Fat bulging below the buttocks is not resolved just by removing fat from that area. The cases often combine a lack of central buttock volume or a hollow along the gluteus maximus border, which makes the side fat look more prominent. Hybrid buttock augmentation is an approach that looks at both together, filling what is lacking and refining hollow lines. Below, we go step by step, starting with why lower-buttock fat stands out.
Contents
What is hybrid buttock augmentation?
It is a method that uses an implant together with fat grafting. The implant creates the desired volume, and fat grafting refines the curves on the sides and boundary areas.
Because each material plays a different role, the line from waist to buttock to thigh can be designed in detail.
Why does lower-buttock fat bulge?
Many people are concerned about a lack of volume or a sagging buttock. In particular, if fat bulging out at the sides of the panty line bothers you, it may not be that fat has gathered only in that spot.
There are also cases where a lack of central volume or a hollow along the gluteus maximus border makes the sides look more prominent.
Related readingWhen a sagging buttock won't lift with exercise is covered in "Sagging buttocks: when can't exercise lift them?" (Korean).
What problems arise if only the lower-buttock fat is removed?
If only the fat in the area of concern is excessively removed, in a flat buttock the sides can become overly hollow and wrinkles can form. The balance of the whole hip line comes before the amount of lower-buttock fat.
So after looking at the shape of the pelvis and hip joint and the degree of side sagging together, we divide the areas to reduce and the areas to fill.
How do the roles of implants and fat grafting differ?
This table shows what each material handles in the hip line.
| Item | Role |
|---|---|
| Implant | Creates central buttock volume |
| Fat grafting | Refines the side and curve lines |
The two materials do not replace each other so much as handle different zones. Enlarging only the center can make the boundaries stand out, and fat grafting alone sometimes cannot create the desired height, so the two are planned together.
In a meta-analysis of 32 studies (2,682 patients) on implant buttock augmentation, the subfascial plane had the most seroma and wound dehiscence, while intramuscular or submuscular placement had fewer complications.[1]
In a study of 147 patients who had implants and fat together, an average of 300 cc implants and 380 cc of fat were used, with the implants placed intramuscularly.[2]
When can it be considered?
If any of the following apply, hybrid buttock augmentation can be considered.
A slim body
Left–right differences in the pelvis and buttocks
Insufficient curve from waist to buttock and thigh
If volume is sufficient and only sagging is the problem, another method may be a better fit.
Hybrid buttock augmentation: common myths and facts
| What many people think… | What the evidence shows |
|---|---|
| "Removing only the lower-buttock fat makes the buttock look lifted." | Removing lower-buttock fat can make a lack of upper volume more visible. |
| "A sagging buttock lifts with fat grafting alone." | When skin and fat have descended, the position of volume must be designed too. |
| "With implants, you just decide the size." | Implant complications differ by placement plane. |
With lower-buttock concerns, lifting often comes before removing. Once the upper buttock is filled, the lower part looks less prominent.
It is good to ask whether the plan only increases volume or also takes into account the shape of the pelvis and buttock and the degree of sagging. Also ask whether there are enough sites to harvest fat for grafting. Recovery time and possible side effects vary by body type and method, so confirm them directly during your consultation.
🔬 Supporting research
Peer-reviewed international journal articles that support this article. Click a title to open the PubMed abstract.
- Plastic and Reconstructive Surgery 2025 — implant buttock augmentation, 32-study meta-analysis · 2,682 patients Complications following Primary Implant-Based Gluteal Augmentation: A Systematic Review and Meta-Analysis. Key finding: complications differ by placement plane In text [1] · PMID 40403281 · DOI
- Plastic and Reconstructive Surgery 2019 — combined buttock augmentation, 147 patients Composite Buttock Augmentation: The Next Frontier in Gluteal Aesthetic Surgery. Key finding: 300 cc implant + 380 cc fat In text [2] · PMID 31764644 · 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.
-
1:23 Buttock augmentation done right at BongBong: a hybrid hip-up real story (Korean) BongBong official · 2018.10.08 -
1:44 Completing a beautiful rear view: all about hybrid buttock augmentation at BongBong (no before/after photos) (Korean) BongBong official · 2018.04.17 -
1:52 All about hybrid buttock augmentation at BongBong (Korean) BongBong official · 2018.04.16
Frequently asked questions (FAQ)
Is it hard to create the desired volume with fat grafting alone?
It depends on body type. For slim bodies with little fat to harvest, it is hard to fill the central height with fat alone, so a design using an implant together is considered.
Lower-buttock fat bothers me — can't I just have liposuction?
Sometimes the reason the lower buttock looks thick is a lack of central volume rather than the amount of fat there. In that case, liposuction alone can hollow the sides and make the line flatter, so the cause is identified first.
My buttocks differ in size — can they be matched?
Differences between the two sides in pelvic shape and gluteus maximus development are common. Rather than putting the same amount on both sides, the smaller side is filled more, and the degree of correction should be confirmed during consultation. Lower-buttock fat is noticeable not so much in itself but when the balance of the whole buttock is off. If you are considering hybrid buttock augmentation, use as your criterion whether the plan divides where to reduce and where to fill. Even with the same concern, the right method differs by body type, so it is best to decide after a consultation.
📖 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— implant buttock augmentation, 32-study meta-analysis · 2,682 patients — complications differ by placement 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— combined buttock augmentation, 147 patients — 300 cc implant + 380 cc fat
BongBong Plastic Surgery · Dr. Park Seong-Soo, Medical Director
Contact us for a consultation