Some people feel their buttocks lack volume, or that the hip line looks flat from the side. When the line from waist to pelvis to thigh is not smooth, the buttocks can look smaller or lower than the body actually is. Buttock fat grafting transfers your own fat, harvested from the abdomen or thighs, to restore volume and shape — and it can design the whole hip line around your body type rather than simply making the buttocks larger.
Contents
What is buttock fat grafting?
Buttock fat grafting uses your own fat to restore the volume and form of the buttocks. Fat is usually harvested from the abdomen, flanks or thighs — areas with enough fat — processed, and then grafted into the buttocks.
Unlike an implant, it uses your own fatty tissue, and the plan can aim for a hip line that harmonises with your existing body shape.
It is not only about adding volume at the back. The line from the waist through the pelvis, buttock and thigh should be considered together. Where the upper buttock is flat or the lateral volume is lacking, the graft plan is built around that specific area, and harvesting from the waist or flanks can sharpen the contrast between waist and hip.
What is achievable differs with the amount of fat available, skin condition and the existing structure of the buttocks.
In an anthropometric analysis of Korean women, Miss Korea winners had a waist-to-hip ratio close to 0.7, while among ordinary women the hip measurement varied widely at the same waist circumference.[1]
When is it considered?
Buttock shape depends on pelvic structure, fat distribution and muscle development. At the same weight, one person may look full while another looks flat or hollow at the side.
Fat grafting can supplement volume where the body type leaves a deficit.
- Insufficient overall volume. Where the buttocks are flat or lack projection, grafting can build a three-dimensional hip line. When the curve from waist to buttock is shallow in profile, the placement and distribution of volume matter.
- A flat upper buttock. Without volume in the upper portion, the whole hip line can appear to drop. Restoring it makes the buttock look more three-dimensional — although where skin laxity is marked, grafting alone may not achieve the desired change.
- A hollow at the side of the pelvis. The depression between pelvis and thigh is commonly called a hip dip. It arises naturally from skeletal structure and fat distribution and is not a disorder that must be corrected, but where the lateral contour is a concern, grafting can supplement that area.
- Wanting the waist and hip line improved together. Because donor and recipient sites are planned together, harvesting abdominal or flank fat while adding buttock volume can emphasise the waist-to-hip contrast.
| Concern about buttock shape | Change fat grafting can aim for |
|---|---|
| Buttocks flat overall | Restore volume to build a three-dimensional hip line |
| Lacking volume in the upper buttock | Restore form and volume in the upper portion |
| Hollow at the side of the pelvis | Design to soften the hip dip contour |
| Left–right volume difference | Grafting planned for balance between sides |
| Weak distinction between waist and hip | Harvest and grafting planned as one body design |
Read alsoDesigning the pelvic line is covered in “Hybrid hip-up surgery: can a flat buttock and pelvic line be improved together?” (Korean).
How is it performed?
Buttock fat grafting generally proceeds through harvesting, processing and grafting.
Body analysis and surgical design. The proportions of waist, pelvis and buttock are assessed first, and the areas needing volume identified. Size is not the only measure: left–right balance, skin condition and donor areas are reviewed together. Locating exactly where volume is lacking is what makes a natural hip line possible.
Harvesting. The required amount of fat is taken from the abdomen, flanks or thighs. Excess at the donor site can be reduced at the same time, but the amount removed should respect skin condition and overall body shape rather than simply being maximised.
Processing. The harvested fat is separated and prepared for grafting; how it is handled depends on the surgical plan.
Grafting. The prepared fat is distributed into the areas that need it. What matters is placing fat in safe planes while considering overall volume and shape, not simply injecting a large amount. In buttock grafting in particular, fat entering muscle or deep tissue can cause serious fat embolism, so the technique demands particular care.
How do graft survival and recovery work?
The volume immediately after surgery is not the final volume. Grafted fat must acquire a blood supply and take up residence in the surrounding tissue — a process called fat survival — and some of it is absorbed, so early and final volumes can differ.
How long does survival take? Swelling and tissue recovery dominate the first weeks. Over roughly three to six months swelling settles and the grafted volume stabilises, at which point the final shape can be assessed. Timing varies with individual recovery and the amount grafted.
What should be avoided during recovery? Sustained strong pressure on the grafted area should be avoided. Prolonged sitting or postures that concentrate pressure directly on the buttocks can affect healing, so posture and activity should follow your surgeon's guidance. Swelling and bruising can also occur at donor sites such as the abdomen or thighs, so both areas need attention.
| Stage | Changes that may appear | What to check |
|---|---|---|
| Immediately to 1 week | Swelling, bruising, tightness, pain | Rest and monitoring of the surgical site |
| 1–2 weeks | Early swelling gradually reduces | Avoid pressure on the graft and strenuous activity |
| 2–4 weeks | Daily discomfort gradually eases | Follow guidance on activity and posture |
| 1–3 months | Swelling falls; volume changes appear | Observe graft survival and hip line change |
| 3–6 months | Grafted volume stabilises | Assess final shape and left–right balance |
The stages above are a reference for understanding typical recovery; actual speed and restrictions vary with the technique and the individual. Sudden breathlessness, chest pain or altered consciousness may indicate an emergency such as fat embolism and requires immediate emergency care.
In a study of 50 patients grafted in the subcutaneous plane of the buttock, fat layer thickness had decreased by an average of 18.2% at 12 months, with the remainder maintained.[2]
In a safety review of fat grafting to the breast and buttocks, most complications were fat necrosis, and they increased with larger graft volumes.[3]
Buttock fat grafting: common myths and facts
| You may think… | In practice |
|---|---|
| "The more fat, the wider the pelvis." | Over-injection raises the risk of fat necrosis. |
| "All the grafted fat stays." | Fat layer thickness was on average 18% lower at 12 months. |
| "Only the buttock needs treating." | Combining with waist liposuction changes the proportions far more. |
In designing buttock grafting I set the waist-to-pelvis ratio first. For the same volume grafted, how much the waist is refined changes how much wider the pelvis appears.
Buttock fat grafting uses your own fat, harvested from the abdomen or thighs, to restore volume and shape — and it can design the line from waist to pelvis to buttock around your body type. Whether the concern is overall flatness, a hollow upper buttock or a hip dip, the plan targets the area that needs volume while harvesting can refine the waist. Some grafted fat is absorbed, with volume stabilising over three to six months, and because injection plane affects safety, the technique, available fat and recovery plan should all be confirmed before surgery.
🔬 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.
- Aesthetic Plastic Surgery 2009 — waist-to-hip ratio in Asian womenHong YJ, Park HS, Lee ES, Suh YJ. Anthropometric analysis of waist-to-hip ratio in Asian women. Aesthetic Plast Surg. 2009;33(2):185-90.Key: Miss Korea winners approached 0.7Text [1] · PMID 18587613 · DOI
- Plastic and Reconstructive Surgery 2019 — subcutaneous-only buttock grafting in 50 patientsCansancao 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.Key: fat layer thickness 18% lower at 12 monthsText [2] · PMID 30688886 · DOI
- Plastic and Reconstructive Surgery 2019 — safety profile of breast and buttock fat graftingChopan M, White JA, Sayadi LR, Buchanan PJ, Katz AJ. Autogenous Fat Grafting to the Breast and Gluteal Regions: Safety Profile Including Risks and Complications. Plast Reconstr Surg. 2019;143(6):1625-1632.Key: most complications fat necrosis, increasing with volumeText [3] · PMID 31136476 · 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.
- What is a good pelvic size? Not padding — this is the method nowSeongsu-ro Doctor · 2024.03.15
- Is more fat always better? How Bi-Volve improves hip-up graft survivalSeongsu-ro Doctor · 2026.08.28
Frequently asked questions
Can buttock volume be increased without an implant?
A. Your own fat can supplement the volume the buttocks lack. Final volume change varies between individuals with the amount of fat available and how much of the graft survives.
Can I expect a natural feel?
A. Because your own fatty tissue is used, the plan can aim for a natural feel. Actual feel varies with the state of the grafted fat, the surrounding tissue and recovery.
Is buttock fat grafting possible for a slim body type?
A. Feasibility is judged from the donor areas and the amount of fat available. Where sufficient fat cannot be obtained, there may be limits on the volume that can be achieved.
Is all the grafted fat absorbed?
A. Not all of it. Some may be absorbed, but fat that establishes itself in the surrounding tissue can persist long term. Volume can change with weight change and individual survival.
When can I sit again after buttock fat grafting?
A. Sitting posture and the period of pressure restriction depend on the technique and recovery. Strong pressure should be avoided early on, so follow your surgeon's instructions.
📖 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.
- Hong YJ, Park HS, Lee ES, Suh YJ. Anthropometric analysis of waist-to-hip ratio in Asian women. Aesthetic Plast Surg. 2009;33(2):185-90. — Aesthetic Plastic Surgery 2009 — waist-to-hip ratio in Asian women. ↩
- Cansancao 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. — Plastic and Reconstructive Surgery 2019 — subcutaneous-only buttock grafting in 50 patients. ↩
- Chopan M, White JA, Sayadi LR, Buchanan PJ, Katz AJ. Autogenous Fat Grafting to the Breast and Gluteal Regions: Safety Profile Including Risks and Complications. Plast Reconstr Surg. 2019;143(6):1625-1632. — Plastic and Reconstructive Surgery 2019 — safety profile of breast and buttock fat grafting. ↩
BongBong Plastic Surgery · Dr. Park Seong-Soo, Medical Director
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