The Procedure

brazilian buttThe Brazilian Butt lift is a term used to describe a cosmetic procedure which involves using your own body fat to lift, reshape and enlarge the buttock area. The medical term for the procedure is autologous fat transfer. Autologous simply means using fat from one’s own body. In summary, fat is harvested from various parts of the body which store excess fat using liposuction. The areas targeted for liposuction usually include the abdomen, waist line, thighs and sometimes the hips. The fat is then purified and injected into the buttocks and shaped to produce a round and more visually appearing silhouette. This article will focus on the procedure itself and exactly how it is carried out.

Technique

First, the areas to be treated are marked out with a medical pen. This includes the areas the surgeon treats with liposuction, as well as the areas in the buttocks to be injected with the fat. The initial part of the surgery is performed under general anesthetic with the patient lying prone (chest down, back up). This position allows the surgeon access to the lower back and hip area where fat is often harvested using liposuction. This is usually done using two small incisions. A solution of xylocaine and epinephrine, or something similar, is used with the instruments inserted for liposuction. The solution is injected under the patient’s skin, into the fat to loosen it up so that it can be sucked out with the instruments. The solution used minimizes bleeding and numbs the area. This solution is also used when injecting the fat into the buttocks to numb the area and minimize post-surgery bleeding.

Liposuction

A syringe technique is used for the liposuction itself. This essentially means that a syringe like instrument is inserted into the areas to be treated using a cannula, the solution injected and the fat extracted using suction. The extracted fat is very clean; however, some body fluids can be included. The extracted fat is sucked straight into a container which is attached by tubing. Liposuction continues until enough fat for each buttock has been harvested. The amount varies depending on the person, but is usually 60 mL in total- with 30 mL for each buttock. This fat is then transferred into syringes allowing the fat to float to the top so that any body fluid can be removed and the fat further purified. The surgeon can then go on to further shape and contour the waist line using machine liposculpture to the desired silhouette.

Injection

The fat is then injected into the buttocks at the top using the same incisions used for the liposuction in a fan like fashion. This is done by repeatedly inserting the cannula containing the fat, injecting a small amount of fat and removing it again, inserting the fat in multiple small tunnels, for even distribution of fat throughout the buttock area. The surgeon repeats the process until all the fat has been distributed evenly in both buttocks. After the process is complete, the wounds where the cannula was inserted are closed with sutures.

More Liposuction

The patient is turned over onto their back (supine) for more liposuction, but this time the fat is aspirated (sucked out) from the abdomen and waist line. Again, the fat is aspirated using syringes and a cannula and the extracted fat is transferred into a sterile container via tubes. Once enough fat has been harvested, which can be seen via measuring lines on the sterile container, liposuction is stopped. Machine liposuction may then be continued for a smooth, sculpted appearance. The aspirated fat is again separated from any body fluid and further purified for more fat transfer.

Further fat transfer

Depending on the requirements of the patient, the liposuction incisions may be closed and the patient turned prone again for further fat transfer into the lower area of the buttocks. Extra fat is injected into multiple channels or tunnels in the buttocks in a fan like motion. Depending on the required end result, this can be at the top- to give the much desired “shelf” like appearance, the sides, to give a more rounded silhouette and in the fold region of the buttocks at the bottom, to give a more rounded appearance to the cheeks. In this second fat transfer, no more than 30mL of fat is usually used. This is because most surgeons who are experienced at performing this procedure are aware of the fact that injecting more fat does not mean that all of the fat injected will survive. If any fat is left over, it is frozen and stored appropriately so that it may be reused at a later date in the event that some volume is lost. Assuming that the procedure is done correctly and that post operative care is appropriate, the fat can remain in place for the long term and in many cases is permanent.

Post-Operative Care

Transferred fat can only survive in the long term if new blood vessels grow into it to supply it with blood. This process is termed vascularization. If vascularization does not occur then the fat cells die and are reabsorbed back into the body. This means that it is of vital importance that the patient does not sit on the buttocks at all for the first four days following surgery. It has been demonstrated scientifically that it takes this amount of time for new blood supplies to form with the new fat cells. Some surgeons even recommend that patients do not sit on their buttocks for the first three weeks following surgery to help the process of vascularization and allow for permanent results. Compression garments must be worn for at least the first two weeks following surgery. Despite the area being full of bacteria, the rate of infection for this type of surgery is relatively low. This is because the area is thoroughly cleaned prior to surgery taking place. The patient will be sore and have bruising post-surgery, but this is normal. There may be slight swelling. Any swelling should be reported to the physician during post-surgery visits as it may need to be aspirated. Most patients recover well and are able to return to normal life within four to six weeks.