A patient’s husband recently said to me, “Most women don’t know what they look like from behind.” Several responses came to my mind. However, I choose to say nothing. Most women are more than aware of what their backside looks like when the Spanx comes off. Whether or not they want to address perceived issues is optional.

A cultural change occurred several years ago. Many people attribute it to Jennifer Lopez appearing in a tight fitting snowsuit that showed off her figure. A fuller and more pronounced bottom is in — and likely here to stay. Options for gluteal augmentation include buttock implants or fat grafting. Buttock implants appear similar to frisbees. Placement requires surgery and an incision across the lower back. There are multiple possible issues with these implants including discomfort, infection requiring removal, and movement of the implant into an undesirable position. The other surgical option is fat grafting. Fat is liposuctioned from other areas of the body. Most commonly, the abdomen is used as the donor site. The fat is processed and injected into the buttocks to give a fuller volume and more projection. A large incision is avoided. However, not all of the transferred fat may live. Repeat fat grafting may be required. Complications with fat grafting are possible; however, the complication rates are lower than the gluteal implants.

Cellulite. The dimples that no woman wants. It is estimated that 90 percent of women have cellulite. It is most commonly seen on the buttocks and thighs. The treatment options, including drugs and therapies, are endless. Results tend to be highly variable and improvement tends to be temporary. Cellfina is new to the market and the most promising procedure for long-term change. It is an in office procedure that gets rid of cellulite by releasing the tethered (dimpled) areas. Result appear to continue to improve over time.

Diet and exercise are the most important aspects of keeping your buttocks in shape. If they are not enough, then other options exist. Make sure that you are seen by a Board Certified Plastic Surgeon who has experience with your proposed procedure.