Derriere Definition

We spend a lot of time thinking about how we look when people meet us—but not enough time considering what they’re seeing as we exit. Do we have a nice, tapered shape in those low-rise jeans, or do our backsides droop or bulge over those jeans? A procedure called ‘back scooping,’ made popular recently by reality TV personality Heidi Montag, is getting some press.

In his blog, Dr. William Huffaker of St. Louis Cosmetic Surgery explains it as a procedure he has done for years. It’s a liposuction technique that removes fat from the lower back and upper thighs to give the back more of a ‘scooped-out’ appearance so the buttocks look firmer and more defined.

“Many women work out a lot and still store fat in that area,” says Huffaker. “Most bodies are not designed to show off that particular portion of their anatomy. If they also have full thighs, the outer thighs appear to flow into the lateral buttocks, and you lose any definition. We can do a lot to help nature. We can use liposuction to trim down the outer thighs to give the lateral buttocks more definition and suction, or scoop, the lower back to accentuate the roundness from above.” If there is extra fat higher on the back, he can suction that out, too. He says sometimes women can go from a 38 bra band size to a 36 or 34 by removing back fat.

As far as sculpting the buttock area, Huffaker deals mostly with the fat, and finds that the best definition is usually achieved by selective liposuction on the back thighs and upper buttocks to shape the area to look “as if she has been doing lunges at the gym.” For hollow areas he can put fat back from the areas with a surplus. The overall effect is a rounder, more youthful looking derrière, he says.

Dr. William Hart of Hart Cosmetic and Reconstructive Surgery Institute says women want their buttocks lifted, decreased in volume, contoured, augmented, tucked and tightened—or some combination of the above. “One of the tools we have to achieve those goals is the buttock implant,” he explains. “When J-Lo first became popular, people started looking into having their buttocks augmented, but the implants were not very good. Today’s implants are a soft silicon elastomer, not a liquid or gel. They come is different volumes, sizes and shapes.”

Hart is seeing an increase in interest in the implants. While fat grafting can help with contouring, he finds it a more tedious procedure with somewhat irregular results. He prefers the implants for a uniform contour the first time. In a surgical procedure under three hours, he puts the selected implant on top of the gluteal muscles and under the fascia that covers them. “This placement is best for the most natural contour, a quick recovery with less pain, and fewer complications,” Hart says.

During the procedure, he may also scoop the lower back with some liposuction and contouring the thigh, hip, flank and even the abdomen to give a shape that looks good in low-riding jeans. In his practice, clients interested in cosmetic surgery of the buttocks are mostly women in their twenties to late forties. As with any cosmetic surgical procedure, he counsels patients considering buttock enhancement to consult a surgeon with experience, one who can show samples of his or her work and has prior patients willing to talk about their experience.

For people who are concerned about being able to sit at work for long periods after surgery, Hart explains that they can do it fairly quickly. “The implant is actually placed higher than where you sit,” he says. “My patients do have to limit their exercise for three weeks or so, but they are often surprised that the procedure is not as painful as they thought.”