Buttock Augmentation: A Guide to the Different Methods

What is buttock augmentation?

Buttock augmentation is body contouring that compensates for missing buttock volume and improves the overall rear view and pelvic line. For a flat buttock, volume is added toward the back to increase three-dimensionality; for hip dips, where the side of the buttock is hollow, the hollow can be filled to smooth the side line. Another important goal is adjusting the volume difference between waist and buttock so the waist looks slimmer and the buttock more three-dimensional. In fact, gluteal surgery is evolving beyond enlarging the buttock alone toward designing the overall silhouette by also adjusting fat in surrounding areas. Even with fat grafting, liposuction of the areas around the buttock, abdomen or waist is often performed to create contrast.

Buttock augmentation with implants

Implant buttock augmentation places a dedicated buttock implant to create clear volume and projection. Because, unlike fat grafting, no harvested fat is needed, a key advantage is that volume can be secured even in slim bodies. It is especially useful when the whole buttock is flat and you want significant backward projection. The size and shape of the implant also allow fairly precise volume design in the desired direction.

So for slim bodies with little fat who want clear volume, the advantages of the implant method are evident.

Creating buttock volume with fat grafting

Fat grafting buttock augmentation harvests fat from the abdomen, waist or thighs, purifies it and grafts it into the buttock. Its biggest advantage is using your own fat to improve buttock volume and the surrounding body shape at the same time. For example, if you have a lot of fat on your abdomen and waist, liposuction can refine the waistline while the extracted fat is grafted into the buttock for volume. Rather than simply enlarging the buttock, you can expect a body-contouring effect that creates the curve from waist to buttock. Because fat is living tissue, part of it takes after grafting and part is absorbed. So the size right after surgery is not maintained as is, and long-term volume is determined by the fat that takes. In short, fat grafting buttock augmentation is particularly useful when you want to contour your body with liposuction while creating buttock volume at the same time.

In a study that followed 50 patients with fat grafted into the buttock subcutaneous layer using ultrasound, the fat-layer thickness that increased right after surgery had decreased by an average of 18.2% at 12 months.^[1]

Related readingHow long hip filler lasts and how it changes after 2 years is covered in "How long does buttock filler last, and how does it change after 2 years?" (Korean).

Filling missing volume with hip fillers

Hip filler supplements buttock volume by injecting filler where needed, without incisions to place an implant or fat harvesting. It is especially advantageous when you want to precisely refine volume in specific areas — such as hip dips, the upper buttock or the side line — rather than greatly enlarge the overall buttock. Another advantage of filler is that there is no surgical incision or fat harvesting. It can be used to add localized volume to the desired areas with less recovery burden. So if you want to simply refine the volume and lines of specific areas rather than undergo major surgery, hip filler can be considered.

What is hybrid buttock augmentation?

Hybrid buttock augmentation uses an implant together with fat. The key is securing basic buttock projection and volume with the implant, and refining the curves around the implant and in deficient areas with fat to create more detailed lines. For example, if the whole buttock lacks volume and you also want to improve the side line or hip dips, the plan can add fat to soften the surrounding boundaries rather than use an implant alone. The biggest feature of hybrid is that it does not rely on a single material but combines the strengths of different methods. Because it uses both the reliable volume of an implant and the natural contour refinement of fat, it is a choice for those who want large volume and detailed lines at the same time.

Buttock volume enhancement with BiVOL

BiVOL is an implant-free volume design concept based on ADM (acellular dermal matrix). ADM is a biomaterial made by removing the cellular components from human dermis, leaving the extracellular matrix that supports tissue. The core of BiVOL is designing the desired volume with ADM without placing an implant. Especially when the foreign-body feel or outline of a conventional implant is a major concern, BiVOL's defining feature is volume design using a biomaterial rather than an implant.

Buttock augmentation methods compared

The key to buttock augmentation is not choosing which method is "always better," but choosing according to the volume and body change you want.

Fat grafting has the advantage of allowing liposuction of the surrounding areas, while implants can create volume regardless of fat. Filler is advantageous for localized refinement, and hybrid can combine the strengths of both methods. BiVOL differs from conventional methods as implant-free volume design using ADM.

In a systematic review of 44 studies on buttock augmentation, overall complications were 21.6% among 2,375 implant patients and 9.9% among 3,567 fat grafting patients. Wound dehiscence was most common with implants and seroma with fat grafting.^[2]

Related readingThe differences between implants, fat grafting, hybrid and BiVOL are compared in detail in "Buttock augmentation methods: implant, fat grafting, hybrid or BiVOL — which is right for you?".

How do I choose the right method?

When choosing a buttock augmentation method, it is best to first define the change you want precisely.

If your whole buttock is flat and you want large volume

Implant buttock augmentation is a typical choice. Its advantage is creating the desired projection even in slim bodies without enough fat to graft.

If you want to reduce abdominal and waist fat while enlarging the buttock

Fat grafting buttock augmentation is a suitable method. Unwanted fat on the abdomen or waist is reduced and redistributed to the buttock, improving the proportions of the whole rear view.

If you only want to fill hip dips or specific areas

Hip filler has advantages. Rather than overall size, it can selectively refine desired areas, such as a hollow on the side of the buttock or a lack of volume in the upper buttock.

If you want to change volume and lines significantly at the same time

Hybrid buttock augmentation can be considered. The implant secures base volume and fat refines the surrounding lines, allowing a finely detailed overall design.

If you want volume without an implant

You can look into ADM-based volume design methods such as BiVOL. Because it creates volume with a biomaterial without placing an implant, it can be a new option for those who want a different approach from conventional implants.

What to check for greater satisfaction after buttock augmentation

Buttock augmentation is not simply surgery to make the buttock bigger. Even with the same added volume, the rear view can look completely different depending on where it is placed. That is why upper buttock volume, central projection, the outer line and the connection with the waist must be designed together. Also, methods whose volume changes over time, like fat or filler, and methods that use a lasting structure, like implants, differ in how the result is maintained.

So in consultation, rather than only asking "how many cc will you put in?", it is important to check where and how volume will be created and how it will connect to the surrounding pelvis and waistline.

Buttock augmentation: common myths and facts