If statistics are any indication, the demand for prominent, shapely buttocks is on the rise. The number of buttock augmentations performed in the U.S. rose from 4,996 in 2009 to 7,034 in 2010, according to the American Society for Aesthetic Plastic Surgery. So why do some plastic surgeons refuse to perform gluteal enhancement?

Buttock augmentation can be performed by transferring fat from another part of the body to the buttocks (as in the Brazilian butt lift), or by surgically rounding out the bottom with gluteal implants. But some plastic surgeons believe that the benefits of buttock augmentation are outweighed by risks like these:

Asymmetry. If the volume of fat injected into your buttocks isn’t equal, the buttocks may look uneven. A skilled plastic surgeon can get aesthetically pleasing results with fat grafting, but even in the best surgeon’s hands, there’s a risk of imbalance.

Implant displacement. Walking, running, standing, sitting and many of the other activities you perform each day engage your gluteal muscles. As a result of natural movement, an implant can slip out of its surgically created pocket, giving the bottom a misshapen appearance.  Implant displacement must be corrected by surgical revision.

Lumps and hardened tissues. Injecting fat into the buttocks from another part of the body, a procedure called autologous fat transfer, may damage the tissues, creating lumps and hardened areas under the skin.

Seromas. Sitting places a lot of pressure on the buttocks, which may cause a seroma, or a pocket of fluid, to form in the implant area. Seromas usually aren’t dangerous, but they can give the buttocks a lumpy, unsightly appearance. If your body doesn’t absorb the fluid naturally, you plastic surgeon may have to drain the pocket.

Fat graft failure. Fat grafting isn’t always successful. If the transferred fat doesn’t survive, the tissues will die.

Implant damage. Like breast implants, gluteal implants can be damaged. Silicone gluteal implants are made of a firm, compressible gel that can hold up to the constant pressure of sitting, but gluteal implants may still break. If an implant breaks, it will need to be removed and/or replaced promptly to avoid complications.

Ultimately, it’s up to you to decide whether the benefits of having a more beautiful bottom are worth the risks. In the hands of a skillful plastic surgeon, a fat transfer or gluteal implant placement can give you a curvier, more prominent derriere, and many women are delighted with the results. For the best outcome with the least risk, take your time finding an accomplished, board certified surgeon dr omarjee who has extensive experience in buttock augmentation.