Some people train consistently without gaining buttock volume, or look flat from the side. That shape reflects skeletal structure and fat distribution as well as muscle. Implant buttock augmentation inserts a gluteal-specific implant to restore volume and projection, and can be considered where central volume is lacking or fat grafting alone cannot achieve the change — though the plane of insertion and tissue thickness determine both the result and the risk.
Contents
What is implant buttock augmentation?
It is surgery that inserts a gluteal-specific silicone implant to restore the volume and form of the buttocks. Unlike breast implants, the implant is made for the structure and movement of the buttock, with size and shape chosen according to existing tissue and the volume wanted.
Depending on the plan, the implant can be placed in an appropriate position such as within the gluteus maximus. The position and the thickness of surrounding tissue affect the shape and feel afterwards.
It is used particularly to add volume at the centre of the buttock, improving posterior projection in profile and the overall three-dimensionality — though buttock shape is not only about projection: the waist-to-pelvis ratio, upper buttock volume and the curve into the thigh all matter.
In a systematic review of 30 studies comparing implant pocket locations, the commonest complication was wound dehiscence (10.29%), followed by seroma (2.49%) and infection (1.12%).[1]
Why do some buttocks look flat?
The reasons differ between people: gluteal muscle development, subcutaneous fat distribution and the structure of the pelvis and femur all contribute.
Where the gluteal muscles are underdeveloped or there is little fat at the back of the buttock, projection can look insufficient in profile. Where overall volume is adequate but the upper portion is flat or volume sits low, the hip can look low or drooping. A hip dip — a hollow at the side of the pelvis — emphasises the outer curve and changes how the body reads.
| Buttock form | What may be seen | What to assess |
|---|---|---|
| Flat buttock | Insufficient projection in profile | Central buttock volume |
| Lacking upper volume | Upper buttock looks flat | Ratio of upper to central volume |
| Volume concentrated low | Hip may look low or drooping | Volume position and skin elasticity |
| With a hip dip | Hollow at the side of the pelvis | The line between pelvis and thigh |
| Left–right asymmetry | Different size or shape between sides | Volume and skeletal difference |
Because the causes differ, which area an implant should supplement must be established first.
How does it differ from fat grafting?
Implant insertion and autologous fat grafting are the two methods most often compared. Both restore volume, but the material and the way volume is created differ.
| Aspect | Implant | Fat grafting |
|---|---|---|
| Material | Gluteal-specific silicone implant | Your own fat |
| How volume is created | Using implant size and shape | Grafting fat into the areas needed |
| Main use | Central volume and projection | Volume and contour by area |
| Body fat | No fat harvest needed | Requires available donor fat |
| Change over time | Implant volume is maintained | Some grafted fat may be absorbed |
| Considerations | Position, infection, capsule formation | Survival, asymmetry, fat embolism |
Where body fat is limited, implant augmentation can be considered; where the aim is to refine the lateral pelvic line or a hip dip rather than add central volume, fat grafting may have a role. Neither is universally more natural or superior — existing shape, the change wanted and the characteristics of each method should be weighed together.
Read alsoWhen an implant is needed is covered in “When buttock implants are needed, and revision criteria” (Korean).
What should be checked before surgery?
Beyond implant size, the insertion position, the thickness of existing tissue and skeletal structure should be assessed. Inserting a large implant simply because the buttock is small can load surrounding tissue or produce a form that does not suit the body.
Where skin and subcutaneous fat are thin, the implant's edge or contour may be more visible. The existing width and height of the buttock, skin elasticity and left–right asymmetry should therefore guide size and position.
Implant augmentation also requires a period of recovery and care. Early swelling and discomfort can occur, and sitting posture and exercise may be restricted according to implant position and healing. Infection, haematoma, implant displacement, capsular contracture and wound healing problems should be discussed; an implant is not a device that needs no attention afterwards, and further assessment or revision may be required.
In a meta-analysis of 32 studies (2,682 patients) on primary implant gluteal augmentation, subfascial placement had the most seroma and wound dehiscence, while intramuscular and submuscular planes had fewer complications.[2]
Implant buttock augmentation: common myths and facts
| You may think… | In practice |
|---|---|
| "Bigger implants are better." | Large implants can raise the risk of dehiscence and displacement. |
| "All implant hip-ups are the same operation." | Complication rates differ markedly by insertion plane. |
| "You can sit comfortably the next day." | Sitting posture is restricted early. |
In an implant consultation I check the thickness of the gluteal muscle first. The muscle must be able to cover the implant adequately for the plane to be secure.
Implant buttock augmentation inserts a gluteal-specific implant to restore central volume and projection, and is considered where exercise has not produced volume or fat grafting is limited by donor supply. Shape depends on skeleton, muscle and fat distribution, so size and position should suit the body rather than being maximised — subfascial placement had the highest rates of seroma and wound dehiscence (dehiscence 10.29% overall) while intramuscular and submuscular planes had fewer complications, and early sitting posture needs restriction.
🔬 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 2013 — systematic review of 30 studies on gluteal implant pocket locationFlores-Lima G, Eppley BL, Dimas JR, Navarro DE. Surgical pocket location for gluteal implants: a systematic review. Aesthetic Plast Surg. 2013;37(2):240-5.Key: wound dehiscence 10.29%, the commonest complicationText [1] · PMID 23354760 · DOI
- Plastic and Reconstructive Surgery 2025 — meta-analysis of 32 studies, 2,682 patientsElsaftawy A, Bonczar M, Jagosz M, Ostrowski P. Complications following Primary Implant-Based Gluteal Augmentation: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2025;156(6):894-907.Key: complication rates differ by insertion planeText [2] · PMID 40403281 · 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.
- Buttock augmentation: how it feels and what the complications areSeongsu-ro Doctor · 2019.02.01
- Hip lines follow trends too: alternatives when hip-up exercise does not workSeongsu-ro Doctor · 2024.03.28
- What is a good pelvic size? Not padding — this is the method nowSeongsu-ro Doctor · 2024.03.15
Frequently asked questions
Is implant buttock augmentation possible for slim people?
A. Where body fat is too limited for adequate grafting, implants can be considered. If skin and subcutaneous fat are very thin, the implant contour may show, so tissue condition should be assessed.
Will it look natural?
A. The result depends on implant size and shape, position and existing tissue thickness. A natural silhouette comes from proportion with the body rather than maximal volume.
Can it also improve a hip dip?
A. Implants mainly supplement central volume and projection. A hip dip at the side of the pelvis may not be adequately corrected by an implant alone, so fat grafting is sometimes considered alongside.
When can I sit after surgery?
A. This varies with technique, implant position and healing. Sitting for long periods or postures loading the site may be restricted early, so follow your surgeon's guidance.
Do implants have to be replaced after a set period?
A. Not everyone needs replacement on a fixed schedule. Removal or exchange may be needed if the implant's state or position becomes a problem, or with complications such as infection or capsular contracture.
📖 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.
- Flores-Lima G, Eppley BL, Dimas JR, Navarro DE. Surgical pocket location for gluteal implants: a systematic review. Aesthetic Plast Surg. 2013;37(2):240-5. — Aesthetic Plastic Surgery 2013 — systematic review of 30 studies on gluteal implant pocket location. ↩
- Elsaftawy A, Bonczar M, Jagosz M, Ostrowski P. Complications following Primary Implant-Based Gluteal Augmentation: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2025;156(6):894-907. — Plastic and Reconstructive Surgery 2025 — meta-analysis of 32 studies, 2,682 patients. ↩
BongBong Plastic Surgery · Dr. Park Seong-Soo, Medical Director
Contact us for a consultation