Health & Medical Cosmetic & Plastic Surgery

Fat Grafting VS. Implants for Buttocks Augmentation

Note: This study was done in Chugay Cosmetic Surgery Institute, Long Beach, California headed by two professional surgeons Dr. Nikolas V. Chugay and Dr. Paul N. Chugay over a period of four years. The original article was published in €The American Journal of Cosmetic Surgery€, Vol. 29, No. 3, 2012.

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Buttock forms have always been under scrutiny, with the advent in the advancement of cosmetic surgery, many cosmetic surgeons has been increasingly tasked in refining people's buttock appearance. A feature often associated to beauty and fertility is a plump and round bottom. To fill the needs of many patients, cosmetic surgeons have been working on how to augment the buttock region with minimal patient's dissatisfaction and complications. Buttock augmentation surgery has improved over time to include the procedure using implants and most recently, by fat grafting. This study wanted to evaluate the two procedures for the period of 4 years and to compare patient's satisfaction to the outcomes and complications.

Purpose of the Study

This study aims to compare the two primary techniques namely Fat Grafting and Implants in buttock augmentation and to determine which one is superior to the other in terms of patient's satisfaction, postoperative pain and complications.


A retrospective study of patients' records was conducted during the period of 2008 to 2011. A total number of 129 patients who have undergone buttock augmentations were identified. 96 patients are by way of silicone prosthesis and 33 via fat transfer with stem cell therapy. Medcalc version 12.1 was used for the analysis of data using chi square tests for areas of interest and the occurrence of complications were also tabulated. Both implant surgeries and fat grafting were performed. None of the patients received general anesthesia and all of them underwent IV sedation for their operations.


Over a four-year period, a total of 33 fat grafting augmentations and 96 implant augmentations procedures were performed in the Institution. The overall satisfaction of the patients who received buttock augmentation using implants was 76.0% or 73/96 of patients. On the other hand, the overall satisfaction of patients who received buttocks augmentation using fat grafting is 69.7% or 23/33 of patients. This was statistically significant (P <.001; 95% confidence interval).

The formation of Seroma was more evident in the implant group (3.0% versus 17.7%; P =.02; 95% CI, 0.070€"15.7), while dents and lumps were more evident in the fat-grafting group (33.3% versus 2.1%; P <.0001; 95% CI, 17.9€"51.8).

Other complications isolated to those who have undergone implant augmentations included contracture (13.5%) and dehiscence (14.6%).

Discussions of Results

All in all, patients were generally satisfied with the results of their buttock augmentations. However between the two, a greater proportion of patients were more satisfied to the result of implant augmentation compared to fat grafting. There is a significant difference (P <.001) in the overall satisfaction between the two procedures. This result is likely attributed to two factors: first, sometimes fat harvesting is insufficient for significant augmentation and second, there is inconsistency in the rate of fat absorption to patients who receive fat grafting.

With the aid of stem cell therapy, there has been an average of 75-80% fat transfer patients who are consistent in the results of other large studies on fat grafting. However, this is not 100% true to all patients. The outcome of the surgery may not be the final result. Therefore, the result shows that patients are satisfied with the initial result right after the surgery, but them there has been a drop in their satisfaction rating after their 3-month postoperative evaluation since there has been a decrease in the size of their augmentation.


Even though fat grafting procedure is getting popular for buttock augmentation, its results are not as reliable and satisfactory compared with implant augmentation. In some cases, there is the risk of having a contracture and dehiscence using implant surgery. Both patients and surgeons should be aware of these possible risks and benefits in implant and fat grafting procedures.

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