Introduction There are few things more appealing than a round, large, curvaceous butt. The big booty trend has set our imagination on fire over the last few years, and more and more people resort to plastic surgery to get the buttocks of their dreams. The benefits of undergoing plastic surgery are that the results achieved are more or less permanent and you get a big butt practically overnight. However, the results provided by the two different methods performed for buttock augmentation are different as the procedures are different in terms of the surgical plan. Butt implant surgery increases the size of the buttocks with implants inserted into the butt. When using fat grafting to increase the size, the plastic surgeon will use a combination of liposuction and fat transfer to sculpt the buttocks and augment them. Fat grafting to the buttocks is widely popular nowadays because it is associated with less and more minor risks than butt implant surgery, and the results it provides are completely natural. During the procedure, the plastic surgeon will use only the patient’s own fat tissue to correct the shape and increase the size of the buttocks, and this guarantees results that look and feel completely natural. Because the procedure is frequently performed all around the United States and the world, many people already know some of the details of the procedure. However, there are a few things less known by patients interested in undergoing fat grafting to the buttocks, such as: Your buttocks will be bigger immediately after the procedure than three months later When fat grafting to the buttocks is performed, the plastic surgeon will treat the donor areas with liposuction, process the fat harvested to remove any impurities and damaged fat cells, then reinject the healthy fat cells into the buttocks. The fat cells need to be reinjected not all in one place as they will die. Different areas of the butt cheeks will receive a fat transfer and the fat cells will be layered at different depths inside the buttocks. This is how the plastic surgeon will ensure the survival of the fat cells transferred. To be able to survive and thrive in the new environment, the fat cells that were grafted need to develop a new blood supply, and this is only possible if they are layered in different areas and not all in one place and if pressure on the buttocks is avoided. Too much pressure on the buttocks during the first few weeks post-op can result in the death of the fat cells. This is the reason why the plastic surgeon will always advise you not to sit directly on the butt or lie on the back after the fat grafting procedure. When the fat cells die, they are reabsorbed by the body. However, it is a known fact that not all the fat cells that will be grafted into your buttocks will survive. A responsible plastic surgeon will make you aware of this even during the pre-operative consultation, so you don’t have any surprises later on. The percentage of the fat cells grafted that is absorbed by the body is usually 30-40%. To fight this absorption rate, the plastic surgeon will inject more fat than necessary to correct the shape and get the augmentation, so the final results will be the best possible ones. But this means that your buttocks will be much bigger immediately after the procedure than compared to a few months after the procedure when the new fat cells have developed a blood network and are there to stay. The fat cells that have remained in the buttocks after the first three months are not going to be reabsorbed by the body after this period as they are already behaving just like the other cells that were in the buttocks initially. Make sure to follow the recommendations of the plastic surgeon and avoid any type of pressure on the buttocks for as long as possible to ensure the survival of the fat cells transferred. The procedure is commonly performed with butt implant surgery When coming to the pre-operative consultation for a butt augmentation, most patients tend to think that it is either implants or fat transfer that is required for them to achieve the buttocks of their dreams. What they often don’t know and discover only during the consultation is that the fat grafting procedure is commonly performed with butt implant surgery. Why would this be necessary? First, the patient would like to get fat grafting to the buttocks but doesn’t have enough fat in the body to provide the desired augmentation. In this case, my recommendation often is to insert small or moderate size implants and complete the look with fat grafting to make the results look more natural. Second, the patient wants big implants but doesn’t have enough tissue on the buttocks to cover them. When this happens, fat grafting with butt implants is mandatory to prevent potential complications that can occur such as visibility and palpability of the implants. Generally speaking, when the two procedures are combined, the results are much improved, look and feel natural and the patient can enjoy the best that both procedures can provide. It is well known that fat grafting can’t provide an impressive augmentation compared to getting implants in one session because there is just a limited amount of fat that we can collect with liposuction and then inject into the buttocks. This is why many patients undergo repeated sessions of fat transfer to get the results they want. When we use implants with fat grafting, repeated sessions won’t be necessary. The sustainability of the results is dependent on you Nowadays the sustainability of the results is one of the most important aspects that patients need to check before undergoing plastic surgery. When it comes to fat transfer procedures, they come associated with multiple benefits, but also a few disadvantages. When it comes to butt implant surgery, the results are mostly dependent on the right size of the implants used and how the procedure was performed. What happens during the recovery period is important, but a few months after the operation when the patient is allowed to resume physical activities, the results are final. Things are different in the case of fat grafting. After fat transfer is performed, your buttocks will decrease in size a bit for the first three months, and then the results become final. However, if you gain weight or lose weight after the procedure, the appearance and size of the buttocks will be affected. Three months after the procedure, the fat cells in the buttocks will start behaving like they were always there. This means that if you lose weight, they will lose volume and if you gain weight, they will increase their volume. The fat cells that were grafted to the buttocks won’t all disappear in time, but their volume can and will change depending on your weight fluctuations. This is the reason why we say that the sustainability of the results is entirely dependent on you after the final results occur. It is important to mention that working out after the plastic surgeon gives you his consent won’t make the fat cells disappear, not unless you lose a considerable amount of weight. Conclusion Fat grafting to the buttocks is commonly performed nowadays all over the United States. When played out by an experienced, board-certified plastic surgeon, the procedure can boost impressive results that are long-lasting in time. However, it is important to know all the details before scheduling your procedure. In this article, we have discussed three things that most people don’t know about fat grafting to the butt. You should know that the buttocks will be larger immediately after the procedure than compared to three months down the line. This happens because a percentage of fat cells that are injected into the buttocks will be reabsorbed by the body before they manage to develop a blood network that would ensure their survival. It is also important to know that fat grafting can be and often is performed with butt implant surgery and that the sustainability of the results of the procedure on the long run is dependent entirely on you and your weight fluctuations.