Introduction Most women who resort to plastic surgery nowadays are aiming either to get rid of unwanted fat from some areas of the body, or to augment a feature of the body such as the breasts or buttocks. As proof of this, we have liposuction and breast augmentation surgery being the two most performed plastic surgery procedures in the world. However, butt enhancement has been seeing a rise in demand year after year for quite some time now. When it comes to improving the buttocks with the help of plastic surgery, fat transfer has started to become very sought after apart from the use of implants. In this article we will discuss butt lipofilling and why losing volume after the procedure can happen. Fat transfer to the butt A rear end that is too flat, lacks perkiness, or has a rather undefined contour can create real emotional complexes for a woman. This is the reason why butt augmentation has become more and more popular among men and women in countries all around the world. Butt implant surgery is still in demand, even if it has a higher risk compared to fat transfer. However, the procedure that is most suitable for your particular case will be recommended by the plastic surgeon during the pre-operative consultation and only after a thorough medical examination. Most patients who resort to butt implants do so because they are not eligible for butt lipofilling or want to achieve results that are not within the range of fat grafting. The condition that needs to be fulfilled to be able to undergo butt lipofilling is to have unwanted adipose tissue in another area of the body. Usually, we are talking about the midline, but it can also be the thighs and even the back. The plastic surgeon will be interested in finding areas that either have a wider surface or a more considerable fat deposit to target for butt lipofilling. The procedure is performed with the patient under general anesthesia and consists of three major steps. For the success of the procedure and to avoid ulterior complications, all three steps need to be performed to the highest level and standards. This is why it is crucial to choose a talented, experienced board-certified plastic surgeon to play out your procedure. The first step of butt lipofilling is liposuction. This means that the plastic surgeon will make incisions that are no longer than 3 to 4 mm in areas of the body with an excess of fat. When the midline is addressed with liposuction, the incisions will be positioned on the abdominal wall and the flanks. This will allow the plastic surgeon to insert the liposuction cannula under the skin and dislodge the subcutaneous fat with back and forth movements before suctioning it out of the body. After the areas have been addressed in a symmetrical manner and the plastic surgeon feels like all the necessary fat has been extracted, the small incisions made for liposuction will be sutured, and the next step of the procedure can begin. The second phase is the purification of fat. The fat that was collected from the donor areas is put through a complex centrifugation process to eliminate damaged fat cells, but also blood and other impurities that were suctioned during liposuction. This is an important stage of the procedure as injecting only the healthy and pure fat cells is essential for their survival in the buttocks. Once the purification process is complete, the fat transfer stage can begin. The fat cells that were purified will be injected into the buttocks by using special syringes. The plastic surgeon will inject small amounts of fat in different areas of the butt and at different depths to ensure their survival. A common reason for losing volume after butt lipofilling is injecting too much fat in one area of the buttocks. Results of butt lipofilling and losing volume after the procedure The results achieved with fat transfer to the butt are very different from the ones achieved when using butt implants. Butt lipofilling targets all areas of the buttocks (including the lower part and the sides), while butt implants mostly deal with increasing the projection of the buttocks as the implants are inserted into the gluteal muscles on the upper part of the butt. However, there is only a limited amount of fat that we can inject in one lipofilling session, so the dimensions of the buttocks after implants can be more impressive compared to one fat transfer session. But in the end, it all depends on the patient’s anatomical characteristics and the goals and expectations from the surgery. The plastic surgeon can inject a maximum of one liter of fat in each buttock. However, this only happens in some cases, and even then, there is a certain percentage of fat that will be reabsorbed in the months following the procedure. What happens immediately after butt lipofilling is that the newly transferred fat cells will try to develop a new blood network to ensure their nutrition and survival in the area. This can take up to a few weeks, and until this happens, the body will reabsorb some of the fat cells that will die. This percentage can be as high as 30 and even 40% in some cases. This is a natural process, and an experienced plastic surgeon will warn you that this will happen. The rest of the fat cells will develop a blood network and start behaving like the cells that were in the buttocks before the procedure. But this also means that they will respond in the same manner if weight loss occurs. Losing volume after butt lipofilling can occur during the first two months, and this is partly as a natural process and could also be caused by the patient’s inability to follow the instructions of the plastic surgeon. However, after the first two to three months, the results should be more or less permanent. If volume loss occurs after this period of time, it is usually because the patient lost a considerable amount of weight. To avoid losing volume after butt lipofilling, patients are advised not to smoke, not sleep on the back, not sit directly on the buttocks, and avoid weight fluctuations in the long run. If the results after two or three months are not visible or the lost volume is considerable (up to 60 or 70%), it often means the procedure was unsuccessful. A cause for this might be not performing the three stages of the procedure up to the highest standards. To avoid this, make sure to choose a talented, experienced, board-certified plastic surgeon. Moreover, it is important for the patient to follow the post-op recommendations to the letter to avoid losing volume after butt lipofilling. Conclusion Through butt lipofilling, patients can achieve spectacular results and a considerable improvement in the appearance of the buttocks. This is an advanced surgical technique that will contour, remodel, and give your butt the perkiness you desire. The first step of the procedure entails the elimination of fat deposits from areas of the body where it is in excess. As a result, not only will you will get a bigger, rounder and perkier butt, but also a smaller waistline and a better-defined silhouette. To achieve the best possible results and to be able to sustain them over time, make sure to choose a board-certified plastic surgeon who plays out this procedure routinely. He will be able to guide you before and after the procedure to ensure the results stay with you. Losing volume after butt lipofilling is normal for the first two months. A percentage that can be as high as 30 or 40% will be reabsorbed by the body during this time. After this, the fat should develop a new blood network that will ensure its survival in the buttocks. Considerable weight fluctuations that occur after the procedure can also result in losing volume after butt lipofilling. Make sure to discuss this aspect in detail with the plastic surgeon to know exactly what you can expect when the procedure is performed.