Patient Details
This patient presented to Dr. Mihail Climov seeking improved body proportions, greater waist definition, and enhancement of her natural buttock shape using her own fat.
At the time of surgery, she weighed 159 lbs with a BMI of 27.3.
Dr. Climov performed an ultrasound-guided Brazilian Butt Lift (BBL) using fat harvested during circumferential 360° power-assisted liposuction. Rather than viewing a BBL simply as a procedure to make the buttocks larger, the surgical plan focused on the relationship between the waist, hips, and buttocks to create a more balanced silhouette.
These before and after photographs were taken just 6 weeks after surgery, while swelling was still resolving and the transferred fat and surrounding tissues were continuing to settle.
Procedures Performed
The patient also underwent a bilateral mastopexy as part of her Mommy Makeover; however, this gallery focuses specifically on her BBL and body-contouring results.
What Is a Brazilian Butt Lift?
A Brazilian Butt Lift, commonly called a BBL, is a body-contouring procedure that uses the patient's own fat to enhance the shape and volume of the buttocks.
Unlike buttock implants, a BBL uses autologous fat, meaning fat taken from the patient's own body.
The procedure has two important components:
First, liposuction is used to sculpt areas such as the abdomen, waist, flanks, and back.
Second, a portion of the harvested fat is prepared and strategically transferred to the buttocks to improve shape and proportions.
This combination is what makes a BBL fundamentally different from simply adding volume to the buttocks.
A BBL Is About Shape—Not Just Size
One of the most important concepts in modern BBL surgery is that bigger does not automatically mean better.
A well-planned BBL considers:
The goal is to determine where additional volume will improve the patient's proportions, rather than simply transferring the largest possible amount of fat.
For some patients, the desired result is noticeably fuller buttocks. For others, the priority is subtle enhancement, improved projection, or smoother transitions between the waist, hips, and buttocks.
Why 360 Liposuction Is So Important for BBL Results
A beautiful BBL result is created not only by where fat is added, but also by where fat is removed.
This patient underwent circumferential 360° power-assisted liposuction to contour the torso before fat transfer.
By reducing unwanted fat around the abdomen, flanks, waist, and back, Dr. Climov can create greater visual contrast between the waist and lower body.
This can help produce:
In many patients, waist sculpting contributes as much to the final BBL silhouette as the fat transfer itself.
What Is an Ultrasound-Guided BBL?
Dr. Climov performs gluteal fat grafting using real-time ultrasound guidance.
During fat transfer, ultrasound allows the surgeon to visualize the relationship between the cannula and the gluteal fascia.
Fat is placed within the subcutaneous tissues above the gluteal fascia rather than intentionally within the gluteal muscles.
Ultrasound provides an additional method of confirming the anatomical plane of the cannula during the fat-grafting portion of the procedure.
Where Does the Fat for a BBL Come From?
BBL fat is harvested through liposuction.
For this patient, donor fat was obtained as part of her 360-degree torso contouring, including the abdomen, waist, flanks, and back.
This creates a valuable two-part transformation:
Areas with unwanted fullness are reduced.
AND
The patient's own fat is used to enhance areas where additional volume is desired.
The result is not simply augmentation—it is redistribution of the patient's existing body volume to improve proportions.
BBL vs. Buttock Implants
Both procedures can enhance the buttocks, but they accomplish this in very different ways.
Brazilian Butt LiftButtock ImplantsUses the patient's own fatUses a manufactured implantIncludes liposuction of donor areasDoes not inherently contour the waistCan improve multiple areas simultaneouslyPrimarily adds gluteal volumeFat is strategically distributed to shape the buttocksImplant provides a predetermined shape and volumeRequires adequate donor fatDoes not require donor fatSome transferred fat is naturally reabsorbedImplant volume remains fixed
For patients with adequate donor fat who also want improvement of the abdomen, waist, flanks, or back, a BBL can provide the additional benefit of body contouring and gluteal enhancement within the same procedure.
Who Is a Good Candidate for a BBL?
An ultrasound-guided Brazilian Butt Lift may be appropriate for patients who:
Not everyone is an appropriate candidate for BBL surgery. Dr. Climov evaluates overall health, anatomy, donor-fat availability, skin quality, gluteal shape, and desired outcome before recommending surgery.
How Much Fat Survives After a BBL?
Not every transferred fat cell will survive.
During the early healing period, some of the grafted fat is naturally reabsorbed by the body. The remaining viable fat establishes a blood supply and becomes part of the patient's long-term tissue.
For this reason, the buttocks can initially appear larger or more swollen than they will after healing.
Patients should not judge their final BBL volume during the first several weeks after surgery.
BBL Results at 6 Weeks
These photographs were taken approximately 6 weeks after surgery, making this an early postoperative result.
At this stage, the patient demonstrates improvement in:
However, 6 weeks is not the final BBL result.
Swelling continues to resolve after liposuction, while the buttocks continue to settle as postoperative swelling decreases and the transferred fat stabilizes.
The patient's contour will continue to evolve over the following months.
Can a BBL Look Natural?
Absolutely—and for many patients, a natural result is the primary goal.
A BBL does not have to create an exaggerated appearance.
The procedure can be customized to provide anything from subtle shape refinement to more noticeable gluteal augmentation, depending on the patient's anatomy, available donor fat, and desired outcome.
Dr. Climov focuses on creating a buttock shape that complements the patient's waist, hips, thighs, and overall frame.
Can You Combine BBL with Other Procedures?
Yes. BBL is frequently performed as part of a broader body-contouring plan.
This patient's BBL was performed in conjunction with:
This allowed Dr. Climov to address the patient's breasts, torso, waist, and buttocks within a customized Mommy Makeover plan.
However, the number and combination of procedures that can be safely performed at one time must be individualized based on the patient's health, anatomy, operative plan, and anticipated surgical time.
Why Choose Dr. Mihail Climov for BBL Surgery?
Dr. Mihail Climov is a fellowship-trained aesthetic plastic surgeon performing advanced body-contouring and fat-transfer procedures in the Houston area.
His approach to Brazilian Butt Lift surgery focuses on proportion rather than volume alone.
The waist, abdomen, flanks, back, hips, and buttocks are evaluated together to determine where fat should be removed and where additional volume can create the greatest improvement in overall body shape.
Dr. Climov also utilizes real-time ultrasound guidance during gluteal fat grafting to visualize the cannula in relation to the gluteal fascia during fat placement.
Schedule a BBL Consultation in Houston
If you want to improve your waist-to-hip proportions, enhance your natural buttock shape, or combine liposuction with fat transfer, an ultrasound-guided Brazilian Butt Lift may be an option.
Schedule a consultation with Dr. Mihail Climov to determine whether BBL, 360 liposuction, or a customized combination of body-contouring procedures is appropriate for your anatomy and goals.
