A Brazilian buttock lift transfers the patient's own fat: fat is liposuctioned from the waist, abdomen, lower back and flanks, processed and filtered, then injected into the fatty layer beneath the buttock skin to add volume and improve contour. The name is misleading, because the procedure adds volume rather than lifting: it removes no excess skin and does not correct genuine sagging. Anyone who needs a lift needs surgical excision, which is a different operation with a different scar. **This is not a treatment for obesity.** The fat removed during the procedure is limited and does not count as weight loss. It is a shaping procedure for people whose weight has already stabilised, not a substitute for diet, exercise or bariatric surgery. Anyone who has it before their weight settles loses the result: transferred fat cells behave like the rest of the body's fat, enlarging with weight gain and shrinking with weight loss, so the shape changes and its proportions are lost. **The gravest risk of this procedure is fat entering the veins and blocking the lung circulation** if fat is injected into or beneath the gluteal muscle where the large veins lie. For that reason the rule followed today is to inject only into the subcutaneous layer above the muscle, using thick cannulas kept in constant motion, and many surgeons use ultrasound to confirm the depth of the cannula. This is not a technical detail but a matter of survival, and you are entitled to ask your surgeon about it directly. **Shortness of breath or chest pain during the procedure or in the first hours afterwards is an emergency.** Other limits are explicit. Not all transferred fat survives; part of it is reabsorbed in the first months, the surviving proportion cannot be predicted for any individual, and a second session may be needed. No guaranteed size can be offered. The procedure does not treat cellulite, which is never permanently cured by any method, and it does not tighten loose skin. Very lean people may not have enough donor fat. And non-surgical devices do not repair genuine skin laxity. Candidacy is decided by clinical examination. The surgeon assesses fat reserves at the donor sites, buttock skin elasticity and the degree of sagging, and discusses your weight and its stability, smoking, and coexisting conditions such as diabetes, clotting disorders, anaemia and any previous clot. **Smoking impairs blood supply and undermines both fat survival and wound healing.** Scars here are small: a few millimetres at each liposuction access point on the waist, lower back or buttock crease, which remain as small permanent marks even as their colour fades.
Procedure steps
- 1
Examination and assessment of fat reserves
The surgeon examines the donor areas and estimates how much fat is available, and assesses buttock skin elasticity and the degree of sagging to separate those who will benefit from injection from those who need surgical excision. Expectations are corrected: no guaranteed size, part of the fat is reabsorbed, and a second session may be required. The danger of deep injection is explained openly, along with the rule that fat goes into the subcutaneous layer only.
- 2
Work-up and clot risk assessment
Blood tests, clotting studies, haemoglobin and blood sugar are checked, and clot risk is assessed because the procedure is performed under general anaesthesia in the prone position and may take some time. Your medications are reviewed so blood thinners and supplements that increase bleeding can be paused in coordination with your treating doctor, prevention is planned with early mobilisation and compression stockings, and stopping smoking is required.
- 3
Harvesting fat from the donor areas
A dilute solution is infiltrated to reduce bleeding, then fat is gently suctioned from the waist, abdomen, lower back or flanks through small access points at low pressure to preserve the viability of the fat cells. The harvesting itself sculpts the waist and defines the buttock borders, and the volume removed is limited by safety thresholds rather than by a wish for more graft.
- 4
Processing and strictly subcutaneous injection
The fat is filtered free of blood, fluid and free oil, then injected in many small aliquots into the subcutaneous layer above the muscle, through a thick cannula kept in continuous motion, strictly avoiding injection into or beneath the muscle so that fat cannot enter the large veins. Many surgeons use ultrasound to confirm cannula depth, and your vital signs are monitored closely throughout.
- 5
Recovery, sitting restrictions and follow-up
The small access points are closed, a compression garment is fitted for the donor areas without pressing on the buttocks, and you are monitored for several hours with particular attention to breathing. Sitting directly on the buttocks is avoided or restricted for weeks according to your surgeon's instructions to protect the grafted fat, and follow-up appointments assess how much volume persists over six months to a year.
Before the procedure
Tell your surgeon about every medication and supplement you take, especially blood thinners, aspirin, steroids, hormonal contraceptives and herbal products, and never stop a long-term medication on your own. Stop smoking, shisha and nicotine substitutes for the period your surgeon specifies; smoking impairs blood supply, reduces graft survival and causes wounds to fail. Do not try to gain weight beforehand to provide more donor fat; ask for a realistic plan instead, and keep your weight stable before and after, because the result changes when it changes. Treat anaemia before your date and fast for the period you are told. Ask your surgeon directly about the depth of injection and whether the procedure is done in a facility equipped for emergencies. Arrange someone to accompany you, and at home prepare a cushion that lets you sit on your thighs and a place to sleep on your front or side.
After the procedure
Walk short distances frequently from the first day to prevent clots, do not sit directly on your buttocks for the period your surgeon specifies and use a cushion that shifts weight onto the thighs, and sleep on your front or side. Wear compression on the donor areas only and keep pressure off the buttocks. Do not massage the buttocks or expose them to intense heat. Expect swelling and bruising at the donor sites that settle over weeks. Keep your weight stable and your nutrition adequate, and expect some of the volume to recede in the first months before it settles. Seek care immediately for: **shortness of breath, chest pain or rapid breathing after the procedure, which may mean fat or a clot has reached the lungs, the most dangerous complication - call emergency services at once** - **leg pain with swelling and warmth** - **fever, purulent discharge or a foul smell from the access points** - **sudden increasing swelling, severe pain, or buttock skin turning blue or black**.
Expected duration
The procedure usually takes two to four hours depending on the number of donor areas and the volume transferred. Most people go home the same day or stay one night. Return to desk work is typically one to two weeks with sitting restrictions, strenuous exercise after six weeks, and the final volume settles at six to twelve months once it is clear how much fat has survived.
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