This article was published in Anti Age Magazine Volume #48. We would like to thank Dr. Raul Gonzalez and Anti Age Magazine for sharing it with the international community.

I have used all of these techniques for the last 40 years: fat, implants, etc. I started with liposuction as, before the 1980s, the trochanteric fat (also known as saddlebags) was the fi rst area to be treated using this technique. Very quickly, liposuction was performed on other parts of the body, such as the buttocks, thighs, arms, etc. and I was perhaps one of the fi rst surgeons to use this fat for reshaping the body.

But in the cases where there was not enough fat to harvest, I had to turn to intramuscular implants. This is a safe procedure that gives good results when we want to signifi cantly enhance the buttocks’ projection, bearing in mind that these implants can only be inserted for posterior projection, not lateral projection. Since attractive buttocks should be rounded on all sides, many women also require us to correct any lateral depressions (hip dips). The solution is to combine implants and fat injections.

Downside: Fat grafts are a wonderful tool, but if we inject too much fat, the buttocks can become heavy and start to sag.

The arrival of hyaluronic acid

In recent years, hyaluronic acid has become extremely popular as women seek quick results with less pain. New products with a high filling potential have recently appeared on the market and are being successfully developed. Nevertheless, hyaluro- nic acid injections are expensive – they cost almost as much as a surgical procedure but do not last as long. I have some patients who, after two or three sets of injections, decide to undergo a more permanent procedure. Hyaluronic acid is very useful for improving minor defects or slightly enhancing the buttocks’ projection. On the other hand, tensor threads have not yet been found to achieve satisfactory results on this part of the body.

The BBL, Brazilian Butt Lift

The BBL is very popular in Brazil and is well accepted. It has become a commonplace procedure. It was the Kardashians who made the BBL so spectacularly popular. It is a lipofilling treatment, involving the extraction of between 800 and 1500cl of fat. Before it is reinjected into the buttocks, this fat is puri- fied in a centrifuge, which makes it lose a significant amount of volume. 70% of the injected fat remains in the body and behaves just like normal fat (increases with weight gain and decreases with weight loss). Enhancing the buttocks and making them more attractive and rounder are requests that we are seeing more and more across the globe. We are actively seeking new procedures and new materials: our buttocks deserve it!