Buttock · Procedure

Projection is
the smaller half.

The buttock is read against everything around it. Against the waist above, the lower back that runs into it, the lateral line of the hip and the fold beneath. Add volume without changing any of those and you get a larger buttock in the same silhouette — which is almost never what the patient meant.

Most of the work in this operation is not the injection. It is the liposuction of the flank, the lower back and the sacral region that creates the frame the volume will be seen against, and the decision about where in the buttock that volume is allowed to go. The second of those has been the subject of the most serious safety debate in aesthetic surgery of the last decade, and this page does not skip it.

FeeFrom ¥1,265,000Fat transfer. Implant ¥1,540,000, composite ¥1,870,000
Stay in Japan2 weeksMinimum, after surgery
AnaesthesiaGeneral¥165,000, additional
Final result~6 monthsOnce graft volume and swelling have settled

The Frame

What is actually being changed.

Ask what makes a buttock look full and most people will point at the buttock. The measurable answer is more interesting. When 989 people were asked to rate gluteal silhouettes, the most attractive posterior view was a waist-to-hip ratio of 0.65, chosen by 44.2 per cent, with 0.60 next. On the side view the preferred ratio was 0.70, and the most attractive position for the point of greatest projection was the vertical midpoint of the buttock — not the top, not the bottom. Preferences did not differ significantly by the respondent’s age, sex or ethnicity.

Read that as an instruction and it says something specific: the ratio is a fraction, and the numerator is not the only variable. Narrowing the waist changes the ratio without adding a single cubic centimetre to the buttock. In practice both are done, and the liposuction half is frequently the half that produces the photograph.

An honest note about the vocabulary A great deal of what is written about buttock shape — the four shape categories, the aesthetic subunits, the “hip dip” as a named entity — comes from book chapters and surgical convention rather than from indexed research. We searched for validated classifications and for any anatomical or outcome study of hip-dip correction, and found none. There is one French anatomical review describing eleven aesthetic subunits, and there is the preference data above. Everything else in that vocabulary is a useful way of talking, not a measured fact, and we would rather label it than dress it up.

The Decision

Fat or an implant.

Two ways to add volume, with genuinely different profiles. What follows is the comparison as the literature actually reports it, including the part that undermines the comparison.

RouteWhat it does wellWhat it cannot do
Autologous fat transfer
¥1,265,000		 Your own tissue, so it feels like you. It improves two places at once — the donor area is part of the silhouette, not a supply run. It shapes: fat can be placed to widen the upper lateral quadrant, soften the trochanteric depression or lift the transition, which a device cannot do. Lower reported complication rates than implants in every comparative review. It cannot be done without enough donor fat, and a slim patient often has the strongest aesthetic case for it and the least of it available. It cannot be promised as a final volume — a substantial fraction does not survive. It carries a specific and serious risk that implants do not, discussed below.
Silicone implant
¥1,540,000		 A defined volume delivered on the day, independent of how much fat you have. The route for a patient with no usable donor site, and for projection at the central buttock that grafting cannot reliably reach in one session. It cannot shape the periphery, so it is rarely the whole plan. It sits in a region that is sat on, walked on and slept on, and the complication profile reflects that: wound dehiscence is reported at rates an order of magnitude above what patients expect. It is a device with a service life.
Composite
¥1,870,000		 An implant for central projection with fat placed around it for the transitions the implant cannot make. The commonest approach where a patient wants substantial projection and has limited donor fat. It cannot remove the implant from the equation. Every implant consideration still applies, and the graft’s considerations are added to them.

In a systematic review of 44 articles covering 2,375 implant patients and 3,567 fat-grafting patients, overall complication rates were 21.6 per cent for implants and 9.9 per cent for fat. A separate review of 4,362 patients found 31.4 per cent for implants, 6.8 per cent for fat and 23.1 per cent for local flaps. Both papers say plainly what a reader should hold onto: there has never been a head-to-head trial. These are pooled retrospective series with different patients in each arm, and the difference cannot be treated as causal.

Fat

How much of it stays.

This is the number to ask about, and it is smaller than the internet suggests. Two prospective studies with objective imaging give the most honest available picture.

Those two are not measuring the same thing, which is the point. One measures volume by surface imaging, the other measures a layer’s thickness by ultrasound. Neither is volumetry. We searched for magnetic resonance or computed tomography volumetric measurement of buttock fat graft retention and found none published, and we found no study at all following grafted buttock volume beyond twelve months, or examining what happens to it when the patient subsequently gains or loses weight. A clinic that quotes you a precise multi-year retention figure is quoting something that has not been measured.

What can be said usefully: plan on keeping roughly two thirds of what is placed, expect the number to be settled by six months, and understand that grafted fat behaves like the fat it came from — it will gain and lose with your body weight for the rest of your life.

The Plane

The one rule that matters more than technique.

Fat is placed in the subcutaneous layer, above the gluteal fascia. Never into the muscle, never below it. That sentence is the whole of this operation’s safety, and the reason it is written so flatly is that the alternative killed people.

The anatomy explains it. In a cadaveric study mapping 20 gluteal regions in three dimensions, the subcutaneous plane contains around 25 vessels, all small — arteries averaging 0.9 mm and veins 1.05 mm in diameter. Go deeper and the calibre changes by an order of magnitude: the superior gluteal vein trunk measured 7.6 mm and the inferior gluteal vein 13.7 mm. A vein wide enough to accept a lobule of fat is a vein wide enough to deliver it to the lung.

Two dynamic cadaveric studies then showed what actually happens. When fat proxy was injected into the muscle, it migrated through into the deep submuscular space in every specimen; when injected subcutaneously with the fascia intact, none was found in the muscle or beneath it. A second study measured the pressure: with the fascia intact, subcutaneous pressure plateaued and everything stayed where it was put; where the fascia had been breached by 6 mm defects, pressure fell away and significant proxy fat was found in the submuscular space. The conclusion the authors reached, and the one followed here, is that there is no such thing as a safely superficial intramuscular injection.

The full account is on another page How this became known — the task force survey of 198,857 cases, the mortality figures before and after the guidance changed, and what ultrasound guidance does and does not prove — is set out with the citations on UGRAFT, which is the ultrasound-guided fat transfer technique used here. It is the same technique, applied to a different region, and it is worth reading before you consent to this operation.

Three things about the buttock in particular are worth knowing beyond that.

What ultrasound guidance is, and is not Real-time ultrasound is used here to confirm the plane the cannula is actually in, rather than the plane it is assumed to be in. It is a reasonable and, in our view, correct standard. It is also not proven in the way the marketing suggests. A 2026 scoping review of nine studies concluded that the evidence is predominantly observational, with no randomised or high-quality comparative studies identified. And a comparison of 200 patients found the aesthetic difference between guided and unguided grafting was 2.04 against 2.81 per cent of lateral projection — the authors’ own word for it was “minimal”. Ultrasound is a safety argument, not a results argument, and anyone selling it as the latter is selling you something else.

Implants

What a device in this region actually involves.

Gluteal implants avoid the fat-embolism question entirely, and they carry a different set of problems that are easy to underestimate because the breast is the reference most people have. The buttock is not the breast. It is loaded every time you sit down, the incision sits close to the intergluteal cleft, and the tissue over the device is muscle rather than gland.

The device used here is a Motiva gluteal implant, placed through a single incision of approximately five centimetres running along the intergluteal cleft, where the scar falls in a natural shadow rather than across the visible surface of the buttock. One incision for both sides is deliberate: it keeps the scar in the one place on the buttock that is never on display, and it avoids two separate wounds in a region that moves. The trade-off is that it is also a region that is difficult to keep clean and impossible to keep still, which is why the closure matters more here than the choice of device.

StudyFinding
Systematic review and meta-analysis of primary implant-based gluteal augmentation, 32 studies, 2,682 patientsTextured against smooth shells: seroma 7.50 versus 2.56 per cent, dehiscence 13.98 versus 6.63 per cent, capsular contracture 2.06 versus 0.55 per cent. By plane, subfascial was worst by a distance — seroma 22.25 per cent, dehiscence 27.07 per cent, implant removal 5.23 per cent. Overall implant removal 1.05 per cent. Intramuscular and submuscular placement performed better.
Single-surgeon series, 200 consecutive patients, 400 implants, mean follow-up 3 yearsSeroma 28 per cent, infection 6.5 per cent of patients, wound dehiscence 1.5 per cent, capsular contracture 1 per cent, reoperation 13 per cent. Patients with intramuscular implants more often reported a lack of lower gluteal fullness.
Multicentre survey of 2,226 implant patientsTotal complications reported at 38.1 per cent. This is the historical high-water mark and is widely quoted; it came from a survey to which only 19 of 83 surgeons responded, so treat it as an upper bound rather than an estimate.
Meta-analysis of combined implant and lipoplasty (composite) augmentation, 13 studiesPooled implant removal 1.70 per cent. Intramuscular plane: dehiscence 14.56 per cent. Submuscular plane: sciatic neuropathy 3.91 per cent. Drain use was associated with more seroma and less infection, in both directions.
Single-surgeon composite series, 423 patients, follow-up 21 to 55 monthsOverall implant-related complication rate 10.8 per cent, seroma the most frequent.
Controlled sensory testing, 20 patients versus 20 unoperated controlsNo difference in touch, heat, cold, pain, vibration or pressure sensation after intramuscular gluteal augmentation. Small study; it cannot exclude a small effect.

The figure to carry away is dehiscence. A wound that opens over a silicone device, in a region that cannot be kept still and sits next to the natal cleft, is the complication that turns a straightforward operation into a long one. It is why the pocket plane is chosen conservatively, why the incision is placed and closed the way it is, and why an implant is not offered to a patient who has adequate donor fat and wants a moderate change.

Candidacy

Who it suits, and who it does not.

The risk that is discussed least A forensic autopsy series of 35 deaths after liposuction-based body contouring, published in 2025, found that pulmonary thromboembolism was the most frequent finding at 65.7 per cent — more frequent than fat embolism — and that 85.7 per cent of the fatal cases had undergone multiple procedures in one session. Higher body mass index was significantly associated with thromboembolic death. Gluteal fat grafting featured in 54.3 per cent of the cases, and in all five of the intraoperative deteriorations. The lesson is not only about the plane of injection. It is that operating time and the number of things done at once are themselves a risk, and that a patient who has just taken a long-haul flight and will take another one is already in a higher-risk category before anyone picks up a cannula. That is why plans here are staged rather than stacked, and why clearance to fly is a clinical judgement made at the time.

The Operation

What actually happens.

  1. Marking, standingThe frame is drawn before the buttock is. Waist, flank, the line of the lower back, the sacral triangle, the lateral depression and the infragluteal fold, together with the existing asymmetry — which is present in almost everyone and is easier to discuss before surgery than to explain afterwards.
  2. HarvestLiposuction of the agreed donor areas, planned as part of the silhouette. In this operation the donor sites are usually the flanks, the lower back and the sacral region, which means the harvest and the shaping are the same act.
  3. ProcessingFluid, blood and oil are separated out so that what is injected is graft rather than volume that disappears within a week.
  4. AccessSmall incisions positioned so that the cannula runs parallel to the surface. The cannula is not angled downward at any point, and a blunt cannula of 4 mm or greater is used — both of these are specific recommendations arising from the mortality data.
  5. Placement, under ultrasoundFat is delivered in many fine retrograde passes into the subcutaneous compartments, with the plane confirmed on screen rather than assumed from feel. No pass enters the gluteal fascia. Compartments are filled selectively according to the plan — upper lateral for the transition, central for projection, and deliberately less in the lower pole, which is where descent begins.
  6. Where an implant is usedAccess is through a single incision of about five centimetres along the intergluteal cleft. The pocket is dissected to planned dimensions in the chosen plane, haemostasis is checked directly, and the device is inserted with the usual measures to limit contamination. Closure is layered with particular attention to the deep layers, because the failure mode here is dehiscence rather than displacement.
  7. Standing you upSymmetry and the shape of the transitions are assessed with you upright before the end of the operation, because a buttock judged lying prone is judged in the one position nobody will see it in.
  8. CompressionGarment and positioning instructions applied before you leave theatre.

Recovery

Two weeks in Japan, six months to the volume.

Something we cannot support with evidence You will be given instructions about sitting, cushions, positioning and compression. They are given here, and they are the standard of practice. You should also know that we searched for controlled evidence that any of them improves graft survival, and found none. No trial has compared sitting restriction against no restriction, or compression against none, for buttock fat grafting. The instructions are based on mechanism and on convention, not on measurement. That is not a reason to ignore them — the mechanism is plausible and the cost of following them is a fortnight of inconvenience — but you are entitled to know which parts of your care are proven and which are reasonable.

Evidence

What the published data shows.

The least flattering figures are included deliberately, including those that concern this operation’s safety record.

StudyFinding
Prospective three-dimensional and ultrasound study, 35 patients, subcutaneous planeFat retention 77.9 per cent at three months, 64.7 per cent at six months. Adipose thickness fell 5.1 per cent at three months and 15.1 per cent at six. Waist-to-hip ratio 0.78 to 0.74.
Prospective ultrasound study, 50 patients, subcutaneous only, 12 monthsSubcutaneous thickness increased a mean 56.5 per cent immediately after surgery, then decreased a mean 18.2 per cent by twelve months.
Systematic review and meta-analysis of gluteal fat grafting, 38 studies, 22,151 patientsPooled minor complications 3.58 per cent; seroma 2.03 per cent; contour irregularity 2.29 per cent; pulmonary embolism 0.04 per cent. Ultrasound-guided against not: major complications 0.02 versus 0.08 per cent. Subcutaneous-only injection had the lowest rates. Lipoaspirate additives and drains did not consistently lower complication rates and were sometimes associated with worse outcomes.
Earlier meta-analysis of gluteal fat grafting, 19 articles, 4,105 patientsMean complication rate 7 per cent (6.7 minor, 0.32 major), with no significant relationship to the plane of injection. Included here because it is a clean example of evidence being overturned: later cadaveric and survey work reversed this conclusion entirely.
Retrospective study of ultrasound-guided gluteal fat transfer, 1,815 patientsPostoperative complications in 4 per cent: seroma 1.2, local skin ischaemia 1.2, surgical site infection 0.8 per cent. No macroscopic fat emboli and no mortality.
Scoping review of ultrasound in gluteal fat grafting, 9 studies“No randomized or high-quality comparative studies were identified.” Evidence is predominantly observational; verification of the injection plane relied mainly on intraoperative visualisation rather than standardised imaging confirmation.
Comparative measurement study, 200 patients, guided against unguidedMean variation in lateral projection 2.04 against 2.81 per cent — described by the authors themselves as minimal. The case for guidance is safety, not aesthetics.
Cadaveric latex-cast vascular mapping, 20 gluteal regionsSubcutaneous plane: about 25 vessels, arteries 0.9 mm and veins 1.05 mm. Superior gluteal vein trunk 7.61 mm; inferior gluteal vein trunk 13.65 mm.
Dynamic cadaveric migration study, 8 hemibuttocksProxy fat migrated through muscle into the deep submuscular space with every intramuscular injection; with subcutaneous injection none was found in the muscle or beneath it.
Meta-analysis of intramuscular fat grafting, 27 studies, 208,692 observationsPooled complication rate 6.2 per cent with very high heterogeneity. Fat embolism mortality reported at 1 in 3,000 for gluteal intramuscular fat grafting.
Systematic review of implant-based gluteal augmentation, 32 studies, 2,682 patientsTextured against smooth: seroma 7.50 versus 2.56 per cent; dehiscence 13.98 versus 6.63 per cent. Subfascial plane: seroma 22.25 per cent, dehiscence 27.07 per cent, removal 5.23 per cent. Overall removal 1.05 per cent.
Single-surgeon implant series, 200 patients, 400 implantsSeroma 28 per cent, infection 6.5 per cent, reoperation 13 per cent, capsular contracture 1 per cent.
Meta-analysis of composite implant and fat augmentation, 13 studiesImplant removal 1.70 per cent. Intramuscular dehiscence 14.56 per cent; submuscular sciatic neuropathy 3.91 per cent.
Systematic review comparing techniques, 44 articlesOverall complications 21.6 per cent for implants against 9.9 per cent for fat. Patient satisfaction was measured too differently across studies to be compared.
Systematic review of 4,362 gluteoplasty patientsOverall 12.4 per cent. Implants 31.4 per cent, local flaps 23.1 per cent, fat grafting 6.8 per cent. No randomised comparison exists; selection differs between arms.
Forensic autopsy series, 35 deaths after body-contouring surgery, 2022–2024Pulmonary thromboembolism in 65.7 per cent and deep vein thrombosis in 40 per cent, exceeding pulmonary fat embolism at 68.6 per cent on histology. 85.7 per cent had multiple simultaneous procedures; body mass index was significantly higher in the thromboembolic deaths.
Ultrasound study of gluteal subcutaneous thickness, 150 individualsEach unit of body mass index corresponds to roughly 3 mm additional subcutaneous thickness in men and 4 mm in women. Ageing thickens the deep layer, rising body mass index the superficial one.
Population preference study, 989 gluteal ratingsMost attractive posterior waist-to-hip ratio 0.65 (44.2 per cent); lateral 0.70 (29.8 per cent); point of maximum projection at the vertical midpoint (45.1 per cent). No significant differences by respondent age, sex or ethnicity.

These figures describe published study populations authored by others. They do not describe results at this practice and are not a prediction of your individual outcome. Full citations are listed at the foot of this page.

Fees

What it costs.

ProcedureFee (JPY, incl. tax)
Gluteal fat transfer¥1,265,000
Fat harvest and processing, additional donor area¥220,000
Gluteal implant (silicone)¥1,540,000
Composite augmentation (implant with fat transfer)¥1,870,000
Contouring of the surrounding frame
Liposuction, per area (flank, lower back, sacral region)From ¥275,000
Additional
General anaesthesia¥165,000
Standard set (anaesthetic, medication, compression garment)¥66,000
Blood tests¥11,000
Body mass index surcharge, 25 to 30¥55,000
Body mass index surcharge, over 30¥110,000

All figures are standard prices, not monitor prices, current as of August 2026 and subject to change. Which surrounding areas are included is decided at consultation and is part of the plan rather than an upsell — the full area schedule is on the HD VASER Liposuction page. Your written quotation is the binding figure and is issued before you book travel. See the full fee schedule and process for international patients.

Guarantee

Not covered, and why we say so here.

The one-year guarantee at this practice applies to VASER liposuction, VASER 4D, Condense Rich fat transfer breast augmentation, mastopexy and gynaecomastia correction. Gluteal fat transfer is not covered by it, and neither are gluteal implants.

The reason is the same reason the retention figures above are given as a range rather than a promise: how much grafted fat survives in the buttock depends on your circulation, your tissue and your body weight over the following year, and none of those is something a surgeon can underwrite. Where liposuction of the surrounding areas is performed as part of the same plan, the liposuction component falls under the guarantee on its own terms. We would rather set the boundary out plainly than let you assume it covers everything.

Risks

What can go wrong.

This is elective surgery, it is not covered by health insurance in Japan, and its outcome cannot be guaranteed. Gluteal fat grafting has been associated with a higher mortality rate than any other aesthetic surgical procedure, and that fact belongs at the top of this list rather than buried in it.

Questions

Frequently asked.

Is this the same thing as a BBL?

Gluteal fat transfer is the operation usually marketed under that name. The name is a marketing term rather than a technical one, and it has attached itself to a very wide range of practice — including, historically, the intramuscular injection technique that caused the deaths this procedure became known for. What is performed here is subcutaneous-only fat placement under real-time ultrasound guidance, which is a different operation from the one the name is associated with.

How dangerous is it, honestly?

It has been associated with a higher mortality rate than any other aesthetic surgical procedure, and that is a direct quotation from the task force report rather than our characterisation. What changed the picture was the plane: reported mortality moved from around 1 in 3,448 to 1 in 14,952 in the two years after guidance recommending subcutaneous-only injection, alongside a fall in surgeons injecting into deep muscle from 13.1 per cent to 0.8 per cent. Those figures come from voluntary anonymous surveys rather than registries, and the authors themselves call the mortality change a trend rather than a proven reduction. The operation is safer than it was. It is not risk-free, and the honest way to reduce your own risk is to ask any surgeon anywhere exactly which plane they inject into and how they verify it.

How much of the fat survives?

Around two thirds, on the best objective evidence. In a prospective three-dimensional imaging study of 35 patients, retention was 77.9 per cent at three months and 64.7 per cent at six. A twelve-month ultrasound study of 50 patients found roughly four fifths of the immediate gain retained at one year. Nobody has measured buttock graft retention by MRI or CT, and nobody has published a follow-up beyond one year. A precise multi-year figure quoted to you is not a measurement.

Do I have enough fat?

This is the constraint that ends the conversation most often, and it works in an unintuitive direction: the slimmest patients frequently have the strongest aesthetic case for the operation and the least fat available for it. It is assessed by examination rather than from photographs. Where there is not enough for the change you want, the honest alternatives are a smaller change, an implant, or a composite approach — and that is said before you book travel, not after.

Fat or an implant?

Fat where there is enough of it, in almost every case, because it shapes the periphery and an implant cannot. Every comparative review reports lower complication rates for fat — 9.9 against 21.6 per cent in one, 6.8 against 31.4 per cent in another — though there has never been a head-to-head trial and the patients in each arm are not comparable. An implant earns its place where donor fat is genuinely insufficient, or where central projection is wanted beyond what grafting can deliver in one session. In practice the two are often combined.

What is the commonest problem with gluteal implants?

The wound opening. Dehiscence is reported between roughly 6.6 and 27 per cent depending on the plane and the implant surface, which is an order of magnitude above what most patients expect, and it is the specific reason the pocket plane, the five-centimetre incision along the cleft and the layered closure are chosen the way they are. Seroma is close behind — 28 per cent in one experienced single-surgeon series of 400 implants. This is a region that is sat on and walked on; it does not get to rest.

Can you fix hip dips?

Partly, and the honest answer involves saying what the depression actually is. It is a fixed attachment between the skin and the underlying bone at the level of the greater trochanter, which is why it does not respond to exercise and why it cannot be removed. What can be done is to add volume above and below it so that it reads as a curve rather than an angle. We searched for anatomical or outcome studies on hip-dip correction specifically and found none published, so what you will be told here is a surgical judgement rather than a cited result.

Do I really have to avoid sitting?

You will be asked to limit and cushion it, and you should. You should also know that no controlled study has ever compared sitting restriction against no restriction for buttock fat grafting — we looked, and the evidence does not exist. The instruction rests on mechanism and convention. The mechanism is plausible, the cost of following it is a fortnight of inconvenience, and we would rather tell you which parts of your aftercare are proven and which are merely reasonable.

Can this be combined with other procedures in one trip?

Some of it must be — the liposuction that creates the frame is part of the same operation. Beyond that, combining is approached cautiously rather than enthusiastically. In a forensic series of 35 deaths after body-contouring surgery, 85.7 per cent of the patients had undergone multiple procedures in a single session, and pulmonary thromboembolism was the most frequent cause. Operating time and combined load are themselves a risk. Where a plan needs more than one operation, it is staged and the staging is written down before you book anything.

Will the result change if I lose weight?

Yes. Grafted fat is your own fat and it behaves like the rest of it — it will shrink if you lose weight and enlarge if you gain. There is no published study following grafted buttock volume through a significant weight change, so nobody can tell you by how much. The practical implication is to have the operation when your weight is stable rather than in the middle of changing it.

Will I lose sensation?

Some numbness over the buttock is common early and usually temporary. In a controlled study comparing 20 patients after intramuscular gluteal implant augmentation with 20 unoperated controls, there was no measurable difference in touch, heat, cold, pain, vibration or pressure sensation. That study is small and cannot exclude a subtle effect, but there is no evidence of a persistent sensory deficit as a routine outcome.

How long do I need to stay in Japan?

Plan for at least two weeks after surgery. That covers the early phase and at least one in-person follow-up before you are cleared to fly. Given that thromboembolism is the leading cause of death in this category of surgery and that long-haul flight adds to that risk, clearance to travel here is a clinical judgement rather than a date agreed in advance. Your arrival date before surgery is set separately in your written plan.

What does it cost?

Gluteal fat transfer is ¥1,265,000 including tax, covering two donor areas. A silicone implant is ¥1,540,000 and composite augmentation ¥1,870,000. Fat harvest and processing from an additional donor area is ¥220,000, and liposuction of the surrounding frame is charged per area from ¥275,000. General anaesthesia, the standard post-operative set and blood tests are additional, and a body mass index surcharge applies above 25. Your written quotation states the total and is issued before you book travel.

Is it covered by the one-year guarantee?

No. The guarantee covers VASER liposuction, VASER 4D, Condense Rich fat transfer breast augmentation, mastopexy and gynaecomastia correction. Gluteal fat transfer and gluteal implants are not included — how much grafted fat survives depends on your circulation and your body weight over the following year, and that is not something a surgeon can underwrite. Where liposuction of the surrounding areas is part of the same plan, that component falls under the guarantee on its own terms.

References

Selected literature.

Retrieved from PubMed. The figures quoted above come from these studies, which describe study populations authored by others rather than results at this practice.

  1. Wong WW, Motakef S, Lin Y, Gupta SC. Redefining the Ideal Buttocks: A Population Analysis. Plast Reconstr Surg. 2016;137(6):1739–1747. doi:10.1097/PRS.0000000000002192
  2. Vartanian E, Gould DJ, Hammoudeh ZS, Azadgoli B, Stevens WG, Macias LH. The Ideal Thigh: A Crowdsourcing-Based Assessment of Ideal Thigh Aesthetic and Implications for Gluteal Fat Grafting. Aesthet Surg J. 2018;38(8):861–869. doi:10.1093/asj/sjx191
  3. Ho Quoc C, Mojallal A. Sémiologie du remodelage fessier par lipofilling. Ann Chir Plast Esthet. 2012;57(6):580–586. doi:10.1016/j.anplas.2012.09.002
  4. Frojo G, Halani SH, Pessa JE, et al. Deep Subcutaneous Gluteal Fat Compartments: Anatomy and Clinical Implications. Aesthet Surg J. 2023;43(1):76–83. doi:10.1093/asj/sjac230
  5. Ordenana C, Dallapozza E, Said S, Zins JE. Objectifying the Risk of Vascular Complications in Gluteal Augmentation With Fat Grafting: A Latex Casted Cadaveric Study. Aesthet Surg J. 2020;40(4):402–409. doi:10.1093/asj/sjz237
  6. Frank K, Casabona G, Gotkin RH, et al. Influence of Age, Sex, and Body Mass Index on the Thickness of the Gluteal Subcutaneous Fat: Implications for Safe Buttock Augmentation Procedures. Plast Reconstr Surg. 2019;144(1):83–92. doi:10.1097/PRS.0000000000005707
  7. Alvarez-Alvarez FA, González-Gutiérrez HO, Ploneda-Valencia CF. Safe Gluteal Fat Graft Avoiding a Vascular or Nervous Injury: An Anatomical Study in Cadavers. Aesthet Surg J. 2019;39(2):174–184. doi:10.1093/asj/sjy237
  8. Ghavami A, Villanueva NL, Amirlak B. Gluteal Ligamentous Anatomy and Its Implication in Safe Buttock Augmentation. Plast Reconstr Surg. 2018;142(2):363–371. doi:10.1097/PRS.0000000000004588
  9. Wang B, He P, Zhao R. B-ultrasound-assisted gluteal fat grafting in Asians: A prospective study of quantitative results from three-dimensional imaging and B-ultrasound analysis. J Plast Reconstr Aesthet Surg. 2024;94:12–19. doi:10.1016/j.bjps.2024.04.035
  10. Cansanção AL, Condé-Green A, David JA, Vidigal RA. Subcutaneous-Only Gluteal Fat Grafting: A Prospective Study of the Long-Term Results with Ultrasound Analysis. Plast Reconstr Surg. 2019;143(2):447–451. doi:10.1097/PRS.0000000000005203
  11. Condé-Green A, Kotamarti V, Nini KT, et al. Fat Grafting for Gluteal Augmentation: A Systematic Review of the Literature and Meta-Analysis. Plast Reconstr Surg. 2016;138(3):437e–446e. doi:10.1097/PRS.0000000000002435
  12. Elsaftawy A, Bonczar M, Jagosz M, et al. Gluteal Augmentation with Fat Grafting: A Systematic Review and Meta-Analysis of Complications and Procedural Factors. Plast Reconstr Surg. 2026;157(3):381e–393e. doi:10.1097/PRS.0000000000012437
  13. Mofid MM, Teitelbaum S, Suissa D, et al. Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force. Aesthet Surg J. 2017;37(7):796–806. doi:10.1093/asj/sjx004
  14. Rios L, Gupta V. Improvement in Brazilian Butt Lift (BBL) Safety With the Current Recommendations from ASERF, ASAPS, and ISAPS. Aesthet Surg J. 2020;40(8):864–870. doi:10.1093/asj/sjaa098
  15. Del Vecchio D, Kenkel JM. Practice Advisory on Gluteal Fat Grafting. Aesthet Surg J. 2022;42(9):1019–1029. doi:10.1093/asj/sjac082
  16. Del Vecchio DA, Villanueva NL, Mohan R, et al. Clinical Implications of Gluteal Fat Graft Migration: A Dynamic Anatomical Study. Plast Reconstr Surg. 2018;142(5):1180–1192. doi:10.1097/PRS.0000000000005020
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  19. Cárdenas-Camarena L, Bayter JE, Aguirre-Serrano H, Cuenca-Pardo J. Deaths Caused by Gluteal Lipoinjection: What Are We Doing Wrong? Plast Reconstr Surg. 2015;136(1):58–66. doi:10.1097/PRS.0000000000001364
  20. Vidal-Laureano N, Huerta CT, Perez EA, Earle SA. Augmented Safety Profile of Ultrasound-Guided Gluteal Fat Transfer: Retrospective Study With 1815 Patients. Aesthet Surg J. 2024;44(4):NP263–NP270. doi:10.1093/asj/sjad377
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The consultation is held online, in English, before you commit to any travel. You will be told how much donor fat you actually have, which of the surrounding areas need to be treated to make the change visible, whether a device belongs in the plan, and where the honest limit sits.

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Important Notice Gluteal augmentation by autologous fat transfer, silicone implant or a combination of the two is elective aesthetic surgery and is not covered by health insurance in Japan. Outcomes, recovery time and risks vary between individuals and cannot be guaranteed. The fees shown are standard prices in Japanese yen including consumption tax, are not monitor prices, are current as of August 2026 and are subject to change; general anaesthesia, the standard post-operative set, blood tests and any body mass index surcharge are additional, and your written quotation is the binding figure. Gluteal fat grafting has been associated with a higher mortality rate than any other aesthetic surgical procedure. Potential risks and side effects include, but are not limited to, pulmonary fat embolism which may be fatal, deep vein thrombosis and pulmonary thromboembolism, partial resorption of grafted fat and a final volume below expectation, asymmetry, contour irregularity of the buttock or donor sites, palpable lumps, oil cyst, fat necrosis, seroma, haematoma, infection which may require drainage or removal of an implant, skin ischaemia or necrosis, wound dehiscence, implant malposition, rotation or extrusion, capsular contracture, implant palpability, chronic seroma, sciatic or gluteal nerve irritation, pain on sitting, altered sensation, unfavourable scarring, change in the result with body weight, the need for further surgery, and complications of anaesthesia. Fat is placed exclusively in the subcutaneous plane under ultrasound guidance; intramuscular injection is not performed. The risk of venous thromboembolism is increased by prolonged operating time, by combining multiple procedures in one session, by raised body mass index and by long-haul air travel, and clearance to fly is a clinical judgement made at the time rather than a date agreed in advance. The one-year guarantee offered by this practice does not apply to gluteal fat transfer or to gluteal implants. Clinical figures cited on this page describe published study populations authored by others; they do not describe results at this practice and are not a prediction of individual outcome. Your suitability will be assessed individually during consultation.