Buttock Implants or Fat Transfer: How the Choice Is Made in Dubai

The choice between buttock implants and fat transfer is not a matter of preference — it is a matter of anatomy. A Brazilian Butt Lift uses your own fat and therefore requires enough donor fat to harvest; a silicone implant creates projection when that fat is not available. What the examination measures is how much fat your body can give, how much projection you are asking for, and whether one technique, the other, or a combination of the two can safely deliver it.

Dr. Paulo Michels is a Brazilian board-certified plastic surgeon and the recipient of the Gold Medal for Best Body Contouring at the World Plastic Surgery Olympiads 2025 (ISAPS, Singapore). He performs buttock augmentation with implants and Brazilian Butt Lift fat transfer at Elyzee Hospital in Abu Dhabi, seeing patients from Dubai and across the UAE. This article explains how the decision is actually made in consultation — and why arriving with the technique already chosen is the most common mistake.

Why can’t I just choose the technique I prefer?

Because one of the two techniques has a hard requirement that the other does not. Fat grafting needs fat. The material for a BBL is harvested by liposuction from the waist, the back, the flanks or the abdomen, purified, and then repositioned in the buttocks. If those areas hold enough fat, the operation does two things at once: it slims the donor zones and it builds the buttock, which is why the silhouette change is often more dramatic than the volume alone would suggest.

If those areas do not hold enough fat, there is nothing to reposition. A very slim woman can want significant projection and simply not possess the raw material for it. No amount of preference changes that. An implant, by contrast, brings its own volume — it is a silicone prosthesis positioned to create projection independently of what your body has stored.

So the first question at consultation is not which operation do you want. It is what does your body have to work with.

What does the surgeon actually assess?

Four things, and they are assessed together rather than in sequence.

Available donor fat. Examination of the waist, flanks, back and abdomen establishes whether there is enough harvestable fat, and whether removing it would improve or flatten the surrounding contour. Fat that looks abundant when standing can behave differently once you are on the table, which is why the assessment is physical rather than photographic.

The projection you are describing. There is a difference between wanting a rounder, fuller shape and wanting distinct central projection. Fat transfer is very good at shaping — filling the upper pole, smoothing the hip dip, softening transitions. Implants are very good at projection in the central buttock. Patients frequently describe one and show reference images of the other, and that gap is worth resolving before any plan is made.

Your frame and proportions. A plan that suits a long torso and narrow hips is not the plan for a shorter, broader frame. The buttock is judged against the waist, the hip width and the thigh, never in isolation.

Soft-tissue cover. How much tissue sits over the area matters more for implants than for fat, because a prosthesis placed under thin cover behaves differently from one placed under generous cover. This is part of why the same implant is appropriate for one patient and not for another.

Does lifestyle influence the decision?

It can, and it is a fair thing to raise. Both operations involve a defined period of protecting the treated area afterwards, and the practical details are not identical between them. For patients whose work involves long uninterrupted desk hours, long drives across the emirates, or frequent flying, that period has to be planned rather than improvised.

The UAE climate is a second practical consideration. Any body-contouring operation that includes liposuction involves compression garments afterwards, which is a genuine factor in the height of summer — our guide to compression garments in UAE summer covers how patients manage it. Because a BBL includes liposuction of the donor areas by definition, garment tolerance is part of that conversation. Implants without fat grafting have a different profile.

None of this outranks anatomy. It influences timing — when in the year you schedule, how much leave you arrange — far more often than it influences technique.

What about revision, longevity and change over time?

Both techniques are durable, and both change with the body rather than standing outside it.

Transferred fat is living tissue. A proportion of it establishes a blood supply in its new position and stays; the rest is reabsorbed in the early months, which is why the result seen immediately after surgery is not the result you keep. Because the retained fat is your own, it also responds to what you do afterwards: significant weight loss or gain after a BBL will be reflected in the buttock as well as elsewhere. Patients who are still actively losing weight are usually advised to reach a stable point first.

An implant is a device. It does not depend on graft survival, so the volume it provides is predictable from the outset and does not fluctuate with body weight. Being a device, it carries the considerations that every implant carries — it sits in a position that has to be planned carefully, and it is a foreign body that the tissues form a capsule around. Implants are also revisable in a way fat is not: an implant can be exchanged or removed.

The honest summary is that each technique has its own advantages and its own limitations, and that the relevant risks are different in kind rather than one simply being higher than the other. They are discussed in detail at consultation, against your specific anatomy, not as a general league table.

When is combining the two the right answer?

More often than patients expect. An implant supplies the central projection; fat grafting placed around it refines the parts an implant cannot address — the upper pole, the transition into the hip, the outer curve, the smoothing of a flank that would otherwise sit awkwardly against new volume.

This combination tends to suit the patient who wants unmistakable projection but does not want the surrounding shape to look abrupt, and who has some — not abundant — donor fat available. It is not a compromise between two options. It is a third plan with its own indications, and for certain anatomies it is the best of the three.

The corollary is worth stating plainly: a patient who arrives having already decided on one technique may be declining the plan that would actually suit her.

When should I contact the surgical team after buttock surgery?

Recovery instructions are given in writing and are specific to the operation performed. Contact the team at Elyzee Hospital promptly — rather than waiting for a scheduled appointment — if you notice any of the following:

• pain that is increasing day by day instead of easing, or pain that is clearly worse on one side
• new redness, warmth or spreading firmness over the buttock or a donor area
• any fluid or discharge from an incision, particularly if it is cloudy, discoloured or has an odour
• an incision that opens or separates
• a sudden change in shape or asymmetry that was not present the day before
• swelling in one leg, or new calf pain, especially with any change in breathing
• a fever recorded on a thermometer, or feeling generally unwell in a way that is worsening

Do not attempt to interpret these yourself. Report what you observe — where, when it started, and whether it is improving or worsening — and let the team decide what it means. Early review is straightforward; late review is not.

Where does the consultation happen?

Dr. Paulo Michels consults and operates exclusively at Elyzee Hospital in Abu Dhabi. There is no clinic in Dubai — patients from Dubai and elsewhere in the UAE attend Abu Dhabi for consultation, surgery and follow-up, and appointments are grouped where the schedule allows to reduce the number of journeys. If you are at the stage of choosing a surgeon rather than a technique, the questions worth asking are set out in our guide for patients looking for a plastic surgeon in Dubai.

The evaluation determines the path — not the other way around. Come with your goal described clearly, and let the examination decide how to reach it.