Butt augmentation: implants or your own fat (BBL), which should you choose?

Augmentation with butt implants involves placing solid silicone implants specifically designed for this area. They are inserted through an incision in the intergluteal crease, which hides the scar to a large extent.

There are two main placement planes: intramuscular (within the gluteus maximus muscle) and subfascial (above the muscle). The intramuscular technique is the most widely used because of its balance between a natural look and a lower risk of displacement. The implants come in anatomical or round shapes and are highly cohesive to withstand pressure and movement. The main benefit is that the volume achieved is stable and predictable, regardless of weight changes.

It is an option particularly suited to very slim patients or those without enough fat for a BBL. The trade-off is that you have to accept a scar and the fact that the implants may need replacing over time.

The BBL (Brazilian Butt Lift) uses the patient's own fat to enlarge and shape the buttocks. The procedure is divided into three stages:

1. Harvesting: liposuction is performed on areas such as the abdomen, flanks or lower back.
2. Processing: the fat is purified to isolate the viable cells.
3. Injection: it is strategically injected into the buttocks to add volume and shape.

The great advantage is that it combines two benefits: butt augmentation and body contouring (a “more defined waist” effect). The result usually looks and feels more natural. - Dr. Orestes

However, not all of the fat survives: between 30% and 50% is reabsorbed, which introduces some variability in the final result. In some cases a second session is recommended to optimize volume.

The choice depends on several factors:

• Little fat available: implants are the best option.
• You want to reshape your waist and back: a BBL gives a more all-round result.
• You are looking for maximum volume and precision: implants.
• You prioritize a natural look and a double benefit: BBL.
• Ideal case and flexible budget: a combination of both techniques.

There is no universally better option; what matters is adapting the technique to your anatomy and expectations. -Dr. Orestes

The combined technique uses a moderately sized implant together with fat transfer to refine the contour. It is indicated for patients who want significant volume but also a natural finish in areas such as the hips or the upper buttock.

The implant provides projection and structure, while the fat softens the transitions and improves the overall shape. The result is usually more balanced than with a single technique.

Recovery day by day

• First 3–5 days: swelling, discomfort controlled with medication.
• Weeks 1–2: gradual return to mobility, avoid direct pressure on the buttocks.
• Weeks 2–3: return to light social activities (sooner with implants than with a BBL).
• Weeks 3–6: with a BBL, sitting directly is still restricted.
• Week 6+: gradual return to exercise.
• 3 months: a more stable result.
• 6 months: final result.

Following the recommendations (especially avoiding pressure) is key to the result. -Dr. Orestes

Approximate prices in Spain (

• Butt implants: €6,500 – €12,000
• BBL: €7,000 – €11,000

These include the operating room, fees, anesthesia and follow-up. Be wary of very low prices: they may mean a lack of experience, weaker safety controls or the absence of qualified doctors.