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Houston Buttock Augmentation

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Fat transfer for buttocks augmentation part 2

Each human being has a stable weight, which is controlled by hormones, biologic feedbacks, and metabolic rate, among other things.
If you gain weight to a moderate obesity of 20 – 40 kg of body fat, the fat cells  actually get bigger, which is called hypertrophy. The absolute number of fat cells remains constant, which is called hypertrophic adipose deposition. Now, as you gain weight in excess of 40 kg of body fat, there is a point where the fat cell cannot get bigger and a process is triggered that forms new cells. This is called hyperplasia adipose deposition, which results in an increase of the actual number of fat cells.

The hyperplasia phenomenon is seen routinely in many of my patients. We certainly  have fat that is very hard to get rid off even with exercises. This diet resistant adipose tissue is due to newly recruited fat cells.  As we gain weight and the critical size of the fat cell is reached, more fat cells are formed. Now, when we lose weight, the size of the fat cells get smaller but the total body fat does not go back to its previous form because of the extra cells that were produced.  Because you cannot get rid of the cell per se, you will not be able to attain the desired weight reduction of certain areas of your body.

From the fat transfer standpoint, hypertrophy appears to be the main factor that surgeons take into consideration for high volume fat transfer.  An obese patient most likely will not be a candidate for surgery and most patients that have undergone the famous Brazilian butt lift have less than 40 kg. of body fat.

Now, fat deposits have certain distribution depending on the sex of the patient. We all have seen this… This fat distribution gives women the gynoid distribution with fat accumulating preferably in the hips, buttocks, and thighs. On the other hand, men have an android fat distribution, which is characterized by deposition of fat in the abdomen and upper body. This complex mechanism is determined by the genetics of the human body added to the complexity of how fat behaves.

Many women that come to my office have a very disproportionate fat distribution. Liposuction performed in those areas and fat transfer to the buttocks transform a woman’s proportion to the ideal form and what is considered the universal shape of sexiness. In summary, understanding how fat behaves has helped me as a plastic surgeon sculpt the human body in ways that were not possible before.

Understanding what fat is and how it behaves is of paramount importance to understand the fat transfer procedure to sculpt any part of the body including the buttocks. Adipose tissue or fat tissue is composed of fat cells and a tissue called connective tissue that holds them in place. These fat cells contain lipids and this is what gives the fat cells the yellow color.  Fat cells can grow as big as 120 microns as a person gains weight. To put this on perspective, a human hair is typically between 40 to 120 microns.  In other words,  fat cells can get pretty large.

A large aggregate of fat cells with connective and its blood supply form two layers throughout the body. There is a superficial layer of fat cell with a well-organized structure and a deep layer with a less structured framework. Clinically, this is very important because the deep layer of fat contributes significantly to the thickness in areas where liposuction is performed.

Fat cells behave in a very unique way depending on the metabolic demands of the body and also on the amount of body fat.  Typically, an individual from 20-25 y/o age, the total fat content is about 15% for men and 25% for female. As a the person  gets obese, the fat cells increase in size but can also increase in numbers. Based on the embryology, which is the science on how living organism grow, it has been determined that during the first year of life the amount of fat cells will triple and will also increase during adolescence.  Then, it will reach a plateau and stay static for the rest of a person’s life as long as a critical threshold in fat cell size is not reached.

Now, what happens after this fixed amount of fat is developed and stays static throughout life has evolved from a notion that we have a fixed number of fat cells throughout the life spam of an individual to the revolutionary theory that there are adiposite derived stem cell. These cells basically can transform into other cell types including fat. These adiposite stem cells have the ability to proliferate after transplantation and increase vessel formation. In other words, not only fat cells can increase in size, but they can also multiply from a common precursor depending on the physiological status of the body at any given time.


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Wilberto Cortes, M.D.
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Suite 100 (West Building)
Houston, TX 77027
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Houston Buttock Augmentation

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