The bottom line

Updated: 6 Oct 2014
Jessica Rule

Find out why the newest cosmetic trend is all about optimising booty.

Jennifer Lopez and Kim Kardashian spent most of the noughties as the butt of jokes for their sizeable backsides. They're having the last laugh now, though, with less well-endowed ladies flocking to surgeons, and waving pictures of J.Lo and Kim like teen girls at a Bieber concert.

Arguably, you can trace it all back to Pippa Middleton. Stealing the spotlight at her sister Kate's wedding day in 2011, the sight of Pippa from behind, trotting along on veil watch, had the world transfixed. The junk in Pippa's trunk saw myriad British women book in for surgery: UK newspaper The Daily Star reported that requests for butt implants went up 60 per cent post the royal wedding. One enterprising cosmetic surgeon even grandly unveiled 'The Pip Package Perfect Posterior'.

Serendipitously, the Pippa phenomenon also coincided with a period when we all got a little nuts about Brazil, too. Zumba, tans, Gisele Bundchen, and teeny weeny bikini bottoms (plus the therefore-requisite Brazilian wax) all came into fashion, as did – you guessed it – Brazilian butts.

The fashion in Brazil is for smaller breasts and large, round buttocks. In Australia,
breast augmentation has been the mainstay for most women for many a year, but
because we live for the beach just like the Brazilians, having a buoyant butt has now become equally desirable.

Thanks to social media, appreciation for this body type has been celebrated far and wide. My own fitspiration (sorry, #fitspo) on Instagram is a former nobody named Jennifer Selter (@jenselter) who has acquired 3.5 million followers and been inundated with sponsorship offers on the back of the attention grabbed by her many hundred workout posts.

With the world in the grip of a fitness craze, Jen is a marketer's wet dream, nailing the target market of women seeking a babing bod with a toned and tremendous ass. Her enthusiastic squat-based workouts have even spawned the term 'seltering'. You know you've made it when your name becomes a verb.

Similarly, social media and the internet have meant the availability of information on surgeries to lift and enhance your rear end has rocketed. Patient forums are buzzing with post-surgery stories, and wannabe patients discussing the ups and downs of butt implants and Brazilian butt lifts (or BBLs, as they're known in plastic land).

Butt implant surgery, like breast implant surgery, places artificial implants either under or on top of your muscle to enhance the size and shape of your rear. The implants are composed of cohesive silicone gel and elastomer, so they cannot leak. They come in many sizes and volumes, in two shapes – round and teardrop – and are inserted via a 2-3 inch incision in the tailbone (the 'bricklayer's crack', in common terms).

In a BBL, the surgeon takes fat from other areas and carefully injects it in multiple layers throughout the buttocks, to give you a more enviable rear view. Additional liposuction is often done around and near the buttocks to improve contouring and the appearance of lifting – even with implants, some fat transfer is usually used to pad things out a bit.

Subiaco cosmetic and plastic surgeon Dr Patrick Briggs says that, at present, buttock augmentation is a procedure that is most common in South America and the 'Latina influenced' areas of the United States, especially Florida.

"The surgery is rare in Australia, with only a small number of surgeons doing augmentation," he says. "I have done a small number over the last few years, but there is no doubt that enquiries are increasing. And with globalisation, the numbers will continue to increase."

Indeed, the American Society of Plastic Surgeons reported a staggering 10,000
buttock augmentation procedures were performed in the United States in 2013, up 16 per cent on 2012.

The major risk of implants is infection and possible movement of the implant, so
a good surgeon will place the implant behind the muscle. "If they are placed just below the skin, the implants may become visible over time," says Dr Briggs.

Although there is no foreign object (such as an implant) used in a BBL, there are still risks. "The limitation here is the amount of fat available on the patient, and that fat transferred may also reabsorbed by the body over time," says Dr Briggs.

Always ensure your surgeon is experienced in the procedure and certified by a reputable plastic surgery medical board. Because the area of the body being worked on is required for walking and sitting, there is more pain and a longer recovery time than many other surgeries, but in spite of the initial discomfort, most women report satisfaction with the results.

Trends on Realself.com – the high-traffic plastic and cosmetic surgery community portal – appear to be more favourable towards BBL at this point in time, from the point of view of both US doctors and their patient market, despite unpredictable results with the fat transfer procedure. A huge 93 per cent of patients who have undergone a BBL said on the site that it was worth it. Of those who had buttock implants, 79 per cent said they were glad they had.

Danielle, a patient of Dr Hal Michael Bass in Florida, was 173cm tall, 72kg and with a bra size 36DD. She got a BBL and liposuction having lost her curves post baby. "I celebrated my 30th with a bang and the body I have always wanted," she says. "I am still loving my new shape and glad that I did it… but this surgery is a quick fix to a visual problem and you still have to work on the inside thoughts about yourself."

Danielle says she has instigated a lifestyle change, and has altered the way she eats and exercises. "I am glad that I came into it with a realistic visual of myself and not thinking that I was going to step out of a phone booth looking like Nicki (Minaj)," she says. "I didn't want men just looking at my ass – at the end of the day I am a woman and a mother, and I hope that the women that go through with surgery do it for them and not to please someone else – don't do this to be the next Nicki, Kim, or anyone else."

So the question is, can you get a backside like Kim Kardashian if you go under the knife? "In order to acquire the dramatic curves of Kim Kardashian, you have to have the proper underlying bone anatomy," says Beverly Hills plastic surgeon Dr Ashkan Ghavami. "Your hip bones should be flared out a bit so that an hourglass shape can be enhanced further with suctioning of fat from specific areas and transferring to your buttock."

Dr Ashkan says it is important your surgeon understands buttock aesthetics. "Your results will really depend on the skill of your surgeon, his artistic eye (to envision
how your final shape should be), and that proper respect and techniques of fat transfer are used," he says. "The more fat you have and the more fat that survives, the more Kardashian-like you can be." Dr Ashkan says approximately 50-80 per cent of the fat cells will survive long term.

Like all plastic surgery, there is the risk of it looking unnatural, so if you don't have the body to carry a bigger behind, or you can't imagine going through surgery to get one, then rest easy. Australia's fitness craze means there are gyms on every street corner, and thousands of personal trainers in parks near you just waiting to put you on a squat program. Working on what your mama gave you, and then shaking it, never hurt anyone. No ifs or butts about it.

The bottom line - Localista