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Transgender BBL: Buttocks Lift or Enhancement Surgery

Medically reviewed by Jennifer Richman on February 22, 2024.

The most successful procedure to date to give transgender patients a fuller, more stereotypically feminine backside is the buttocks enhancement. Also referred to as the Brazilian Butt Lift (BBL), transgender BBL, body sculpting BBL or MTF buttocks lift surgery, or body feminization surgery (BFS), it differs from traditional buttock implants because it uses fat from selected areas of your body (rather than artificial implants) to more naturally enhance your backside. This article explains the risks and other benefits of this multi-step procedure: targeting fat from the abdomen and flanks, then transferring it to the buttocks for long-term results.

Some trans women and feminine spectrum non-binary and gender-diverse folks may experience dysphoria or discomfort associated with the shape of their buttocks. While hormone therapy can change the shape of the buttocks, it can only do so much. For some folks, buttocks enhancement can help reduce feelings of dysphoria or discomfort associated with body fat distribution.

This procedure is remarkably similar to the Brazilian butt lift, but with specifics tailored to gender-affirming needs. To determine if you are a good candidate for a buttocks enhancement, schedule a consultation.

Long Lasting Results and Other Benefits of Buttocks Lift Surgery

This surgery is a versatile procedure with a variety of benefits:

• You can increase your waist-to-hip ratio without increasing your overall body weight.
• Through a technique called fat transfer, this procedure offers a less invasive, more natural enhancement than traditional silicone buttock implants. Donor fat can be harvested from parts of the body such as the abdomen and flanks, which can help achieve a more cinched waistline and possibly an hourglass figure. 
• Because this procedure uses the patient’s own fat as opposed to foreign bodies, such as silicone implants, the risk of rejection is almost non-existent.
• The answer to “how long does a Brazilian buttock lift last?” depends on each case. Generally speaking, if the host tissue accepts the fat that is transferred or grafted into it, the results are essentially permanent, meaning results can be life long. However, even if the fat transfer is successful, if the patient undergoes weight loss and loses overall body fat naturally, the area that was grafted will also shrink in size.

The Procedure

Buttocks lift surgery is a two-step process: fat harvesting from the trunk and then fat grafting to the buttocks. Once the patient has been sedated), your surgeon will use a thin tube, called a cannula, to break up and suction out unwanted fat from a donor site on your body.

Donor fat can be taken from almost anywhere on your body, but most patients benefit from trunk liposuction, which contours the waistline prior to augmenting the buttocks. This is a preferred strategy for patients seeking to achieve a conventionally more “feminine” body shape. Once the fat has been harvested, it is processed and purified. Your surgeon will then carefully re-inject the fat to produce a more rounded and convex outer buttocks. Injections are administered in a fan-like pattern and the process of redistribution may involve hundreds of small injections.

To achieve natural-looking results, buttocks feminization requires both technical expertise and nuanced artistry. For this reason, it’s very important to always select a board certified plastic surgeon for your surgery. When performed correctly, this procedure offers long-lasting results without the need for touch-ups or an additional round of fat injections.

Risks of Buttocks Enhancement

Generally speaking, this procedure offers less risk and more natural-looking results than other augmentation options. However, all surgical procedures have risks. During recovery, it’s possible (and likely) that you will experience temporary discomfort, swelling or bruising.

More serious complications may include infection, fluid build-up (seroma), bleeding or scarring. Likewise, there is a 30% chance of fat reabsorption. If you have questions or concerns about surgery, our surgical team would be happy to discuss the procedure with you in-depth during a personal consultation.

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