Butt Augmentation With Implant Houston, TX | Dr. Wilberto Cortes

17th Feb 2016


The hourglass butt augmentation procedure is a high volume fat transfer to the buttocks and hips, which is Dr. Cortes’s feature technique. The hourglass buttock augmentation is a procedure developed by Dr. Cortés.  This procedure has two main objectives. First, it is used to increase the size of the buttocks by performing liposuction to harvest the fat from the abdomen flanks, low back, upper back, thighs, and injecting this fat into the buttocks.  Secondly, it is performed to provide a better hip to waist ratio to attain an hourglass shape.  If you are considering an hourglass butt augmentation with Dr. Cortés, this description will provide you with a basic understanding of the procedure, how the procedure is performed, what to expect after surgery, basic recovery information, and the most common and frequently asked questions.  At the end of reading this information, you will realize that this procedure is more than a buttock augmentation; it is a total body transformation.

The Difference Between the Brazilian Butt Lift and the Hourglass ButtAugmentation

The Brazilian butt lift is a procedure that is commonly referred to when we talk about fat transfer to the buttocks. This procedure is mainly used to improve the projection of your buttocks. With the hourglass butt augmentation, Dr. Cortés not only increases the projection of your buttocks but also their shape. Changing the shape of your buttocks is the most challenging part of the procedure since there are many different types of buttocks. Anybody can increase the size of your buttocks from the side profile but not everybody can change the shape into an hourglass shape from the back profile. This is where artistry and experience play a major role. In addition, with the hourglass butt augmentation, Dr. Cortés will inject fat in the hips. This is an additional anatomical area that is addressed with this procedure to improve the hourglass shape from the front and the back view.

Who is the Best Candidate for an Hourglass Butt Augmentation?

The best candidates for this procedure are patients with excess fat in certain areas like the back, abdomen, flank sides, thighs, etc.  For references, ideally, if you were a size 11 to 12 in dresses, you are best suited for the hourglass butt augmentation.  If you are thin and wear a dress size from 2 to 4, you will not be a good candidate for this procedure simply because there is not enough fat to be used.  Do not get discouraged if you are a thin patient and want to have a fat transfer to the buttocks since there are other options.  For these particular patients, Dr. Cortés recommends the patient to gain from 10 to 20 pounds before the procedure.  Otherwise, if this is not possible, a butt implant is another option.  In addition, you must have realistic expectations about what this procedure can do for you.  Not only do you need to have the necessary fat to be transferred, but other factors like your skin tone will ultimately determine the results in skin retraction after your liposuction as well as the projection that you might get.  Your age is not a major consideration; however, the older you are, the more elastic is your skin and you might not achieve the same results as a younger patient with tighter skin. Overall, you must be completely healthy.  If you have diabetes, high blood pressure, or any medical issues, this will need to be addressed and controlled before surgery.  Sometimes, Dr.Cortés will request a surgical clearance from your primary care doctor for those health issues that require particular attention.

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Your Consultation

We encourage our patients to connect through YouTube at DrWilbertoCorteslivechannel.  We have a lot of different educational videos that will help you understand the surgery.During the consultation, he will explain the areas that are suitable for fat harvesting aswell as determine the areas that require fat transfer to provide you with an hourglass shape.He will review with you, if you smoke or if you take any medication, vitamins, or drugsthat can affect postoperative care and might increase the chances of bleeding and heart problems.He will also discuss your expectations and how realistic you should be about the results.  One ofDr. Cortes’s main qualities is his frankness when describing alternatives, risks, and limitations.During your consultation, the most important factor that will be discussed is theprojection that you desire.  Projection is determined by many factors. Not only the amount of fatthat you will have will result in a bigger behind, but other things to be considered are yourcurrent buttock shape before surgery, your hip bone, your muscle structure, and the amount ofprojection prior to surgery.  With this procedure, everybody can get a better shape andprojection, but not everybody can get an extremely large buttock.

Surgical Risk

Liposuction in general is normally safe as long as the patients are carefully selected, thesurgeon has a good understanding of the anatomy of the body, and the procedure is performed ina facility with the necessary equipment.Dr. Cortés uses advanced surgical techniques to perform procedures that remove the largeamount of fat that is required for this type of procedure.  For this particular reason, you will bestaying overnight at the hospital for monitoring.However, it is important to keep in mind that even with the best equipment and the besttraining of the surgeon can improve your chances of having good results but there is noguarantee.  Complications do occur although rarely.  The risk of liposuction increases with theamount of fat that is removed as well as the number of areas that are treated simultaneouslyduring the procedure.  Postoperative complications include the following:


Blood clots

Skin loss or burns

Unsightly scars

Fat embolism

Bleeding and fluid collections

Liposuction deformities

Discoloration of the skin

Prolonged pain


This is why being a smoker or having uncontrolled high blood pressure or diabetes canincrease significantly the risk of complications and delayed healing.  If you are a smoker, Dr.Cortés advises to stop smoking two weeks before the surgery.During your preoperative visit, we will provide you with specific instructions on how to getprepared for surgery including what to eat, when to have sex, when to return to work, and whichmedication and herbals you need to avoid.It is very important that after surgery, when you are discharged from the hospital, to makesure someone will drive you home after the procedure and, if necessary, help you for a day ortwo.

Location, Where Your Surgery Will Be Performed, and Type of Anesthesia

Dr. Cortés performs the hourglass buttock augmentation at Houston Northwest MedicalOutpatient Center.  You will need to stay overnight for monitoring.  To perform this procedureand remove the fat that is required to sculpt the body, it is necessary to perform the surgery undergeneral anesthesia.  You cannot be awake because you are not going to be able to tolerate thesurgery due to pain and discomfort.  In addition, because of the amount of fat that is removed,the amount of local anesthesia required will be toxic to your body if local anesthesia is beingused.  For this reason, Dr. Cortés performs all buttock augmentations under general anesthesia.He only hires board certified anesthesiologists, a professional assistant, and a certified nurseanesthetist for all his surgeries.

The Surgery

Typically, the time that is required to perform the hourglass butt augmentation is about 4hours.  This can range from 3 to 4 hours depending on the size of the patient, the areas thatrequire liposuction, and the amount of fat being removed among other factors.  Dr. Cortés startshis procedure while you lie on your back and performs liposuction in your abdomen, flank sides,and thighs.  Once he finishes performing liposuction on these anatomical areas, you will beplaced on your chest and liposuction is then performed in the upper and lower back and sides.Liposuction is performed through small incisions and a cannula of about 5 mm is inserted.  Thecannula is connected to a vacuum machine.  The cannula moves back and forth and the fat isbroken into small fat globules and are suctioned.  Dr. Cortés uses the power-assisted liposuctiontechnology on the very low settings to protect the fat during suctioning.  You cannot have a fattransfer procedure using the Vaser liposuction, ultrasonic liposuction, or laser liposuctiontechniques because such techniques will destroy the fat, thus increasing the chances ofcomplications and bad results.

What to Expect After Your Surgery

After your surgery, you will be staying at Houston Northwest Medical Center where wewill give you IV antibiotics and will control your pain with IV medication.  We will encourageyou to walk around immediately after surgery since this diminishes the risk of having bloodclots.  In general, your pain will feel like soreness, as if you had been exercising for a long time.We will prescribe medications to control your pain and you will be discharged within 24 hoursfrom the hospital.  Dr. Cortés will see you in about 3 to 5 days after the surgery.  Your stitcheswill be removed in 7 to 10 days.  The full recovery to be able to see the final results will be inabout 6 to 9 months.  It is important for you not to sit at all for 2 weeks.  After 2 weeks, you willbe using a special cushion for 2 1/2 months while you are sitting.  If you sit too early aftersurgery, it will cause pressure necrosis, which implies that the fat will die and you will havesuboptimal results.

Getting Back to Normal

The recovery of the hourglass butt augmentation is a slow process.  Dr. Cortés will insistthat you to move around in the first 5 to 7 days to reduce swelling and help prevent blood clots from forming in your legs.  It will take about 10 to 14 days before you can go back to work.  Youwill need to wear girdles for about 3 to 6 months.  This is the most important part for yourpostoperative recovery since it diminishes the swelling.  You will need to be patient.  Swellingwill take a while to resolve and there is no magic pill to get the swelling improved within 48hours.  You will be able to sit for a short period of time to do any of your body necessities.Nevertheless, you will need to lie on your stomach during your leisure time and for sleeping forabout 14 days.  After this, we will give you a specialized cushion to relieve any pressure fromyour buttock area.Your abdomen, leg, face, back, flanks, and arms will be swollen, bruised, tender, numb,and hard.  All the symptoms will resolve over time.  You will notice that the swelling willdecrease the most in the first month after surgery.  You will see that your body has changedtremendously right after surgery, but you will not see the final results for about 6 to 9 months.Dr. Cortés will give you instructions for medications, follow-up, showering precautions,drain care as well as what to expect after surgery.  His staff will communicate with you throughe-mail, phone, and text messages to monitor your progress.

The New You

The hourglass butt augmentation will give you amazing results with a new curvy andsexy figure.  In most cases, the results are long lasting unless you lose a lot of fat or weight or if you do not follow the postoperative instructions and sit too early after surgery.

Frequently Asked Questions

  1. Will I look like Kim Kardashian after surgery?

One of the most difficult parts of this procedure is that the expectations of the patients arevery, very high.  The patients want to look like their favorite celebrity.  Although this is possiblein certain patients, it is not the norm for most patients.  When it comes to this procedure, yourresults will be determined by your anatomy.  You need to understand that your body is differentfrom those of other human beings.  It is not realistic for a plastic surgeon to be able to transformyour body exactly the same as somebody else’s.  Nevertheless, this procedure will make youlook better. It will be a better you.  In other words, you will look sexier.  The factors thatdetermine how you are going to look after surgery include your bony anatomy, your skin tone,your excess skin, your projection before surgery, the amount of fat that you have, how tight yourbuttock is, and the attachment between the muscles and the skin, among others.Dr. Cortes’s goal during the surgery is not to make you look like your favorite celebritynor the way you want to look.  His main goal is for you to look better with an hourglass shapeand a bigger behind.  There’s no doubt the hourglass butt augmentation will improve your image.

  1. How many cc’s of fat can be injected in the buttock?

The amount of cc’s that can be injected into the buttock will depend on your buttockanatomy.  This is something that neither the patient nor the surgeon can actually know forcertain.  If you want a bigger behind, the only thing that Dr. Cortés can tell you is that he willmake your buttocks as big as your buttocks allow it.  Think about it.  The skin of the buttocks iselastic.  When you start injecting fat into the buttocks, the skin will stretch to a critical limit.  Upto a certain extent, the skin does not stretch anymore.  It is not that Dr. Cortés can indefinitelyinject fat into the buttocks.  Going beyond the limits will increase complications, including fatnecrosis, nerve compression, and unsatisfactory outcome.  Nevertheless, Dr. Cortés typicallyinjects between 800 cc’s to 1200 cc’s of fat into each buttock and about 200 cc’s to 400 cc’s offat into each hip.

  1. Is the hourglass buttock augmentation a total body liposuction?

These are the main areas where the fat is removed:

  1. Abdomen
  2. Back
  3. Flanks
  4. Sides
  5. Thighs

In essence, it is not a total body liposuction.

  1. How will my belly look after the procedure?

You need to understand that the hourglass butt augmentation is a buttock procedure.  It isnot an abdomen procedure.  It is not a thigh procedure.  It is not an upper or lower backprocedure.  Ninety percent of the patients that have undergone this procedure will have excessskin in their abdomen and other areas secondary to pregnancy or weight gain.  Because in thisprocedure liposuction is used to harvest the fat needed to increase the buttock size, any areawhere you have excess skin will have excess skin after the surgery. In other words, the procedurewill give you an hourglass shape and a better behind but, if you have additional areas withexcessive skin, you will need additional procedures to enhance these areas to the level of yoursatisfaction.  Remember thet the liposuction cannula is not a magic wand.  In other words, if youhave excess skin, the liposuction cannula will not make the skin tight after surgery.  The patientsthat have good skin tone, have not had babies nor stretch marks will have a very tight abdomendue to the nature of their skin anatomy.

  1. Are results permanent?

Dr. Cortés is an expert in buttock augmentation and his results are permanent.Nevertheless, you are going to lose 20 to 30% of your volume due to swelling and some of thefat that does not survive.  In addition, if you lose weight, your buttocks get smaller; if you gainweight, your buttocks get bigger.  The fat is alive and it will respond to the same hormones andstress of the body as well as your metabolism.  This is the reason why it is important not to sit forabout 2 weeks after surgery to avoid an unnecessary pressure on the buttocks that will jeopardizethe results expected.

Before and after pictures

Dr. Cortés’ work can only be better explained through the results of the hundreds of surgeries he has performed. Confirm this by visiting his impressive electronic gallery.

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