Buttock augmentation is not just about making the buttocks bigger; it is body contouring that decides where to place volume within the curve running from the waist through the hips to the thighs. Implants are the usual choice for large volume, fat grafting for a natural line and body contouring, and hybrid when both are needed. BiVOL is a relatively new approach that uses biocompatible material.
Contents
- What exactly is buttock augmentation?
- When should implant buttock augmentation be considered?
- How is fat-grafting buttock augmentation different?
- Why combine both in hybrid buttock augmentation?
- What kind of approach is BiVOL?
- Common myths and facts — buttock augmentation methods
- Which method suits my body?
What exactly is buttock augmentation?
Buttock augmentation is body contouring that addresses volume, projection, the waist-to-hip connection and the line into the thighs together. The curve in side and back views matters more to the result than size seen from the front.
- Upper volume: the upper buttock looks empty, so the buttock looks saggy
- Central projection: not enough roundness in side view
- Lower support: the area around the buttock crease looks saggy
- Side line: the side of the hips looks hollow (hip dip)
So the key to planning is not "how big" but "where and in what shape" to place volume.
When should implant buttock augmentation be considered?
Implant buttock augmentation places a dedicated implant inside the buttock to create predictable volume of a set size and shape. With fat, the final volume depends on how much survives; with an implant, the planned volume stays as it is.
- Good fit: very little natural buttock volume, in a slim body with little fat to harvest
- What to plan: implant size, placement plane, position and fixation
- Recovery: reduce pressure and friction and keep the advised positions until the implant settles
Because complications differ with which plane the implant is placed in, planning the plane comes before choosing the size.
Research confirms why the placement plane matters. In a meta-analysis of 32 implant buttock studies (2,682 patients), subfascial placement had the highest rates of seroma (22.3%) and wound dehiscence (27.1%), while intramuscular and submuscular placement had fewer complications.[1]
How is fat-grafting buttock augmentation different?
Fat-grafting buttock augmentation harvests fat from the thighs, abdomen or flanks and grafts it in portions where it is needed. Because it adds buttock volume while slimming fatty areas, it is well suited to shaping the curve of the whole body.
| Item | Implant | Fat grafting |
|---|---|---|
| Volume predictability | Planned size stays | Depends on fat survival |
| Body contouring | Buttocks only | Donor areas are slimmed too |
| Requirement | Not dependent on fat | Needs enough fat to harvest |
| Main complications | Wound dehiscence, seroma, etc. | Seroma, under-correction, etc. |
Not all grafted fat survives. Fat needs a blood supply to survive, so where and how it is distributed matters more than how much is injected. In a study that followed 50 patients with subcutaneous-only grafts by ultrasound, the fat layer that thickened right after grafting was about 18% thinner on average at 12 months.[2]
A systematic review of 44 studies comparing the two found overall complication rates of 21.6% with implants (2,375 patients) and 9.9% with fat grafting (3,567 patients). The most common complication was wound dehiscence (9.6%) for implants and seroma (3.5%) for fat grafting.[3]
Related readingHow to judge which of the two suits your body type is covered in detail in “Fat Grafting vs Implant Buttock Augmentation: Which Is Right for Me?” (Korean).
Why combine both in hybrid buttock augmentation?
Hybrid buttock augmentation uses an implant for base volume and projection, then grafts fat at the edges and where volume is lacking to refine the line.
It is chosen, for example, when you want a clear overall increase in size but an implant alone would not make the curves between the waist and buttock and between the buttock and thigh flow naturally. The key is combining the volume of an implant with the contour refinement of fat grafting.
Combining two techniques also means more to plan. In a meta-analysis of 13 studies on combined techniques, complication rates such as wound dehiscence and sciatic symptoms differed depending on the implant plane.[4]
A study reporting 147 patients treated with both implants and fat used an average of 380 cc of fat and 300 cc implants, with no cases of pulmonary embolism, fat embolism or death.[5]
What kind of approach is BiVOL?
BiVOL combines 'Bio-compatible' and 'Volumizer'. The concept uses biomaterials such as acellular dermal matrix (ADM) to improve the tissue environment and support volume. ADM is a dermis-derived extracellular matrix with the cells removed, and it has been used in reconstruction and regenerative medicine.
Approaches combining ADM with fat grafting are being introduced for buttock augmentation, but BiVOL as a name and method has not been established as a standard buttock procedure. Clinical evidence in buttock augmentation is still more limited than for implants or fat grafting, so rather than judging by the name, check the actual material, its approved uses, the treatment area and the clinical evidence.
Related readingWhy BiVOL buttock augmentation considers the material and the tissue environment together is explained in “BiVOL Buttock Augmentation: Why Look at the Tissue Environment Too?” (Korean).
Common myths and facts — buttock augmentation methods
| What many people think… | What the evidence shows |
|---|---|
| "The most famous method is the best one." | The right method depends on desired volume, fat supply, skin thickness, sagging and asymmetry. |
| "Slim people can't have buttock augmentation." | With little fat, grafting alone has limits, but it can be planned with implants or a hybrid approach. |
| "Grafted fat all disappears over time." | Fat that survives stays; only fat that does not survive is absorbed. There is simply a difference between the immediate and final volume. |
| "Newer methods are safer." | Newer approaches actually have less long-term evidence. Check the material and evidence specifically. |
Which method suits my body?
| Method | Key feature | Best suited for |
|---|---|---|
| Implant | Builds the desired volume directly | Very little volume and little fat |
| Fat grafting | Improves volume and line with your own fat | Natural volume and body contouring |
| Hybrid | Implant + fat grafting | Large volume with a natural line |
| BiVOL | Biomaterial to support tissue environment and volume | When considering a regenerative approach (check the evidence) |
Before choosing a method, look at waist-to-hip ratio, left–right size difference, fat distribution, skin elasticity, muscle shape and degree of sagging together. It is important to choose a surgeon who explains the pros and cons of several methods and plans around your body, rather than one who recommends a single method.
Each method needs its own aftercare. Early on, swelling and bruising can make the shape look different from the final result; fat grafting needs early care for graft survival, and implants need care to keep their position.
In buttock consultations, the first things I check are "how much fat can be harvested" and "whether the skin can accommodate the volume". The same concern — "I don't have enough volume" — leads to implants or hybrid for slim bodies and fat grafting when there is enough fat. A plan that starts from your body's conditions, not the method's name, decides the result.
There are several buttock augmentation methods — implant, fat grafting, hybrid and BiVOL — but no single best one. The key is choosing a method that matches your fat supply, skin and muscle condition and the volume you want.
🔬 Supporting research
Peer-reviewed international journal articles that support this article. Click a title to open the PubMed abstract.
- Plastic and Reconstructive Surgery 2025 — Meta-analysis, 32 studies · 2,682 patients Complications following Primary Implant-Based Gluteal Augmentation: A Systematic Review and Meta-Analysis. Key finding: complications differ by implant plane — intramuscular and submuscular are relatively safer In text [1] · PMID 40403281 · DOI
- Plastic and Reconstructive Surgery 2016 — Systematic review, 44 studies · 5,942 patients Determining the Safety and Efficacy of Gluteal Augmentation: A Systematic Review of Outcomes and Complications. Key finding: overall complications 21.6% implant vs 9.9% fat grafting — each method has different common complications In text [3] · PMID 27018670 · DOI
🎬 Watch — Dr. Park Seong-Soo · BongBong Plastic Surgery
Related videos from BongBong Plastic Surgery's official channel and Dr. Park Seong-Soo's channel. Videos are in Korean and play on YouTube.
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8:04 Hip dips and the apple hip: implant-free BiVOL buttock augmentation (Korean) Dr. Park's channel · 2026.08.26 -
6:04 Filling the hips in slim bodies: a guide to hip BiVOL (Korean) Dr. Park's channel · 2025.12.22 -
2:13 Buttock augmentation at BongBong: what are the methods? (Korean) BongBong official · 2019.01.18 -
1:52 All about hybrid buttock augmentation at BongBong (Korean) BongBong official · 2018.04.16
Frequently asked questions (FAQ)
Which is better for buttock augmentation, implants or fat grafting?
Implants are the usual choice for a large, reliable increase in volume, and fat grafting for natural volume and body contouring. If you want both, a hybrid approach can be considered.
Can slim people have buttock augmentation?
Yes. But fat grafting needs fat to harvest, so with little fat there may be limits to the volume achievable. In that case, implants or a hybrid approach are considered.
Does fat-grafted volume all disappear over time?
No. The grafted fat that survives remains; fat that does not survive is absorbed. That is why the volume right after surgery and the final volume can differ.
Why choose hybrid buttock augmentation?
To secure base volume with an implant while refining the surrounding line and edges with fat grafting. The aim is to improve volume and a natural curve together.
How is BiVOL different from a standard implant?
BiVOL is presented as an approach that uses biomaterials such as ADM to improve the tissue environment, rather than inserting an implant. However, clinical evidence and the scope of use in buttock augmentation are more limited than for established methods, so check the material and technique specifically.
What should I check first when choosing a buttock augmentation clinic?
First check whether the surgeon can propose a technique suited to your body. It is important to choose a clinic that explains the pros and cons of several methods and plans around your body, rather than one that recommends a single method.
📖 References
Click a [number] in the text to jump to its source, and ↩ to return. Only papers whose title, journal and year were verified on PubMed are listed.
- ↩ Elsaftawy A, Bonczar M, Jagosz M, Ostrowski P. Complications following Primary Implant-Based Gluteal Augmentation: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2025;156(6):894-907.PMID 40403281 · DOI— Meta-analysis, 32 studies · 2,682 patients — complications differ by implant plane; removal rate 1.05%
- ↩ Cansancao AL, Condé-Green A, David JA, Vidigal RA. Subcutaneous-Only Gluteal Fat Grafting: A Prospective Study of the Long-Term Results with Ultrasound Analysis. Plast Reconstr Surg. 2019;143(2):447-451.PMID 30688886 · DOI— Subcutaneous fat grafting, 50 patients (ultrasound) — fat layer 18% thinner on average at 12 months
- ↩ Sinno S, Chang JB, Brownstone ND, Saadeh PB, Wall S Jr. Determining the Safety and Efficacy of Gluteal Augmentation: A Systematic Review of Outcomes and Complications. Plast Reconstr Surg. 2016;137(4):1151-1156.PMID 27018670 · DOI— Systematic review, 44 studies — overall complications 21.6% implant vs 9.9% fat grafting
- ↩ Elsaftawy A, Bonczar M, Bonczar T, et al. Characteristics and Complications of Combined Implant and Lipoplasty Techniques in Primary Gluteal Augmentation: A Systematic Review and Meta-Analysis. Aesthet Surg J. 2026;46(7):720-727.PMID 41092126 · DOI— Combined implant + fat meta-analysis, 13 studies — removal rate 1.70%; complications differ by plane
- ↩ Aslani A, Del Vecchio DA. Composite Buttock Augmentation: The Next Frontier in Gluteal Aesthetic Surgery. Plast Reconstr Surg. 2019;144(6):1312-1321.PMID 31764644 · DOI— Composite buttock augmentation, 147 patients — average 380 cc fat + 300 cc implant
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