Butt Implants: What the Surgery Involves, Recovery Timeline, Risks, and BBL Comparison
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What are butt implants?
Butt implants are silicone implants a plastic surgeon places inside or below the gluteal muscle to give flat or square-shaped buttocks a rounder, firmer shape. The result is permanent, but surgery takes several hours under general anesthesia, recovery takes weeks, and complications are common, so choosing an experienced surgeon matters. [1]
What the research says
Implants had about twice the complication rate of fat transfer. A systematic review of 44 studies found an overall complication rate of 21.6% in 2,375 implant patients, compared with 9.9% in 3,567 fat-transfer patients. The most common implant problems were wound opening (9.6%), fluid buildup (4.6%), infection (1.9%) and temporary sciatic nerve tingling (1.0%). (Sinno et al., Plast Reconstr Surg, 2016) [2]
Where the implant sits changes the risk. A systematic review of 30 articles found complication rates of 13.18% with the intramuscular "XYZ" method, 17.60% below the muscle, 18.05% inside the muscle and 54.84% in the subfascial plane. Wound opening (10.29%) was the most common problem overall. (Flores-Lima et al., Aesthetic Plast Surg, 2013) [4]
Experienced surgeons still report frequent complications. A survey of 19 experienced surgeons covering 2,226 patients recorded 848 complications (38.1%). Most of these surgeons (68.4%) preferred placing implants inside the muscle. (Mofid et al., Plast Reconstr Surg, 2013) [5]
Key takeaways
Butt implants are soft silicone implants placed inside or below the gluteal (buttock) muscle.
They suit healthy non-smokers with a flat or square-shaped buttock who don't have enough body fat for a Brazilian butt lift (BBL).
Surgery takes several hours under general anesthesia, through an incision between the buttock cheeks.
Expect two to three weeks of no sitting or back-sleeping, a pillow under your thighs for at least eight weeks, and exercise only after eight to 10 weeks.
Final results show after swelling settles, often three to six months after surgery.
Complications are common, and a BBL may look more natural with a lower complication rate.
Butt implants at a glance
Question | Short answer |
|---|---|
What is it? | Silicone implants placed in or under the gluteal muscle |
Anesthesia | General: you are asleep and feel no pain |
Surgery time | Several hours |
Incision | Between the buttock cheeks, at the top or bottom |
Back to work | About 2 to 3 weeks (sitting on a pillow) |
Exercise | After about 8 to 10 weeks |
Final shape | Often 3 to 6 months, once swelling settles |
Permanent? | Yes, no top-up procedures needed to keep the look |
What are butt implants?
Butt implants are a cosmetic surgery that uses silicone implants to make the buttocks look rounder and shapelier. [1]
A plastic surgeon inserts the implants into the gluteal muscle or below it. The exact position depends on the surgeon's approach and your anatomy.
The procedure is one of several ways to add buttock volume. Others include a fat-transfer Brazilian butt lift (BBL) and nonsurgical options such as fillers. For a wider view of aesthetic procedures, see our guide to cosmetic surgery, or this patient overview of buttock augmentation.
Where are butt implants placed, and do they look natural?
How natural butt implants look depends mainly on where the surgeon places them, and the two main positions trade appearance against nerve safety. [1]
Placement | Main advantage | Main drawback |
|---|---|---|
Inside the gluteal muscle | Lower risk of damaging the sciatic nerve | The implant may stick out |
Below the gluteal muscle | Tends to look more natural | Higher chance of nerve damage |
The sciatic nerve runs deep in the buttock, beneath the muscle. That is why placing an implant lower, under the muscle, raises the risk of nerve injury. If you already live with nerve pain, our sciatica guide explains how this nerve works.
Implant size matters too. Larger implants can raise the chance of problems such as incisions opening after surgery and implants shifting out of place.
Who is a good candidate for butt implants?
A good candidate for butt implants is a healthy non-smoker with a flat or square-shaped buttock who doesn't have enough body fat for a BBL. [1]
Your plastic surgeon makes the final call and may suggest a different procedure.
Usually a good candidate | Usually not a good candidate |
|---|---|
In good general health | Can't stop smoking for several weeks before and after surgery |
No condition that slows healing, such as diabetes | Weight goes up and down often |
Not enough body fat for a BBL | Has a lot of loose or sagging skin |
Doesn't smoke | Wants a quick fix and isn't ready for a long recovery |
Has a flat or square-shaped buttock | — |
How should you prepare for butt implant surgery?
Preparing for butt implant surgery mainly means stopping smoking and pausing medicines that raise bleeding risk. [1]
Your surgeon will give you written instructions. Common steps include:
Stop smoking for at least six weeks before surgery.
Avoid blood-thinning medicines such as aspirin. Ask for a complete list of medicines to stop.
Avoid herbal supplements before surgery.
What happens during butt implant surgery?
Butt implant surgery is done under general anesthesia, so you are asleep for the whole procedure and feel no pain, and it usually takes several hours. [1]
The surgeon:
Makes an incision between the buttock cheeks, at either the top or bottom of the buttocks.
Places the implants inside or below the gluteal muscle.
Closes the incision with stitches or surgical tape.
What is recovery like after butt implant surgery?
Recovery after butt implant surgery is long and centers on keeping pressure off the buttocks for several weeks. [1]
Before you go home, your surgeon explains incision care. You may need to:
Avoid putting direct pressure on your buttocks.
Skip showering for 48 hours.
Take an antibiotic and a stool softener.
Use surgical drains.
Wear compression garments.
Time after surgery | What to expect (if there are no complications) |
|---|---|
First 48 hours | No showering |
Weeks 0 to 3 | No sitting or sleeping on your back, except to eat and use the toilet |
Weeks 2 to 3 | Return to work, sitting on a pillow |
At least 8 weeks | Use a pillow under the backs of your thighs (hamstrings) when sitting |
Weeks 8 to 10 | Start exercising again; complications may mean waiting longer |
Months 3 to 6 | Swelling settles and final results appear |
Swelling is normal after surgery. That is why the final shape may not be clear until around three to six months later.
What are the risks of butt implants?
Butt implant surgery has a high rate of complications, even though it is considered relatively safe overall. [1] [2]
Working with an experienced plastic surgeon lowers, but does not remove, these risks:
Blood collecting under the skin (hematoma)
Fluid collecting under the skin (seroma)
Incisions that separate (wound dehiscence)
Infection
Chronic pain
Permanent scarring
Implants shifting or sitting in the wrong place (malposition)
Permanent tightening of the tissue around the implant (contracture)
Implant rupture
Skin discoloration
An uneven appearance
How common are complications? Reported rates vary by study. A review of 52 studies covering 7,834 patients, 4,781 of them with implants, found an overall complication rate of 30.5% with implants, compared with 10.5% with fat grafting, yet patient satisfaction was consistently high across techniques. [3]
Study type | Patients | Overall complication rate with implants |
|---|---|---|
Systematic review (44 studies) | 2,375 | 21.6% |
Literature review (52 studies) | 4,781 | 30.5% |
Multicenter surgeon survey | 2,226 | 38.1% |
What are the benefits of butt implants?
The main benefit of butt implants is a rounder, firmer and more defined buttock shape that lasts. [1]
If you like the result, it is permanent, so you won't need extra procedures to maintain it. Implants also offer an option for people with a lean frame who don't have enough fat for a BBL.
Will butt implants leave scars?
Butt implants leave some scarring, and how visible it is depends on where the incisions are made. [1]
Because the incision usually sits between the buttock cheeks, ask your surgeon where they'll cut and whether the scar will show after healing.
Good incision care helps keep scars as small as possible. If a scar heals thick or raised, read about hypertrophic scars and scar revision.
How do butt implants compare with a Brazilian butt lift (BBL)?
A Brazilian butt lift uses your own fat instead of silicone implants, and it tends to look and feel more natural with a possibly lower complication rate. [1] [2]
In a BBL, the surgeon removes fat from an area such as the belly or thighs with liposuction, then injects it into the buttocks. Learn more in our Brazilian butt lift guide, our fat transfer guide or this overview of the BBL procedure.
Factor | Butt implants | BBL (fat transfer) |
|---|---|---|
What adds volume | Silicone implants | Your own fat |
Best suited to | Leaner frames without enough fat to harvest | People with enough body fat |
Look and feel | Rounder, firmer, more defined | Usually more natural |
Complication rate (systematic review) | 21.6% | 9.9% |
Recovery | Longer | Shorter by comparison |
The right choice depends on your body, your goals and your surgeon's assessment. Bring both options to your consultation and ask which one fits your anatomy.
When should you call your surgeon after butt implant surgery?
You should call your surgeon's office promptly after butt implant surgery if you notice signs of infection or allergy, heavy bleeding or swelling, fever, or severe pain. Call 911 for chest pain, sudden shortness of breath, or a swollen, painful leg, which can be signs of a blood clot. [1]
An allergic reaction or signs of infection
Heavy bleeding or swelling
Fever
Pain that is severe or doesn't go away
Conclusion
Butt implants offer a permanent way to add shape and volume, and they are often the best fit for leaner people who don't have enough fat for a BBL. The trade-offs are real: several hours of surgery, weeks without normal sitting, and complication rates that research puts well above fat transfer. The safest path is an honest consultation with an experienced plastic surgeon who can weigh implant position, size and alternatives against your own anatomy and goals.
Next step: Save or print this guide and take it to your consultation. It covers the key questions to ask about placement, recovery and risks. Want to compare your options first? Read our guides on the Brazilian butt lift, fat transfer, nonsurgical butt lifts and liposuction.
Frequently Asked Questions
Are butt implants permanent?
Yes. Butt implants are a permanent procedure, so if you like the result you won't need more procedures to keep it.
How long does butt implant surgery take?
Butt implant surgery usually takes several hours and is done under general anesthesia.
When can I sit down after butt implants?
Many surgeons advise no sitting for the first two to three weeks, except to eat and use the toilet. After that, you sit on a pillow under the backs of your thighs for at least eight weeks.
When can I exercise after butt implants?
If you have no complications, you can usually start exercising after eight to 10 weeks. Complications can mean waiting longer.
When will I see my final results?
Final results show once swelling goes down, which can take around three to six months.
Do butt implants look natural?
It depends on placement. Implants below the muscle tend to look more natural, while implants inside the muscle may stick out but carry a lower risk of sciatic nerve damage.
Can I get butt implants if I smoke?
You need to stop smoking for at least six weeks before surgery. People who can't quit for several weeks before and after surgery are not good candidates.
Is a BBL safer than butt implants?
Research shows a lower overall complication rate with fat transfer (9.9%) than with implants (21.6%), and a BBL tends to look more natural. A BBL needs enough body fat, so it isn't right for everyone.
Who is a good candidate for butt implants?
A good candidate is a healthy non-smoker with a flat or square-shaped buttock who does not have enough body fat for a Brazilian butt lift. A plastic surgeon will help you decide which option fits you.
Will butt implants leave a scar?
Yes, but the scar is usually well hidden. The incision is most often made between the buttock cheeks, and the scar fades over time.
Related Reading
Butt Augmentation: Types, Risks, Recovery and What to Expect compares implants, BBL and butt lift options for buttock shaping.
Brazilian Butt Lift (BBL): Procedure, Recovery, Risks, and Results explains the BBL procedure, recovery and fat clot risks.
Butt Lift Surgery: What It Is, Who It Suits, Recovery, and Results explains how a butt lift removes sagging skin and what to expect.
Nonsurgical Butt Lift: Enhancing Shape and Volume Without Surgery covers nonsurgical buttock options like fillers and laser treatments.
References
Cleveland Clinic. Butt Implants: Surgery, Recovery, Scars & vs. BBL. Cleveland Clinic. Last updated June 27, 2022. https://my.clevelandclinic.org/health/treatments/23353-butt-implants
Sinno S, Chang JB, Brownstone ND, et al. Determining the safety and efficacy of gluteal augmentation: a systematic review of outcomes and complications. Plast Reconstr Surg. 2016;137(4):1151-1156. PMID: 27018670. https://doi.org/10.1097/PRS.0000000000002005
Oranges CM, Tremp M, di Summa PG, et al. Gluteal augmentation techniques: a comprehensive literature review. Aesthet Surg J. 2017;37(5):560-569. PMID: 28203698. https://doi.org/10.1093/asj/sjw240
Flores-Lima G, Eppley BL, Dimas JR, et al. Surgical pocket location for gluteal implants: a systematic review. Aesthetic Plast Surg. 2013;37(2):240-245. PMID: 23354760. https://doi.org/10.1007/s00266-012-0018-8
Mofid MM, Gonzalez R, de la Peña JA, et al. Buttock augmentation with silicone implants: a multicenter survey review of 2226 patients. Plast Reconstr Surg. 2013;131(4):897-901. PMID: 23542262. https://doi.org/10.1097/PRS.0b013e3182818ec0
The Aesthetic Society. Butt Lift. The Aesthetic Society. Accessed October 30, 2026. https://www.theaestheticsociety.org/procedures/body/butt-lift
American Board of Cosmetic Surgery. Brazilian Butt Lift. American Board of Cosmetic Surgery. Accessed October 30, 2026. https://www.americanboardcosmeticsurgery.org/cosmetic-procedures/body/brazilian-butt-lift-surgery/
Medical disclaimer
This article is for general education only and is not a substitute for advice from a qualified healthcare professional. Talk with a board-certified plastic surgeon about whether any procedure is right for you.
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