Improving the shape and size of flat buttocks remains an artistic challenge for most plastic surgeons. Buttock augmentation has been performed for many years now, but achieving impressive results only happens when using the right treatment option and a talented plastic surgeon. The buttock augmentation method, be it a fat transfer to the buttocks or a butt implant surgery, is chosen according to the morphology of the patient. Factors such as weight, presence of localized fat deposits in other areas of the body, and the width of the waist and thighs all play an important role.Buttock augmentation is not just for womenNowadays it is not uncommon for both men and women to complain about flat buttocks. The demand for buttock augmentation is higher, especially in certain places where the weather allows people to sunbathe almost all year long. In other areas, the majority of patients are women.Flat buttocks are not just a swimwear issue. It can be hard to find good jeans and other clothing to fit you well if you have small buttocks. Thankfully, there are many options available to remedy this issue through plastic surgery.Fat transferLipofilling or fat transfer is an alternative used by many patients who desire to increase the volume of their buttocks. To be eligible for this procedure, the patient must have adipose deposits in other areas of the body. This procedure is performed without introducing a foreign object inside the body; it only uses the patient’s own fat cells.During the lipofilling procedure, fat is extracted from where it is in excess, usually in the abdomen area or the flanks. The procedure is known to improve the skin quality in the injected areas and to correct the imperfections in the areas from where fat is harvested for the transplant.Most plastic surgeons will prefer this technique when the physiological conditions and the wishes of the patient allow it. The fat transfer to the buttocks provides a mild to moderate increase due to the systematic injection of fat into the butt. In some cases, if the patient desires a more impressive projection, an additional session of fat transfer can be considered. The second surgery is usually performed six months after the initial fat transfer. The general volume of a buttock augmentation with lipofilling is equivalent to the volume of a buttock implant of 200 to 250 cc.Buttock implants This technique is usually performed when there is not enough fat to augment the buttocks. These cohesive silicone gel implants are similar to breast implants but of a thicker consistency. The implants are inserted through a small incision in the inter gluteal fold, allowing the scar to be completely hidden. However, this technique can entail a risk of infection due to the bacteria in the gluteal area. Other risks include the compression of the gluteal muscles or displacement of the implants. This delicate and complex procedure should only be performed by a qualified and board-certified plastic surgeon.There are also cases where the surgeon will recommend a combination of butt implants and fat transfer. The butt implants provide projection and augment the size of the buttocks, while the fat harvested from other areas can create definition and give the butt a nice shape. When considering fat transfer to the buttocks, either by itself or in combination with butt implant surgery, keep in mind that you will also have the benefit of reshaping the areas from where the fat is harvested.Hyaluronic acid injectionThis is a non-surgical technique that consists of injecting hyaluronic acid (also known as Macrolane) in the buttocks. This gel is advertised as natural and of a non-animal origin. While it is biodegradable, the product has the drawback of being absorbed by the body. To be able to maintain the results, touch-ups are required every year. Even if there are so-called specialists on the market today offering this for buttock augmentation, keep in mind that this product does not have the FDA approval. Some surgeons also express reservations regarding this alternative as the entire medical community does not have enough experience using this technique.Other injectable fillersLike hyaluronic acid or Macrolane, all the other injectable fillers are not FDA approved, so it is recommended not to consider them as viable alternatives to correct a flat buttock. Think carefully before undergoing a procedure that is not proven safe for you or can cause life-threatening complications.ConclusionButtock augmentation comprises of either a fat transfer, the use of implants, or a combination of both. Keep in mind that a good result will depend on a good indication, as well as the procedure being performed with care and talent by an experienced plastic surgeon.