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A new look: Fat injections used to enhance buttocks shape, projection


Autologous fat harvested from sites of the body can be injected into the buttocks to reshape them. Clinicians can use epidural anesthesia to make the procedure relatively painless. Forceful massage is necessary to distribute the fat and to optimize vascularization through increased contact with the muscles in the buttocks.

Key Points

New Orleans - Fat injection can effectively remodel buttocks to give them enhanced shape and projection, according to William Murillo, M.D., a plastic surgeon at the Universidad del Valle in Cali, Colombia.

"There has been an increasing demand for buttock augmentation in the last few years," says Dr. Murillo.

Fat injection

Indeed, Dr. Murillo has injected as much as 1,260 cc on each side of the buttocks without sequelae occurring.

Different ways have been attempted to treat the autologous fat that is harvested from the body to implant into other sites, such as the buttocks.

Dr. Murillo, who has performed the buttock augmentation procedure on more than 400 patients, says that decantation has been found to be the most effective way to separate fat cells from saline and serosanguineous components.


The fat injection is done through an incision on the sacral area, under either epidural or general anesthesia, with the majority of Dr. Murillo's cases receiving epidural anesthesia.

The key to the success of the procedure is vigorous massage of the buttocks following fat injection.

"You have to act like a baker who is kneading bread or making a pizza," Dr. Murillo says.

"It's very important to ensure distribution of the fat to optimize its vascularization with more contact with the muscles through massage," Dr. Murillo tells Dermatology Times.

In addition, vigorous massage also decreases the possibilities of fat necrosis, he says.

Fat can be injected subcutaneously in the lower portion of the buttocks in smaller quantities to provide roundness.

A study that Dr. Murillo published in Plastic and Reconstructive Surgery in 2004 found that the use of magnetic resonance imaging (MRI) supported the use of large quantities of fat cells being injected into the buttocks.

Longevity, reabsorption

In six patients, Dr. Murillo used MRI to capture visual images and to confirm the intramuscular location, integration and duration of injected fat.

Dr. Murillo harvests the fat with a 5 mm blunt cannula, stores it in an empty, sterile intravenous fluids bag or bottle trap, and then uses decantation to separate fat cells from other components. Although patients are able to comfortably sit down after the procedure, it is recommended that they avoid strenuous sports following the procedure, for about three weeks.

Measurements demonstrated a 20 per cent loss of augmentation effect during the first four months of treatment. At 12 months, Dr. Murillo observed no further re-absorption of fat.


There are some contraindications to the procedure. Patients who have chronic disease such as diabetes and/or cardiovascular problems are ruled out.

Further, patients should have sufficient excess fat deposits to permit clinicians to harvest at least 1,000 cc of fat, he says.

Disclosure: Dr. Murillo reports no relevant financial interests.

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