Buttock augmentation with implants is an aesthetic surgery procedure aimed at increasing the volume and projection of the buttocks when available fat volume is insufficient or when the patient seeks a more structured and predictable result. Unlike fat grafting (BBL), this technique relies on the implantation of solid silicone prostheses, with specific indications, benefits and risks.
Clinical indications for buttock augmentation with implants
Buttock augmentation with implants: medical indications
This surgery may be considered when:
- the patient presents with insufficient buttock volume with little mobilisable fat,
- a loss of projection exists despite stable weight,
- a stable result not dependent on fat gain is desired,
- reconstructive or secondary surgery is necessary following failed fat grafting,
- the patient seeks maximum predictability of the final result.
Implants are particularly indicated in slim or very athletic patients who do not have sufficient fat for effective fat transfer.
How buttock augmentation with implants works
Surgical principle of buttock implants
The procedure involves creating a surgical pocket in the buttock region to insert a solid cohesive silicone implant, specifically designed to withstand the mechanical stress associated with sitting and muscle contraction.
Types and characteristics of buttock implants
The implants used are high-density cohesive silicone prostheses, different from breast implants due to their increased resistance to compression.
Available shapes:
- Round: overall and homogeneous volume increase
- Anatomical oval: targeted projection with more natural shape
Volumes: generally 200 to 600 cc depending on the patient's morphology, soft tissue thickness and desired result.
The volume and shape are chosen before the procedure during consultation, based on precise anthropometric measurements and muscle thickness. This selection allows for result predictability, unlike fat grafting where part of the injected fat may resorb variably.
Surgical techniques for buttock augmentation with implants
Buttock implants: operative techniques
Implant placement plane
Clinical studies describe several possible surgical planes:
- Intramuscular plane: the implant is placed inside the gluteus maximus muscle (most commonly used technique currently)
- Submuscular plane: the implant is positioned beneath the muscle
- Subfascial plane: the implant is placed above the muscle (technique associated with more complications)
Surgical data show that the intramuscular plane offers the best implant coverage, reduces palpability and presents lower complication rates than superficial planes.
Surgical approach
- Single incision in the median intergluteal fold (4 to 6 cm)
- Sometimes double incision depending on the chosen technique and patient anatomy
The scar is concealed in the natural fold between the buttocks, making it minimally visible after complete healing.
Course of the procedure
- Duration: 2 to 3 hours depending on complexity
- Anaesthesia: general anaesthesia required
- Hospitalisation: 1 to 2 nights depending on the surgeon's protocol and postoperative progress
- Technique: pocket creation, implant insertion, meticulous closure in several layers with temporary drainage
Preparation and postoperative recovery
Before and after buttock augmentation with implants
Before the procedure
- Smoking cessation recommended at least 4 weeks before surgery
- Complete preoperative assessment (blood tests, anaesthesia consultation)
- Precise evaluation of skin and muscle quality
- Thorough discussion of realistic expectations and implant choice
- Photographic planning and anthropometric measurements
Detailed recovery protocol
Weeks 1 to 3:
- Direct sitting position strictly limited or with specific pressure-relief cushion
- Sleep only on stomach or side
- Time off work recommended (except standing telework)
- Light walking authorised from day 2 to promote circulation
- Wearing compressive compression garment
- Pain controlled by appropriate analgesics
Weeks 4 to 6:
- Gradual return to normal sitting position
- Return to usual daily activities
- Light physical activities authorised (walking, gentle activities)
- No intense sport or weight training yet
Week 8 onwards:
- Complete return to sport (running, weight training, contact sports)
- Final result visible between 3 and 6 months after complete oedema resolution
- Regular follow-up with surgeon to monitor implant position and condition
Results, timelines and clinical efficacy
Results of buttock augmentation with implants
Surgical publications show:
- Immediately visible volume from leaving the operating theatre
- Initial swelling phase during the first 2 to 4 weeks
- Result stabilisation after the initial inflammatory phase (approximately 3 months)
- Long-term volume durability, the implant not resorbing unlike fat grafting where 20 to 40% of injected fat may disappear
Patient satisfaction
Overall satisfaction is high in published series, with patients particularly appreciating the predictability and permanence of the result. Main satisfaction factors include improved silhouette in clothing and stable projection over time.
Long-term results
Buttock implants are designed to last many years. Unlike old-generation breast implants, modern cohesive silicone buttock implants show excellent durability. Replacement may however be necessary in case of complication, displacement or simply if the patient wishes to modify the volume after several years.
Possible complications of buttock implants
Risks and complications of buttock augmentation with implants
Complications reported in clinical analyses include:
Early complications:
- Wound dehiscence: 15 to 30% in historical series, reduced to less than 10% with intramuscular plane and modern protocols. Treatment by local care, rarely reoperation.
- Seroma: fluid accumulation around the implant in 5 to 15% of cases according to studies. Generally resolvable spontaneously or by simple aspiration.
- Haematoma: postoperative bleeding sometimes requiring drainage.
- Infection: 2 to 8% of cases. May require prolonged antibiotic treatment, or even temporary implant removal followed by delayed reimplantation.
Late complications:
- Implant displacement: less than 5% of cases with adequate fixation and compliance with postoperative protocol. Requires repositioning surgery.
- Excessive implant palpability: depends on chosen plane and patient tissue thickness.
- Painful fibrous capsule: formation of tissue envelope around the implant that may create discomfort.
- Asymmetry: may require surgical revision.
- Need for revision surgery: estimated at 5 to 15% of patients within the first 5 years.
Overall complication rates are higher than for isolated fat grafting, which underscores the importance of rigorous patient selection and expert surgical technique.
Contraindications to buttock augmentation with implants
When to avoid buttock implants
Absolute contraindications
- Active or chronic infections in the buttock region
- Severe uncontrolled healing disorders
- Uncontrolled diabetes
- Active autoimmune diseases affecting healing
- General health condition incompatible with general anaesthesia
Relative contraindications
- Active smoking (significantly increases risk of healing complications)
- Very high or very low body mass index
- Unrealistic expectations regarding the result
- Insufficient soft tissue quality (very thin skin, atrophied muscle)
- History of radiotherapy in the buttock region
- Significant weight instability
A complete medical evaluation determines whether the patient is a good candidate for this procedure.
Buttock implants vs Brazilian Butt Lift: what's the difference
Understanding the two approaches to buttock augmentation
Buttock implants and the Brazilian Butt Lift (BBL) are two distinct techniques addressing different needs. Understanding their differences allows choosing the most suitable approach for each situation.
Volume source and result nature
Augmentation with implants relies on inserting a solid silicone prosthesis, whilst the BBL uses the patient's autologous fat harvested by liposuction. This fundamental difference influences all other aspects of the procedure.
With implants, the volume is immediate and predictable: the surgeon knows exactly what the final result will be from implant selection. With BBL, part of the injected fat (generally 20 to 40%) resorbs in the months following the procedure, making the final result less predictable.
Evolution over time
Implants offer stable and permanent volume. They do not change with weight variations, which can be an advantage for some patients seeking a constant result, but a disadvantage for others wishing natural evolution.
BBL, using living fat, follows weight variations: transferred fat increases or decreases like the body's native fat. Some patients appreciate this natural adaptation, others prefer implant stability.
Touch sensation and natural appearance
Autologous BBL fat offers a very natural sensation to the touch, indistinguishable from normal buttock tissue. Implants, whilst increasingly sophisticated, may sometimes be palpable, particularly in very slim patients or depending on the chosen placement plane.
Natural visual appearance depends more on surgical technique and chosen volume than on the method itself. Well-placed implants can give a very natural result, just as BBL can appear artificial if volumes are excessive.
Ideal candidates for each technique
Implants are particularly suitable for slim or very athletic patients with little available fat for transfer, those seeking maximum predictability, or those having already undergone BBL without satisfactory result.
BBL is better suited to patients with sufficient mobilisable fat (storage areas in abdomen, flanks, thighs), those wishing to combine body remodelling and buttock augmentation, or those preferring to avoid a foreign body.
Course and recovery
Procedure duration is generally shorter for implants (2-3 hours) than for BBL (3-4 hours including liposuction).
Social downtime is comparable: approximately 3 to 4 weeks for implants with strict sitting position limitation, 2 to 3 weeks for BBL with the same restrictions to protect transferred fat.
Postoperative pain is often more pronounced with implants due to muscle dissection, whilst BBL combines discomfort from liposuction areas and the buttock region.
Specific risks
Implants present risks related to prosthetic material: infection potentially requiring implant removal, displacement, rupture (rare with modern implants), and fibrous capsule formation.
BBL carries a specific and serious risk: fat embolism, although rare when technique is respected (injection only into subcutaneous fatty tissue, never into muscle).
Combined approach
Some surgeons propose a composite approach combining implant and fat grafting to optimise the result: the implant provides projection and structural volume, whilst fat grafting refines contours and improves transition with adjacent areas.
Which technique to choose
The choice between implants and BBL should not be dictated by general preferences but by individualised assessment taking into account patient morphology, aesthetic objectives, medical history and risk tolerance. A thorough consultation with a surgeon experienced in both techniques allows determining the most suitable approach.
Price of buttock augmentation with implants in Belgium
Cost of buttock implant surgery
Price range in Belgium
The cost of buttock augmentation with implants in Belgium is generally between £5,900 and £7,500 for the complete procedure.
This range includes:
- Surgical fees
- Anaesthesia fees
- Clinic and hospitalisation costs (1-2 nights)
- Implant cost
- Initial postoperative follow-up
Elements influencing the price
Several factors explain price variations:
- Implant quality and brand: latest generation implants are more expensive
- Surgeon's experience: specialist surgeons with recognised expertise charge higher fees
- Clinic standard: the most recent or prestigious establishments have higher rates
- Technique complexity: intramuscular plane and certain sophisticated approaches may increase cost
- Associated procedures: if complementary fat grafting or refinement liposuction is performed simultaneously
Financial details
These rates exclude potential additional fees and additional costs (medicines, specific compression garments, follow-up consultations beyond the standard protocol).
Buttock augmentation with implants being an aesthetic surgery procedure, it is not reimbursed by Belgian health insurance, except in exceptional cases of reconstruction following trauma or documented congenital malformation.
