The term butt lift has been widely used to mean not only lift but more importantly shaping.  Butts, like breasts, come in many different shapes and sizes.  Essentially, there are 4 basic shapes:

 

Heart Shaped

Studies show that most prefer the heart shaped butt characterized by a smaller waist and bigger hips; picture an upside down heart).  The heart-shape closely mimics the "ideal" waist-to-hip ratio of 0.7.  

Round

After heart shaped, the round butt ranks second in preference.  This shape has been popularized by many celebrities and is characterized by it's fullness.

Square

On side view, a square butt looks flat and masculine.  This shape is very amenable to liposuction to remove fat around the butt creating more of a contrast in the waist hip area and to achieve a curve.

V-Shaped

Generally considered the least attractive shape, the V-shape is characterized with a paucity of buttock skin and tissue with more fat in the waist and outer thigh.  This is the also the most difficult to correct.

OPTIONS

Fat Transfer:  Brazilian Butt Lift	Silicone Butt Implants	Injectable Filler:  Sculptra

To lift, shape, or augment the butt using volume there are essentially 3 options:

1. Autologous Fat:  Use your own fat
2. Silicone Butt Implant
3. Injectable Filler:  Sculptra

Autologous Fat:  Brazilian Butt Lift (BBL)

The most popular and widely used method is with your own fat; autologous fat.  Liposuction is used from areas where fat is unwanted:  arms, bra fat, back, flanks/love handles, abdomen, and thighs.  The fat is processed to remove all impurities and then re-injected into the butt to the desired endpoint.  

Because fat is natural, the result is a natural increase in volume with the ability to sculp the butt by placing fat where it is needed.  Unfortunately, not all of the fat that is placed will permanently stay and a variable amount will be absorbed by the body.  The use of liposuction to sculp the waist, hips, and thighs also contributes to the result by accentuating the body's natural and desired curve.

For safety reasons, fat is not placed into the muscle but rather into the fatty layer above the muscle.  

Silicone Butt Implants

Silicone butt implants can be used in cases where there is not enough fat to harvest with liposuction.  Many women are simply too thin to donate fat for a BBL.  In those cases, silicone implants can be used to add volume.

Implants come in different shapes and sizes:  round, anatomical, and natural contour.

Implants are generally placed into the muscle using an incision in the midline gluteal cleft to hide the incision.  Implants can be combined with fat transfer to add extra volume, help blend the implant contour, and provide more shape.

Widespread use of implants has been limited because of a relatively high rate of complications including infection and chronic pain.  

Injectable Filler:  Sculptra

Some patients desiring a butt lift many not have enough fat or prefer not to have liposuction.  In these cases, a filler can be used to add volume.  Of the available filler, Sculptra is preferred because it provides more volume and stimulates your body to produce collagen.  

The buttock is a large area so filler can only provide more subtle changes because filler volumes are far more limited than fat.  Sculptra is priced by the vial so the cost for this approach can be prohibitive for many patients.

Sculptra is ideal for very fit women who desire small and subtle changes to their shape.  For example, a thin, athletic women with a flat butt who desires a subtle curve and shape would be a good candidate for the procedure.  

Sculptra can be done in the office using only local anesthetic.  A typical treatment consists of about 5 vials per side or a total of 10 vials.  In most cases, an additional treatment is necessary to achieve the desired result.