Buttock Fat Grafting in Seoul: How Much Fat Stays, and How Much Change Is Realistic

How does buttock fat grafting change your shape?

Buttock fat grafting moves your own fat. Fat is taken by liposuction from places where you have some to spare, filtered, and then injected into the buttocks and the sides of the hips.

Two effects work together. One is the volume added to the buttocks. The other is the curve that appears when the waist and flanks, where fat was taken out, become slimmer. A study that measured results with ultrasound and standardized photographs showed this. The projection of the buttocks compared with the surrounding areas increased more than the projection measured on its own. This was because the flanks were suctioned at the same time.² Slimming the areas around the buttocks shapes the result as much as adding volume. In the figure below, grey marks where fat is taken and yellow marks where it goes.

The body from behind: where fat is taken and where it goes

Replay

1. 1Where fat is takenliposuction from areas you would like to reduce: upper arms, waist and love handles, thighs
2. 2Filteredonly usable fat is kept
3. 3Where it goesspread over the buttocks and hip sides where volume is lacking
4. 4Two effects togetheradded volume and a slimmer waist shape the curve together

A systematic review (a study that gathers and re-analyzes many earlier studies) pooled 19 studies and 4,105 patients. Fat was usually harvested from the legs and back, an average of about 400 ml was injected into each side, and most patients rated their results as "excellent".¹ That is roughly the volume of two small cartons of milk. Most of those studies were case series, which simply report a group of treated patients without a comparison group. So these figures describe published experience, not what any one person should expect.¹

When do people usually ask about it?

At Bonita Clinic, we suggest considering lower-body line correction in situations like these:

• Buttocks that lack volume
• A hip line that has dropped and flattened
• A blurred border between the buttocks and thighs
• Buttock volume that looks small relative to the width of the pelvis

Will the grafted fat stay?

Not all of it. "Graft take" or "survival" means the part of the transferred fat that picks up a blood supply in its new place and stays. The part that does not survive is absorbed by the body. Few studies have measured this directly in the buttocks, and those that have used different methods.

In the table, "under the skin" means the fat layer just beneath the skin, and a "control group" is a set of people followed for comparison. Taken together, part of the injected volume is lost over the first months, and roughly two-thirds was reported to remain. Put simply, if you put in 3 parts, about 2 parts were still there a few months later.

Replay

1. 1Right after graftingthe moved fat sits in small parcels in the fat layer under the skin
2. 2Fat that gets a blood supplythe part that picks up a blood supply in its new place survives (graft take)
3. 3Fat that does notthe part that does not survive is absorbed by the body
4. 4Months laterabout two-thirds remained in two studies · put in 3, about 2 stay

Both studies are small, though. The author of the first one lists its limits plainly: a single surgical method, thickness measured in one direction only, and no information on what happens after a year.² Body weight also changes the thickness of the fat layer. So that study weighed patients on the same scale before and after surgery and corrected for the change.² In practice, this means weight gain or loss after surgery also affects how the result looks.

So "the survival rate" is not a fixed number. It depends on how and when it is measured, on the technique, and on weight change. At Bonita Clinic, we plan the volume to graft with absorption in mind, and judge the need for a touch-up after watching how the result settles.

What limits how much bigger the buttocks can get?

Three things set the limit: how much fat you can spare, how much the buttocks can take, and how much thickness can realistically be added.

How much fat you can spare

Every millilitre that goes into the buttocks has to come from your own body. In the measurement study above, every participant had areas of excess fat available as donor sites.² Pushing liposuction too far to collect more fat can cause problems. The author notes that it raises the risk of wound problems such as seromas (pockets of clear fluid). Bumpy, uneven areas can also appear at the donor sites, especially in thin women.²

How much the recipient area can take

The skin and fat of the buttocks can only accept so much. The same paper cites earlier work cautioning that grafting too much relative to the capacity of the recipient site can lower the proportion that survives.² Injecting more and keeping more are not the same thing.

How much thickness is realistically added

On ultrasound, the fat layer of the buttocks thickened by an average of 0.66 cm on one side and 0.86 cm on the other.² The author calculated that even if none of the fat were absorbed, spreading 287 ml over an area of about 250 square centimetres could add only about 1 cm.² That means about 1 cm of extra fat thickness is a realistic range. His conclusion was that accepting a smaller change may be better than donor-site deformities, seromas and painful changes in sensation caused by overly aggressive harvesting.²

How much thicker can the fat layer get?

Replay

1. 1287 ml per sidethe mean volume injected into each buttock in the study
2. 2Spread over about 250 cm²the fat spreads thinly over a wide area
3. 3About 1 cm thickcalculated assuming none of it is absorbed
4. 4The thickness actually added0.66 cm and 0.86 cm on average by ultrasound

When you look at before-and-after photos, check whether they were taken at the same angle, posture and lighting. It helps separate the effect of added volume from the effect of a slimmer waist.

Shape before size: how are the buttocks assessed?

A classification system for gluteal contouring looks at four things together. They are the frame type, the type of gluteal muscle, the relationship between the muscle and the frame, and the degree of sagging (ptosis).⁴ Pelvic width, waist height and the lower buttock border vary from person to person. That is why the same volume can look very different on two people.

At Bonita Clinic, we decide what to check first based on the concern you bring:

What concerns you most?

• 1Sagged, flattened buttocks

  The upper hip line height comes first, with where volume was lost

• 2Blurred border with the thigh

  Reduce the thigh, or fill above the border?

• 3Hollow-looking side hips

  Filling the side hips too is considered

• 4Wanting a much larger size

  Your frame and spare fat come first; too much can look unnatural

What options are there, and how do they differ?

Buttock shape can be changed in three broad ways: by reducing, by moving fat, or by inserting a foreign material. Of these, we use the first two at Bonita Clinic. Which one fits depends on whether you have areas to reduce, areas to fill, or both.

How do surgery and recovery go?

At Bonita Clinic, we perform buttock fat grafting as surgery under sedation or general anesthesia; you go home the same day, and stitches are used. How long recovery takes, and how many follow-up visits you need, depends on the extent of surgery and on you.

A compression garment is snug clothing that presses on the treated areas to limit swelling. How long it is worn depends on the areas and extent, and is explained before surgery.

What problems can happen?

Complications have to be considered at both ends of the procedure. In the systematic review, the mean complication rate was 7%; most were minor, and major complications occurred in 0.32%.¹ Out of 100 people, about 7 had some kind of problem, and most of these were minor. Keep in mind, as noted above, that most of the studies in that review were case series.

• Where fat was taken: seromas (fluid collections), uneven areas, and numb or painful changes in sensation can occur in addition to bruising and swelling.²
• Where fat was placed: infection, fat necrosis (part of the grafted fat dies and hardens) and oil cysts (small pockets of melted fat) are possible. The measurement study checked for them with ultrasound after surgery and found none among its 21 patients.²

The rarest but most serious risk is fat embolism, in which fat enters a large vein in the buttock and travels to the lungs. The review concluded that avoiding injury to the gluteal vessels may prevent most of these feared complications.¹ Injection depth and the international safety recommendations are covered in detail in our Brazilian butt lift safety guide.

How we approach it at Bonita Clinic

The figure below shows where those four points are on the body. The waist is usually an area to reduce, and the side of the hips can be an area to fill. At the thigh line, the choice is between slimming the thigh and filling above the border, depending on your shape.

Four points set before any fat goes in

Replay

1. 1Waist curvethe waist and love handles are usually areas to reduce
2. 2Upper hip line heightwhere the buttocks begin
3. 3Side hip volumethe curve seen from the side · can be an area to fill
4. 4Line into the thighsslim the thigh or fill above the border, depending on your shape

Treatment options you can discuss in Seoul

Since 1995 Bonita Clinic has stayed at one address, and its director, who holds Brazilian board certification in plastic surgery, Dr. Kwang-Seop Chung, sees patients himself. For buttock and lower-body contouring, the options described on our treatment pages are:

• Buttock fat grafting combined with liposuction of the waist, love handles, upper arms or thighs
• Brazilian Layered Hip-up, which fills the buttocks, hip joint area and outer thigh in layers
• 7:10 Pelvic Contouring, focused on the line from the waist to the side of the hips

Which of these suits you, and in what combination, is decided only after an examination.

Why do the plan and cost differ from person to person?

Two people asking for "a fuller buttock" can need very different operations. The extent of liposuction and grafting, rather than the name of the procedure, shapes both the plan and the cost.

• How many donor areas are suctioned
• How much fat is grafted
• Buttocks only, or side hips too
• Anesthesia: sedation or general
• Previous liposuction or grafting
• Whether a touch-up may be needed

Final plan and quote after seeing you in person

A final estimate is given only after an in-person examination, once the donor areas, the volume to graft and the type of anesthesia are clear. Photos give a sense of direction; the scope is settled only in person.

What can photos show, and what needs an in-person exam?

Photos are a good starting point for a conversation about shape. They cannot show how much fat you can spare or how your tissue will respond.

Photos can show

• Overall silhouette from back and side
• Waist-to-hip line and the thigh border
• Asymmetry and visible hollows
• Scars from earlier procedures

Needs an in-person exam

• How much donor fat you have
• Skin quality and looseness
• Firmness or lumps from earlier grafts
• Pelvic frame and muscle shape
• Health conditions affecting surgery

Helpful photos: standing straight from the back, both sides and the front, plus a three-quarter view from behind, in plain underwear against a plain background and in even light. Keep the camera at hip height. If you have had liposuction or fat grafting before, tell us when and where, and how much was done if you know. Feel free to send your photos and questions by message.

Planning your visit and recovery

What is confirmed in advance is limited to the treatment information above. Surgery is under sedation or general anesthesia, with same-day discharge and stitches. A compression garment is worn, and how long is explained before surgery. How long to stay in Seoul, when to come back for a check, and when stitches are removed depend on the areas treated and the volume grafted. These are planned together with you at consultation.

Swelling hides the final line at first, so the result is judged once the swelling has gone down and the fat has settled. Keep dated photos taken in the same way as your pre-operative ones; they make later checks, at our clinic or with a doctor at home, much easier. If you notice increasing redness, heat, pain, discharge or a growing swelling instead of gradual settling, contact a doctor promptly.

Real treatment cases

These cases appear on Bonita Clinic's buttock fat grafting page. Results vary from person to person.

Back view: flat buttocks with a blurred lower border

Back view: the curve from the waist into the buttocks

* Results vary from person to person. Side effects are possible, so please decide after a thorough consultation with a doctor.

Frequently asked questions

How much of the grafted fat remains?

Part is absorbed, and the part that takes remains. Measurement studies abroad report that roughly two-thirds of the injected volume was still present a few months after surgery. But the figure depends on how and when it is measured, and it varies widely between people. We plan the volume with absorption in mind and decide on a touch-up after watching the result.

Can the buttocks be made much bigger in one operation?

The range is set by how much fat can be transferred and by your frame. Collecting more fat than you can spare risks uneven areas or fluid collections at the donor sites. Overfilling the recipient area can also lower the share that survives. That is why the amount is based on balance with your waist and hips.

I am slim. Is fat grafting still possible?

It depends on where you have fat to spare and how much. In slim people, donor areas are more prone to unevenness, so liposuction has to be planned with extra care. Even for slim patients, we look for proportions in which the waist, thighs and buttocks work together; see our Brazilian Layered Hip-up page for more.

I have had liposuction or fat grafting before.

Please tell us. Areas already suctioned may have less fat to give or firmer tissue. Any fat remaining from an earlier graft also affects the plan. Irregularities, asymmetry and sagging left after a previous operation can be corrected; the method depends on the remaining fat and the condition of the skin.

How long do I wear the compression garment?

It depends on the areas and extent, and the period is explained before surgery. Since both donor and grafted areas are involved, ask how to wear it and when sitting is allowed as part of your surgical plan.

What to prepare before your consultation

• Which areas you would like to reduce and which to fill (waist, flanks, upper arms, thighs, buttocks, side hips)
• Previous liposuction, fat grafting, buttock fillers or implants, and when they were done
• Weight changes over the past year and any plans to lose weight
• Medicines you take regularly and any medical conditions

Bonita Clinic is on the 3rd floor of 565 Gangnam-daero, Seocho-gu, Seoul, about 100 m on foot from Exit 8 of Nonhyeon Station (Line 7). You can read more on our Buttock Fat Grafting page. Layered grafting and injection-depth safety are covered on the Brazilian Layered Hip-up page and in the Brazilian butt lift safety guide. The waist-to-hip ratio and the side-hip line are covered on the 7:10 Pelvic Contouring page and in the guide to pelvic fat grafting.