When the buttocks look flat or lack volume, the two familiar answers are an implant and fat grafting. The implant creates volume and projection; fat grafting uses your own tissue to shape the surrounding volume and line. Increasingly the two are combined as hybrid buttock augmentation, dividing the work rather than choosing one.
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How is buttock augmentation performed?
Size and shape can be improved with an implant, with fat grafting, or with both. An implant is placed within the gluteal tissue to create consistent volume in a chosen area; fat grafting injects your own fat harvested from the abdomen or thigh to supplement volume and contour.
The two differ from the start in how volume is made. An implant has a fixed shape and size, which suits creating central volume and projection. Fat can be distributed to specific areas, which suits softening hollows and blending the transitions around the buttock. Hybrid surgery uses each characteristic within one operation.
What does a gluteal implant do?
An implant enlarges buttock volume directly — useful where the buttocks are overall small or flat and more three-dimensional projection from behind is wanted. Because it has a set size and shape, it can plan a volume that fat grafting alone struggles to reach, and unlike fat, which depends on take, the implant occupies space itself.
- Volume in the centre of the buttock
- Projection when seen from behind
- Predictable, consistent volume
- Improved shape in a flat buttock
- A lifted silhouette
Its role is the buttock's size and central volume.
Read alsoThe plane for implant hip-up is covered in “Implant hip-up: can a flat buttock become a voluminous hip line?” (Korean).
What does fat grafting do?
Fat is harvested from the abdomen, thigh or flank and transferred where needed — not only into the centre of the buttock but into hollows and deficient volume to refine the overall line. Because fat can be distributed fairly precisely, it can improve the transition between buttock and thigh, left-right volume differences and the contour around the pelvis.
Some grafted fat is absorbed, so the immediate postoperative volume and the settled volume can differ.
- Uses your own tissue
- Supplements volume around the buttock
- Improves the pelvis-to-buttock transition
- Corrects left-right volume difference
- Refines the buttock contour
Its strength is the overall line and fine volume.
What is hybrid buttock augmentation?
It is buttock augmentation using an implant and fat grafting together. Because their strengths differ, the two can be assigned different roles: the implant for central volume and projection, fat for the area around the implant and the pelvis-to-buttock junction.
The result is not simply a larger buttock but a planned relationship between central volume and surrounding line. The point is not to use both in equal measure, but to use each where it does most.
In a study of 147 patients treated with both, the average was a 300cc implant plus 380cc of fat, with the implant placed within the muscle.[1]
What are its advantages?
- Centre and border together: the implant builds central volume while fat fills hollows, so size and line are planned at once.
- Three-dimensional shape in a flat buttock: where fat alone cannot produce enough central projection, the implant creates it and fat blends the surroundings.
- Buttock-to-thigh transition: a natural connection between buttock and thigh matters more than size alone, and fat refines the lower and lateral areas.
- Different methods for different areas: implant where volume is needed centrally, fat where contour needs supplementing.
In a meta-analysis of 13 studies of combined implant and fat buttock augmentation, the implant removal rate was 1.70%, and complications varied with the plane in which the implant was placed.[2]
When is it considered?
- Buttocks that are overall flat with insufficient volume
- Wanting central projection
- Fat grafting alone unlikely to reach the volume wanted
- Wanting the pelvis and thigh line refined along with the buttock
- Needing the lateral or surrounding hollows supplemented
- Wanting a three-dimensional hip line rather than simple enlargement
How is recovery managed?
Because implant and fat grafting are combined, pressure and posture matter. Grafted fat in its early take phase can be affected by strong pressure, so positions that put prolonged direct pressure on the buttocks are avoided for a period — typically avoiding long sitting and lying prone or on the side to reduce pressure. Exercise resumes after adequate recovery, usually from about six to eight weeks for the fat grafting component.
Swelling, bruising, pain and sensory change can occur, and infection, haematoma, seroma, asymmetry and scarring are possible. With fat grafting in particular, the depth and location of injection are directly tied to safety: injection into muscle carries risk related to fat embolism, so the plane and method must be confirmed.
Hybrid buttock augmentation: common myths and facts
| You may think… | In practice |
|---|---|
| "An implant alone gives a natural line." | Blending the implant border with fat looks more natural. |
| "Fat alone can build large volume." | Take limits cap what fat alone achieves. |
| "Doing both doubles the risk." | Plane and injection volume per component drive the risk. |
When planning hybrid hip-up I give the implant the central projection and the fat the pelvic border and the edges. Divided that way, neither method has to be pushed beyond what it does well.
Implant and fat do different jobs: the implant creates central volume and projection in a fixed size, while fat supplements hollows and the pelvis-to-thigh transition. Hybrid surgery assigns each role — in 147 patients the average was a 300cc implant plus 380cc of fat, implant within the muscle — and a 13-study meta-analysis reported a 1.70% implant removal rate with complications varying by plane. Safety hinges on the injection plane and volume, and recovery means protecting the graft from prolonged pressure for weeks.
🔬 The research behind this article
These are the international journal papers that support the content above. Select a title to open the abstract on PubMed.
- Plastic and Reconstructive Surgery 2019 — composite buttock augmentation in 147 patientsAslani A, Del Vecchio DA. Composite Buttock Augmentation: The Next Frontier in Gluteal Aesthetic Surgery. Plast Reconstr Surg. 2019;144(6):1312-1321.Key: 300cc implant plus 380cc fat, implant in the intramuscular planeText [1] · PMID 31764644 · DOI
- Aesthetic Surgery Journal 2026 — meta-analysis of 13 studies of combined implant and fat buttock augmentationElsaftawy A, Bonczar M, Bonczar T, et al. Characteristics and Complications of Combined Implant and Lipoplasty Techniques in Primary Gluteal Augmentation: A Systematic Review and Meta-Analysis. Aesthet Surg J. 2026;46(7):720-727.Key: implant removal rate 1.70%; complications vary by planeText [2] · PMID 41092126 · DOI
🎬 Watch: Dr. Park Seong-Soo on video
Korean-language videos from BongBong Plastic Surgery's official channel and Dr. Park's channel, “Seongsu-ro Doctor”. Titles are translated for reference; selecting one opens YouTube.
- Everything about hybrid hip-up surgery at BongBong (no before/after photos)Seongsu-ro Doctor · 2018.04.17
- We did hip-up properly — a hybrid hip-up real storySeongsu-ro Doctor · 2018.10.08
Frequently asked questions
What is hybrid buttock augmentation?
A. It combines a gluteal implant with fat grafting — the implant for central volume and projection, fat grafting to refine the surrounding line.
Why use both together?
A. Their roles differ: the implant is good at central volume and projection, while fat can precisely supplement the lateral and surrounding hollows.
How does it differ from fat-only buttock augmentation?
A. Fat-only uses your own fat to build volume and line; hybrid adds an implant so central volume and projection are more clearly defined.
Can I sit straight after hybrid surgery?
A. No. To protect the fat graft, prolonged sitting with direct pressure on the buttocks is avoided early on, and pressure is reduced by lying prone or on the side.
Is it only about size?
A. No. Beyond central volume, the lateral buttock, pelvis and thigh junction are contoured so the whole hip line becomes three-dimensional.
📖 References
Select a [number] in the text to jump to the source, and ↩ to return. Only papers whose title, journal and year were verified on PubMed are included.
- Aslani A, Del Vecchio DA. Composite Buttock Augmentation: The Next Frontier in Gluteal Aesthetic Surgery. Plast Reconstr Surg. 2019;144(6):1312-1321. — Plastic and Reconstructive Surgery 2019 — composite buttock augmentation in 147 patients. ↩
- Elsaftawy A, Bonczar M, Bonczar T, et al. Characteristics and Complications of Combined Implant and Lipoplasty Techniques in Primary Gluteal Augmentation: A Systematic Review and Meta-Analysis. Aesthet Surg J. 2026;46(7):720-727. — Aesthetic Surgery Journal 2026 — meta-analysis of 13 studies of combined implant and fat buttock augmentation. ↩
BongBong Plastic Surgery · Dr. Park Seong-Soo, Medical Director
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