The hottest plastic surgery procedures for the summer are definitely the so called “Brazilian butt lift” and breast augmentation with fat grafting. Both are based on using fat harvested from other parts of the body through liposuction and re-injecting it in the buttocks or the breasts.
The popularity of the Brazilian butt lift has recently increased in social media, and Kim Kardashian and other celebrities are often brought up as examples of ideal buttock and breast shape. This has sky-rocketed the percentage of patients requesting these two procedures.
The ideal body shape image has always been a subject of change through the decades. Most recently, there has been a drastic shift from very thin to curvaceous.
At the same time, plastic surgeons have discovered that fat grafting was an ideal procedure to enhance the buttocks and the breasts because it delivers a natural result and is well tolerated by the patient. Progress has been made in how to harvest the fat, how to purify it, and how to safely inject it. Also, specifically to the breasts, radiologists are better at detecting the difference between malignancy and fat artifacts, so breast augmentation with fat has quickly become a very well accepted procedure.
But, despite all the positive feedback from patients regarding both procedures, there is an aspect that, in my opinion, has been overlooked. Often, the volume of fat grafting exceeds the parameters of safety and aesthetic sense. This is because social media is driving plastic surgeons to provide patients with larger and larger volume to meet the current demand. This is true for both the Brazilian butt lift and breast augmentation (with fat or implants).
Larger volume has been directly linked to an increase in early and late post-operative complications. In both procedures, when a large amount of fat is injected, part of it does not survive and causes hardening, infections, and late reactions. A major long-term problem that I have seen with large volume used in breast enlargement, both with implants and fat grafting, is that after a few years the excessive weight of the breasts causes the skin to stretch and the breasts to sag invariably. I continue to see patients with moderately large implants that complain about this as they get older. Unfortunately, there is no easy solution to the problem than to proceed with a breast lift, which requires major incisions and scars on the breasts. I can see the same problem happening in a few years with the Brazilian butt lift; as the patient gets older, the skin will inevitably stretch and the once fuller buttock will become saggy.
So, in conclusion, both the Brazilian butt lift and fat grafting breast augmentation are excellent procedures. But, like everything in life, the extreme volume will in the long term be detrimental and cause more harm than good.