buttock and little fact in the transition zone between gluteus maximus and medius. In these patients fat grafting will be required.
  6. The intergluteal space. this represents a discrete area of fat between the coccyx and ischial tuberosity. This area is difficult to treat and if part of the aesthetic goal is to create a diamond shaped gap below the gluteal cleft at the top of the thighs, a skin excision may be required in addition to liposuction.
  7. The midlateral buttock sits on the side of the bottom above the saddlebag region and comes around towards the front of the thigh and is commonly requiring fat grafting
  8. The posterior leg below the inferior gluteal crease is the area in which a “banana roll” can be found: May require and number of different techniques

Increasing the size of the buttocks:

Most of the visual effect from this surgery is in relation to improving its shape and reducing the volume of fat in distracting adjacent areas.

Some patients still prefer to have their buttocks noticeably increased in size and once the shape has been optimised, further fat can be grafted more uniformly through the buttocks to give a global increase in volume.

Accessory procedures

A Brazilian buttock lift is frequently part of a combined procedure and this is most frequently abdominoplasty, circumferential trunk liposuction or body lift surgery. Less common additional procedures might include direct buttock excision or lift surgery.

The Ideal Candidate

Who is a good candidate?

The ideal candidate for Brazilian Butt Lift:

  • Has good general health with a positive attitude and realistic goals.
  • Is close to or in the normal body weight range and has achieved their goal weight if weight loss is required and has remained stable at this weight for some time. Patients who are very slim may not have sufficient fat to achieve their goals especially if this involves a noticeable size change as opposed to shape changes.
  • The chemicals in cigarettes reduce the blood flow in the skin and have the ability to impact wound healing and graft survival. Every patient who smokes would be encouraged to stop smoking for at least six weeks prior to surgery and remain off cigarettes for at least 4 weeks following surgery.
  • The best outcomes from any procedure involve three aspects:
    • selection of the correct procedure to reach the goal,
    • surgery that is a safe procedure that is technically performed well,
    • a patient who diligently follows the post-operative management plan.
  • Deviation from this path at any step may alter the outcome and importantly that also includes not following the post-operative instructions.

Preparation

The consultation.

When you attend for your consultation with Dr Magnusson you will initially be seen by a nurse who will check your medical history, your current medications, any allergies you may have and clinical photographs for your record will be taken. These images are a private and confidential part of your medical record and are not shared in any way without your consent and prior approval. Clinical photographs greatly assist the consultation process as we can look at photographs of the body from angles that you would not normally see to help explain relevant points of the examination and treatment decisions that may be considered.

In this procedure especially they form a vital role in planning the surgery: planning what should be removed and what should stay.

Information that is important includes past surgical procedures, medications, allergies and adverse reactions to medications.

You will be seen in a lengthy consultation with Dr Magnusson. He will want to determine your goals, expectations and motivating factors.

Your body mass index will be assessed as there is a differential rate of risk and different outcomes associated with different levels of body weight and different body shapes. Dr Magnusson will have a frank discussion about your weight and your goals in this regard.

This surgery has many forms and in some patients additional procedures are indicated.

An examination will be performed that will include:

The assessment of skin elasticity and the distribution of stretch marks if any are present

Fat distribution and volume all the way around the body

Buttock fat content and shape.

  1. Fat distribution around the buttock in the flank, lower back, outer thigh and back of the thigh
  2. Fat distribution in the buttock particularly in the upper outer buttock over gluteus medius and lower outer buttock below the hip joint
  3. The bony pelvis plays a very strong role in creating buttock shape and in particular its height and the height to width ratio which can’t be altered and needs to be camouflaged
  4. Relationship between the gluteal muscles which and in particular the amount that the gluteus medius extends above the gluteus maximus muscle. The four quadrants of the buttock will need to be separately assessed to determine if they are sufficient or deficient and therefore requiring grafting
  5. The transition areas between the gluteal muscles and the frame at the sacrum, the top of the pelvis/iliac crest, the outer part of the buttock, hip and the fold underneath the buttock at the upper part of the thigh
  6. Skin excess and buttock droop including the intergluteal space below the gluteal crease at the top of the inner thighs and the inferior gluteal crease.

A/Prof Magnusson will then spend time educating you about the various elements of the surgery and what they are designed to do and how this could relate to you specifically.

Commonly there is more than one option to consider. The natural tendency is to choose the smaller and simpler option. A most important aspect in choosing a procedure is to have a clear goal and by understanding how the various elements of the procedure interact to lead to outcomes it will become clear which procedure or combination is going to get you closest to that goal.

Choosing an alternative procedure which won’t logically take you to your goal may be performed well, you may recover flawlessly and yet not be completely satisfied. If your goal and the surgical procedure do not align it is time to pause and realign your decision-making to avoid this.

Dr Magnusson will expertly guide you along this path.

Realistic expectations.

It is worth repeating that most of the visual effect from this surgery is in relation to improving its shape and reducing the volume of fat in distracting adjacent areas.

For a lot of women buttock fat grafting is not about a large bottom but about shaping the bottom and this frequently requires 400 to 600 mL of fat grafted into each buttock. For other women they are trying to enhance the volume as well as shape and the volume of transferred fat may be as high as 1000 mL on each side. Obviously to have this much fat to return to the buttocks, liposuction has to be performed widely and fat is usually harvested from the abdomen, flank and back (circumferential trunk liposuction) as well as the thighs.

There are a limitations regarding the volume that can be returned to the buttocks. For fat grafting to work, the individual fat cells need to be surrounded by normal tissue so that the blood supply returns to the fat for it to survive. If excessive pressure is developed within the buttocks by returning too much fat, putting too much pressure on the treated area following the surgery (sitting) or if large volumes of fat are returned in significant “lumps” then the process of healing may not be complete and more of the graft will not work interfering with the outcome.

For slim patients there may be limitations as to how much fat is available. There is not much fat that can be harvested from any one location and consequently small volumes need to be harvested from wide spread areas and even then there is a maximum limit that can be harvested without creating new contour changes that are bothersome.

A question that is often asked is “how large can you make my bottom?”. If fat grafting is being used for a slim patient: the answer is, as large as possible but we may find that insufficient fat is available for a noticeable size change in slim patients and the focus will be on shape change.

Preparation for Brazilian butt lift surgery and the hospital

BBL surgery is performed by Dr Magnusson at fully accredited hospitals under a full general anaesthetic with fully qualified and experienced anaesthetists.

When performed in isolation and BBL may be a day case (going home the same day). Depending upon the volume of fat transferred too the buttocks or if additional procedures are undertaken, some patients may stay overnight in hospital. If the surgery is more complex such as an additional abdominoplasty or body lift procedure some may stay two nights or less commonly longer.

You will be contacted by a nurse at the hospital prior to admission who will go through your medical history to ensure there are no additional requirements in preparation for your anaesthetic.

You will be admitted to the hospital a couple of hours prior to your surgery and these details will be checked again to ensure that the right person has the right operation.

Dr Magnusson will see you before the anaesthetic and lines will be drawn onto your skin while you are awake in a combination of standing and lying positions to plan the operative procedure. You will have an opportunity to ask questions at this point however it is not good for complex questions because at this point most patients are more focused on the immediacy of the surgery rather than the answers to these questions.

You will be well cared for.

After you are asleep, a catheter is inserted into your bladder, the skin is prepared and the procedure is undertaken as outlined above.

You will wake up in the recovery room and you will have your compression garment on.

If you are staying overnight, after about 45 minutes you’ll be taken to the ward and attending family will be able to see you there.

Dr Magnusson will see you before he leaves the hospital and you will be seen on each day if you remain at the hospital.

All patients having BBL will need to sleep side to side or on their stomach following the surgery so that excessive pressure is not placed upon the buttocks. When sitting you will need to use a large foam rubber caution which has an area removed centrally to sit in which helps reduce the amount of pressure on the buttocks while sitting. This is all designed to increase the amount of fat that survives in the buttocks in a permanent fashion. The cushion is required for two months.

Dr Magnusson will need to see you on a number of occasions over the next 12 months. Your post-operative visits will be the next day if you had surgery as a day case, at two weeks, two months, six months and 12 months following surgery. If there are concerns or problems arising along the way you will be seen as required at other times.

Recovery

Preparing for the return home.

When you return home from hospital you will have a reduced ability to perform your normal activities and especially your normal household duties.

For those with children arrangements will be necessary to ensure that they are adequately cared for during this time.

Meals: prepare with simple meals that are easy to reheat and healthy snacks with lots of available water.

Accessibility: think of those things that you will need to take such as toiletries, medications, tissues/wet wipes, phone/charges/computer/TV remotes. These items should be readily available at hip height so that they don’t require bending or reaching.

Written instructions: keep information about your medications, their timing and your post-operative recovery instructions handy for regular reference as required. Consider a medication organiser so that regular medications can be taken at the right time of the day.

Recovery.

There are various stages of the recovery from surgery and especially from a significant procedure such as an brazlian butt lift.

Immediately after the surgery is common to feel a little dizzy, discomfort and a bit disorientated in association with the medications from your anaesthetic and for managing pain.

The various stages include managing discomfort and the activities of daily living, managing more general household responsibilities, returning to activities including driving and exercise and finally the full maturation of the outcome and scar. These aspects all occur at different speeds.

You will remain in hospital until you are able to manage your discomfort and perform all the necessary routine activities of daily living with the level of support that you will have available at home. This maybe as a day case or after one night in hospital.

You will be commenced on a medication called clexane and taught how to administer it at home. Clexane thins your blood and is administered by injection once a day to diminish your risk of a DVT. This is a very effective precaution and is continued for a total of 10 days for most patients unless there is additional risk.

In the short term when you get home there will be no driving, no significant exertion and you will feel as if you are quite bruised in many areas from both the liposuction and the fact grafting a little like falling down a hill but without breaking any bones. This early discomfort is most noticeable for the first three or four days and then settles very rapidly but the buttocks do remain tight and need special care to reduce pressure using the cushion.

At about one week you are well in control. You can return to driving but still need to use the cushion. The medications are becoming far less necessary to remain comfortable. A relatively moderate discomfort during the day can be ignored when you are busy or thinking of other things that may become more noticeable when you are trying to clear your mind for sleep. Consequently many patients may still take a stronger pain tablet at night.

Patients with a sedentary job and need to be back at work may be able to go back on light duties if they are no longer requiring strong painkillers and especially if they are able to have shortened hours. Most patients will prefer to wait until two weeks if their circumstances permit. If the level of exertion at work can’t be controlled then four weeks off work will be required in uncommon circumstances.

By three weeks you are performing a gentle exercise such as walking quickly. You are in control of all aspects of your recovery and most patients are completely off painkillers. At this stage you will be performing most of your normal activities they will just be a little more slow and deliberate than usual because you will still be avoiding significant exertion and not moving quite as freely as usual to avoid exacerbating any discomfort.

At eight weeks you are liberated! You can discard the cushion and return to all activities even exertion at the gymnasium. You will have both good days when you do a bit more and bad days when you feel the results of those activities.

At eight weeks your scars will appear as a relatively fine pink line. From this point it will actually become pinker and reach its most obvious point for most patients between three and five months.

At about three months most patients feel that they are not reminded daily about the surgery. They are back to their normal activities. The post-operative swelling associated with areas of liposuction will have largely stabilised and resolved. There will be further improvements particularly in areas of liposuction over the next 12 months but these won’t be occurring at a appreciable rate from day-to-day.

At six months result in the buttocks will be close to the final outcome. About two thirds of the grafted fat will remain permanently. The scars will be improving but the full improvement of the scar is slow and takes 18 to 24 months.

Is there any Medicare and health fund assistance with Brazilian butt lift surgery?

There are no physical symptoms associated with small buttocks and this procedure is cosmetic. As a consequence there is no Medicare or Health Fund assistance.

Following your consultation you should understand and have answers to the following questions:

  • Are you a good candidate for this surgery?
  • What type of procedure are you going to need to achieve your goal?
  • Are your goals realistic and achievable?
  • The length, quality, duration and location of scarring.
  • The important aspects of your recovery.
  • The timing of your return to work and other activities.
  • The risks of brazilian butt lift surgery and the likelihood of complications and what is required to manage them.
  • What is required of you to achieve the best outcome from surgery both in preparation for the procedure and the recovery from surgery.

Request a consultation for Brazilian butt lift in Toowoomba or the Gold Coast

A/Prof Magnusson can provide you with information regarding a Brazilian butt lift, including risks and recovery time, as well as additional surgeries such as breast lifts and liposuction. He has assisted patients with this procedure in Brisbane and throughout Queensland. Arrange an appointment by contacting his reception at either his Toowoomba or Gold Coast clinics.

Dr Magnusson

Dr Mark Magnusson

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