New Study: Fat Grafting Beats Implants for Buttock Augmentation

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A new study co-authored by SAFELipo® creator Dr. Simeon Wall Jr. finds autologous fat transfer has a lower complication rate than implants for buttock augmentation.

Fat grafting, a cornerstone of Dr. Simeon Wall Jr.’s SAFELipo approach to liposuction, is the safest option for butt augmentation, according to a new study.

According to a recent study published in Plastic and Reconstructive Surgery, autologous fat transfer is the safest way to enhance a plastic surgery patient's buttocks. Compared with silicone prostheses, the other prevailing method, butt augmentation via fat transfer had a significantly lower rate of complications. The study’s senior author, Simeon Wall Jr., M.D., is an expert in fat grafting and the originator of Expansion Vibration Lipofilling (EVL) and the SAFELipo technique for liposuction (

The study aggregated findings from the PubMed, MEDLINE, and Cochrane databases, for the purpose of directly comparing approaches to buttock enhancement. It found that in 2,375 instances of silicone buttock implants, there were 512 total complications (or 21.6 percent), ranging from wound rupture at the incision site to the buildup of fluid. In 3,567 instances of buttock augmentation through autologous fat transfer, there were 353 total complications (or 9.9 percent), with fluid buildup and undercorrection by the surgeon as the most common complications.

Independent of these study results, buttock augmentation with autologous fat grafting -- also dubbed the Brazilian butt lift -- has overtaken implants and buttock lifts as the most popular option, as well. In its 2015 Plastic Surgery Statistics Report, the American Society of Plastic Surgeons (ASPS) procedure tally listed 2,540 buttock implants, 4,767 buttock lifts, and 14,705 buttock augmentations with fat grafting.

The widespread adoption of autologous fat transfer in butt augmentation surgery comes as the procedure is in ever-increasing demand. In the same report, the ASPS noted that the number of buttock lift surgeries has increased 252 percent since 2000, with a buttock procedure being performed once every 30 minutes in 2015, on average.

SAFELipo has also contributed to the development of Expansion Vibration Lipofilling, or EVL, an effort to further improve fat transfer outcomes in patients. Dr. Wall worked closely with Dr. Daniel Del Vecchio to create an integrated system of EVL in a move he says shows the continued potential of autologous fat transfer.

“We have ongoing studies that will determine if we can take an already good procedure and make it even safer and better for patients by using EVL,” he says. "The innovative use of fat transfer in SAFELipo grew out of my desire to dramatically improve outcomes for liposuction revision patients. The fact that it has moved so far beyond that initial goal is exciting and inspiring."


SAFELipo ( is a comprehensive fat management process originated by board-certified plastic surgeon Dr. Simeon Wall Jr. The 3-step contouring process uses elements of liposuction, fat shifting, and fat grafting to separate fat from the surrounding tissue, selectively remove it, and use the remaining fat as targeted micrografts to create a smooth result. The first and final steps are what differentiates the procedure from standard liposuction, and it developed from Dr. Wall's efforts to help patients who had obtained unsatisfying liposuction results elsewhere. Dr. Wall completed general surgery and plastic surgery residencies at Stanford University before joining his family’s Shreveport, Louisiana plastic surgery practice, The Wall Center.

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Simeon Wall, Jr, MD, FACS
The Wall Center
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