Brazilian Butt Lift: What to Expect on the Day of Surgery

A Brazilian butt lift (gluteoplasty) has two parts: retrieving the fat that will be transplanted into your buttocks (harvesting) and injecting that fat to create a fuller, more contoured backside (grafting).

This is done in one surgery, and the areas of extraction and placement are discussed ahead of time during pre-procedure consultations.

Before the Surgery

When you arrive for your surgery, you will check in, turning in any forms you were asked to fill out ahead of time. You will also be asked to sign various consent forms.

There will be an area where you can change into a hospital gown and store your belongings. If you forgot to forego wearing jewelry or make-up, you will be asked to take it off at this time.

A care team member will review your medical history as well as whether or not you complied with suggested preparation steps (e.g., not eating or drinking after 12 a.m. that day, avoiding showering and using skin and hair care products the night before and day of your surgery).

Although you will have already discussed your desired outcome, areas of existing fat that can be used as harvest sites, and the full surgical plan itself, your surgeon will quickly go over this again on the day of surgery.

You will also meet with the anesthesiologist to discuss the planned form of anesthesia and its risks.

The surgeon will outline where the additional fat is desired with a surgical marker. They will also mark the incision sites through which the fat will be injected, as well as the site(s) from which the fat will be retrieved. (Common areas include the hips, thighs, belly, and lower back.)

During the Surgery

You will be placed on the surgical table either supine (face-up) or prone (face-down), depending on where your surgeon will first begin harvesting fat.

Various monitors that allow the team to keep an eye on your heart rate, oxygen levels, blood pressure, and temperature throughout the procedure will be hooked up. You will be given either general anesthesia (which puts you completely to sleep) or IV sedation (you won't be unconscious, but will not feel any pain).

The donor sites will then be cleaned with an antibacterial solution to prevent infection.

Once the anesthesia/sedation takes effect, the surgeon begins by making small incisions to retrieve the fat from the harvest site(s). Surgeons are typically very mindful of trying to make the incisions where they will not easily be seen (e.g., where a bra band sits over the skin).

Liposuction

The surgeon will inject the harvest site with tumescent fluid—a solution made of lidocaine and epinephrine mixed with saline. This helps numb the area and constrict blood vessels to reduce bruising and bleeding.

A thin tube connected to a hose and surgical vacuum will then be inserted into the incisions to perform liposuction.

Using a back-and-forth motion, the surgeon will suction out the necessary amount of fat from the donor location. The material immediately goes into a special air-tight container that keeps it from being contaminated.

This is repeated for all harvest sites that are part of the surgical plan.

Processing

The fat (which is mixed with blood and fluid) is not immediately grafted.

Instead, it is processed to rid it of components—debris, dead cells—that could compromise the fat's viability or other cells in the buttocks once injected.

Injection

Once that is done, you will be moved to a prone position, if you are not there already. The skin of the buttocks will now be cleaned.

Your surgeon will make several small incisions on your buttocks. A rod-like tool will be inserted and moved back and forth to loosen up bands of tissue.

In a process that is essentially the reverse of liposuction, they will inject the harvested fat into the desired areas using a thin tube connected to either a hose and a collection container or a filled syringe. The same back-and-forth motion will be used.

The exact amount of fat injected into each buttock will likely differ, simply due to natural anatomical differences.

It's likely that your surgeon will inject more fat than is needed to achieve the desired result. This is because it is common for some grafted fat to fail in its new location.

The same rod-like tool used to break up bands of tissue is re-inserted to move any injected fat to its ideal location.

Finally, the surgeon will stitch up your incisions. Steri-strips may be placed on the incisions after they are closed.

Anesthesia/sedation will be stopped and you will be moved to a recovery area.

After the Surgery

If you received an IV sedative, you will slowly start to feel more alert. If you received general anesthesia, you will wake up still feeling out of sorts and tired.

You will feel some discomfort or pain at the incision sites. Your surgeon will give you pain medication, as well as a prescription you can fill once you are sent home (which is normally the same day).

You will also be given a compression garment to wear to reduce swelling and promote healing.

Your surgeon will give you full instructions on what to do (and what not to do) in your recovery period. For example, you will be directed not to sit or lie on your backside for a few weeks after your surgery.

Though you will be scheduled for a follow-up visit to monitor your healing and results, and remove stitches (if not dissolvable), be sure that you are clear about when you should call the surgeon's office between now and then.

For example, while bruising and swelling is to be expected, a red, hot incision site is a sign of infection. A day or two of pink/red drainage from an incision is normal, but foul-swelling, yellow/green discharge is not.

You will see a fuller, rounder butt immediately after surgery and can likely return to light activities within a week and work within two weeks. However, the final outcome of your surgery is really only visible after healing is entirely complete (about six months post-op).