What is buttock reshaping?
Buttock reshaping is a body-contouring procedure designed to improve the shape, volume and projection of the gluteal region, giving the silhouette a more harmonious, well-proportioned profile. Many people, despite regular physical exercise, cannot achieve the shape they desire because of genetic factors, significant weight loss or simply their individual anatomy.
There are two main approaches, which Dr. Marco Galati evaluates carefully at consultation to identify the most suitable solution for each patient:
- BBL – Brazilian Butt Lift (gluteal fat grafting): a technique that uses the patient's own fat, harvested by liposuction from donor areas such as the abdomen, flanks, thighs or back, then purified and reinjected into the buttocks. The great advantage is the complete biocompatibility of the transferred material, since it is the patient's own tissue. The technique also reshapes the donor areas at the same time, slimming the waist and further defining the silhouette.
- Silicone buttock implants: indicated when the patient does not have enough fat for grafting, or wishes a more pronounced volume increase. The implants, made of solid or semi-solid silicone, are placed surgically in a submuscular or intramuscular pocket through an incision hidden in the intergluteal fold, making it practically invisible.
In selected cases, Dr. Galati may propose a combined technique using buttock implants integrated with fat grafting, to achieve the optimal result in terms of both volume and naturalness of the profile.
Who are the ideal candidates?
The ideal candidate is an adult in good general health with realistic expectations. For the BBL, sufficient adipose tissue in the donor areas is essential, which makes the procedure particularly suited to patients of normal weight or with localised fat deposits. With buttock implants, even slim patients with little donor fat can achieve an excellent result. In both cases, personal motivation and the ability to follow the post-operative instructions are key to the success of the procedure.
How the operation is performed
Brazilian Butt Lift (BBL)
The BBL is performed under general anaesthesia or, in selected cases, local anaesthesia with sedation, and takes approximately 2–4 hours. It comprises three main phases:
- Liposuction of the donor areas: fat is harvested from one or more areas (typically abdomen, flanks, back or thighs) using fine cannulas connected to a controlled-pressure aspiration system. Donor sites are planned pre-operatively to optimise both fat yield and overall body contouring.
- Fat purification: the harvested tissue is purified by centrifugation or filtration, separating viable fat from oil, blood and cell debris. Only healthy, intact adipocytes are selected for transfer.
- Reinjection into the buttocks: the purified fat is reinjected through micro-punctures, distributed in layers to maximise graft survival and ensure a natural result. Injection is performed exclusively in the subcutaneous plane and superficial muscle layer — never deep into the gluteal muscle — to avoid the risk of fat embolism.
Buttock implants
Buttock implant surgery takes approximately 2–3 hours under general anaesthesia. A single incision is made in the intergluteal fold, practically invisible once healed. Through this incision, a pocket is created either beneath the gluteus maximus muscle (submuscular) or within it (intramuscular), where the silicone implant is positioned. The plane of placement is chosen according to the patient's anatomy and the desired result: the submuscular position gives greater implant coverage and a more natural appearance, while the intramuscular position offers better stability. The incision is then closed in layers and dressed.
Pre-operative preparation
In the weeks before surgery the patient undergoes blood tests and an anaesthesiology assessment. Dr. Galati recommends suspending anticoagulant medication (aspirin, NSAIDs, oral anticoagulants) at least 10–14 days beforehand and stopping smoking completely for at least 4 weeks, since nicotine impairs the microcirculation and significantly reduces fat graft survival in the BBL.
Recovery and results
After surgery the patient is observed for a few hours or overnight, depending on the complexity of the procedure. In the first days it is normal to experience moderate discomfort, swelling and tightness, easily managed with the prescribed pain medication.
For the BBL, the most important post-operative rule concerns positioning: for the first 4–6 weeks direct pressure on the buttocks must be avoided. This means sleeping on the stomach or side and, when sitting is necessary, using a doughnut cushion that shifts the weight onto the thighs. This precaution is essential for the transferred fat to develop its own blood supply. After buttock implants, recovery involves limiting sudden movements and intense physical effort for 4–6 weeks, with a gradual return to daily and sporting activities.
Compression garments are worn over the liposuction donor areas for 6–8 weeks: they promote resolution of the swelling, reduce the risk of seroma and help the skin readhere correctly. Dr. Galati schedules follow-up visits at 7 days, 1 month, 3 months and 6 months.
After a BBL, swelling resolves gradually over the first 4–8 weeks. The transferred fat reaches its definitive condition between 6 and 12 months, once the physiological survival and reabsorption process is complete; the proportion of fat that survives stably is typically 50–70%. After buttock implants, results are appreciable within the first weeks and the definitive result stabilises at around 3–4 months. Modern silicone implants offer a very natural look and feel with excellent longevity, although they may require revision over the years.
Frequently asked questions
The BBL uses fat harvested from the patient by liposuction and transfers it to the buttocks: the result is very natural to see and touch, with the added benefit of slimming donor areas such as the abdomen and flanks. Silicone implants are recommended when the patient lacks sufficient donor fat or desires a more pronounced, definitive volume increase. In some cases Dr. Galati combines the two techniques for the best possible result.
On average 30–50% of the transferred fat is reabsorbed in the first 3–6 months, which is why the surgeon always transfers slightly more volume than the final goal. Graft survival depends on surgical technique, post-operative care and lifestyle — in particular avoiding direct sitting pressure in the first weeks and not smoking around the time of surgery.
For the first 4–6 weeks it is essential to avoid direct pressure on the buttocks so the grafted fat can establish its blood supply. Sleep on your stomach or side and, when sitting is necessary, use a special doughnut cushion that shifts the weight onto the thighs. Dr. Galati provides personalised guidance at each follow-up visit.
With a BBL, the fat that survives behaves like normal body fat: it stabilises definitively after 6–12 months but can change with significant weight fluctuations, so a stable weight is important. Silicone buttock implants are very long-lasting and unaffected by weight changes, though they may require revision or replacement over the years, as with any implant.
Safety depends critically on technique. In line with international guidelines, Dr. Galati injects fat exclusively into the subcutaneous plane and superficial muscle layer — never deep into the gluteal muscle — to avoid the risk of fat embolism. The procedure is performed in an accredited surgical facility with full anaesthesiological monitoring.