Board Certified
Plastic Surgeon
Since 1989

Brazilian Butt Lift vs. Butt Implants | Which is better?

The decision to undergo cosmetic surgery is not a decision people make lightly. Deciding to have butt augmentation surgery is also challenging since there are drastically different approaches to achieve the desired result of a more round and shapely posterior. In this interview, Dr. Widder shares his preference for Butt implants and why the Brazilian Butt Lift, which uses natural fat injections, should be not be considered as a viable long-term solution.


Q: Do you have any recent news or experiences with specializing in performing buttock implants?

I recently had a patient who came to me from a distant state.  She actually works for a cosmetic surgeon who does fat injections to the butt yet she came to see me for butt implants.  She has written to me more than once about how happy she is and how everything is going as wonderfully as she hoped.  She is considering more surgeries with me in the future.  To me, that is the ultimate affront to people who believe in fat injections.  Here’s someone who works in an office with someone who does it and she sees those patients every day.  That’s why she didn’t do it there.

Q: How did she find you?

On the internet.

Q: This patient made the decision to come to you based on the results of other patients that she saw on the internet.  How do you think others make decisions about butt augmentation?

I had a discussion about this today with one of my patients whom I’ve done a lot of surgeries on.  She’s undecided about butt implants vs. fat injection.  She says, “I’m totally obsessed about it – I don’t know what to do.”  She goes to websites that say how wonderful the Brazilian butt augmentation with the fat injection is.  I told her from my own experience that the fat injection only lasts 6-12 months.  She is still undecided.  She’s vacillating and is really a tortured soul about it right now.  She knows me – I’ve done a tummy tuck and breast augmentation on her.  Both were redos.  They had been done by somebody else and she looked terrible.  Now she is so happy.  I also did primary liposuction on her thighs.

So she trusts me and likes my work and the quality of my work.  But at the same time, it sounds very attractive to her to do liposuction and put it in the butt.  She reads all those anecdotes from other doctors about the results of fat injection.  So she’s totally confused and doesn’t know what to do.  I usually don’t have that issue; either my patients want to do it or not. In this case, we’ve been going back and forth for three months.  Even today she called me.  That’s ok with me – I told her, “It’s your decision. Use your knowledge and your common sense.”

It will be a shame if she has to pay $10-13,000 dollars to be disappointed.  I told her that one of my patients spent $26,000 on multiple fat injections and it almost all disappeared.  Then, she came to me for the butt implant and it cost her even more because she had to pay for my procedure.

Q: What do you think draws the undecided patient to the idea of fat injection?

Well, it’s so popular.  It’s in a lot of magazines , the internet, and everyone is talking about it.  It sounds like a great idea.  It would have been a great idea if it was viable, but it’s not and that’s the problem.  I would have done it if I felt it was a good procedure.  I don’t do it because I couldn’t face the patient who would come to me after having the procedure and the fat had all or almost all disappeared.  What could I say?  What could I do?  I couldn’t face them.  To me, it’s unethical.   I know one thing,  the implant will stay.  It won’t go anywhere. Sometimes because of the popularity of fat injection, I feel like one voice in the wilderness.

So, I think about that patient from out of state.  She came all that way to me after having seen the results of fat injection first-hand.  I’ve mentioned her to a few of my other patients.  I don’t know which way they’re going to go.  But for me, it is common sense and due diligence.  I tell people to use their own judgment and don’t believe everything that’s written down.  My undecided patient was already burned by surgeons with bad surgery and now she’s found someone who really makes her happy with the outcome.    I hope she’ll follow her good experience with me because I want my patients to be happy.

Q: Any more thoughts on making this big decision?

Some people have trouble making up their minds on certain issues, which is ok.  There was a study that says the average time it takes a person to make a decision about cosmetic surgery is a year.  Now, that’s an average, a median.  So, some people take just a few days and some take years to make a decision.   I told my patient who’s undecided, “You have just been thinking about it for 3 months.  Give it a few more months and think about it.  Just don’t make a decision that you’ll regret.”

It’s not only the time and money that they’re losing if surgery doesn’t work out.  It’s the disappointment that they didn’t achieve their goal. That’s what I tell them.  Money and time are both important, but more important are the fact that they had a dream, they had an expectation, and it wasn’t fulfilled.   I think the disappointment can be dramatic.

I know other people are struggling with this decision, and I hope this encourages them to think about the option of butt implants.  So many doctors are doing fat injections because it’s a moneymaker and they don’t want to give it up.  It’s on all the media – TV, cable, printed media, Internet, chat rooms, but the balloon will explode. It’s like what happened with the economy– eventually, the bubble will burst if there’s no good basis for it. It requires such a large amount of fat in order to increase the butt.  They have to inject 800-1,000 sometimes even 1,500 cc depending on how big they want to be.  How can it survive? It’s irrational physiologically.  There’s just no good scientific basis for fat injections in the buttocks.

Dr. Shlomo Widder is affectionately known as the “D.C. Butt Doctor.” Widder Cosmetic and Plastic Surgery Center offer premium services to fit every cosmetic surgery need in the greater D.C. area. To find out more about our center, stop by during office hours: 9 – 5pm, Mon – Fri, or visit our website at:

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