THE BOOTY BOOM: THE PSYCHOLOGY AND SURGERY OF BUTT ENHANCEMENT

Do you know who won Miss BumBum World last year?  Or what a Belfie is?  Who coined the term Bootylicious, and was it a reference to J Lo, Kim Kardashian, or Beyonce?  If you don’t know the answers to these questions, then you’re a little behind (pardon the pun). But seriously, all you have to do is scroll the instagram accounts of millenials, fitness models, and influencers to see how common butt selfies and butt-enhancing exercise videos have become.  Behind-the-scenes footage of old has morphed, slowly but surely, into scenes-of-behinds footage.  Why is this? Why has the behind become front and centre (you know what I mean!) in the psyche of women who want to enhance their appearance and sculpt their bodies, and what are they doing to make their butts bigger, rounder, and more voluptuous?

THE BEHIND IS THE FUTURE

Creating the illusion of having a larger butt is not new.  In the late nineteenth century women wore dresses with large bustles—tufts of material protruding from the back—to give the impression of voluptuousness and balance the proportions with the breasts¹.  Painfully tight corsets were also used to cinch the waist and enhance the ratio between the waist and the hips.  What about surgery, though, to actually make the butt larger or more shapely?  The American Society of Aesthetic Plastic Surgery (ASAPS) releases statistics annually informing us of the latest trends in cosmetic surgery. According to ASAPS stats, 26,774 buttock augmentation surgeries were performed in the US in 2018 alone². That’s up 61% in the previous 5 years, representing one of the fastest growing cosmetic surgical procedures. Almost all were female butt enhancements, and 94% were performed using the patient’s own fat, a procedure known as fat grafting.  These women spent over $100 million on their bums, and most of them were between 18 and 50 years old.  The bottom line?  Like the butts themselves, the trend of surgical liposculpture to reshape and enhance the booty is growing. 

ATTRACTING ATTENTION

Amongst psychologists and anthropologists, it’s widely agreed that we humans are attracted to physical traits that are cues to reproductive health³. 

What does that mean? Well there’s a correlation between certain waist and hip measurements in women and their ability to reproduce.  In fact, women with a waist to hip ratio of 0.7 have a higher reproductive potential, and are perceived as being more attractive according to numerous scientific studies^4,5.  So to become more attractive to men, a woman with a waist to hip ratio of 0.8 could either reduce the circumference of her waist, or increase the circumference of her hips to get closer to the 0.7 ratio. The non-surgical (and cheaper) way: a corset or a frock with a bustle. The surgical way:  body contouring with liposuction of the waist and fat grafting into the buttocks and hips.  Building a bum in the gym to achieve that 0.7 ratio naturally is an ideal alternative, provided you have a lot of discipline, and some favourable genes. 

BUTT BLASTERS

Nowadays there are not only machines dedicated to building the perfect behind, like the Butt Blaster and Booty Builder, but entire gyms devoted to gluteal sculpting.  Bünda gym in Los Angeles is “home of the better butt” where you can lunge and thrust and donkey kick your way to a head-turning rear⁶.  Resistance training exercises and manoeuvres designed to induce hypertrophy of the gluteus maximus (the body’s largest muscle) are all over the internet. 

Some experts, like Bret Contreras PhD (aka The Glute Guy) have dedicated much of their careers to education and personal training in techniques to strengthen and build the buttocks⁷.  Yet despite the readily available guides, programmes and classes on glute training and booty building, many women take it a step further, and undergo surgical intervention to get the look they want.  The thing is, unless you’re well informed, that step could be in the wrong direction!

CAUTIONARY TALE

All sorts of things have been placed in the butt to augment it.  Over 50 years ago, silicone breast implants were implanted into the butt in an effort to provide enhancement.  This didn’t really work well—the small implant just floated around like a single duvet in a king-size duvet cover.  Silicone implants, however, can be removed.  Google ‘silicone butt injections’ and you’ll find a ream of horror stories that leave you bemused as to why anyone would subject themselves to such risky, illicit interventions.  I’m talking about butt injections: injections of industrial-grade silicone, hydrogel, liquid plastic, motor oil, cement⁸.   Whatever these black market “practitioners” can get their hands on, it seems.

And these deadly injection treatments are being carried out in hotels, apartments, and backstreet basements.  Surgeons who pick up the pieces report the painstaking task of managing horrendous complications that include infections, foreign body reactions, skin gangrene, lumps, and serious lung and heart issues⁹.  The injected material can travel to the heart, lungs and brain causing respiratory distress, stroke, and death.  That’s exactly what happened to 48 year-old Lesbia Ayala from Philadelphia after she had silicone pumped into her butt by an unlicensed provider who was previously in jail for doing the same thing¹⁰. 

FAT’S THE GOLD STANDARD

The vast majority of Brazilian Butt Lifts (BBL) performed by licensed surgeons these days use your own fat. It’s like a transplant from one part of your body to another.  Millions of fat cells are sucked into a sterile canister during the liposuction part of the procedure.  The idea is to slim the waist with lipo, then add the fat to the buttocks to shape and increase the size, increasing the perkiness and increasing the hip circumference. 

In theory, this should improve the waist to hip ratio and improve attractiveness.  It’s worthwhile bearing in mind, though, that complications exist with any surgical procedure; especially the Brazilian Butt Lift.  If fat happens to be injected into, or leak into, large veins deep in the buttocks, bad things can happen.  Some studies report that fat grafting to the buttocks is the riskiest cosmetic surgical procedure of them all.  Even experienced surgeons are advised to modify their practice to consider the risks associated with the Brazilian Butt Lift¹¹.  Other, world-leading fat grafting surgeons describe keys to optimising safety in this high-demand procedure, such as injecting the fat using certain instruments under the skin and not deeply into the muscle¹². 

ART OF GLUTEAL SCULPTING

Butt enhancement surgery has become a discipline in itself and whole texts have been published on the subject¹³.  So what exactly can you expect if you’re pondering this treatment? Your surgeon will want to assess you to see if you’re a good candidate, obviously, and that includes having enough fat to “harvest” from other parts of your body.  If you get the green light, you’ll either be put under general anaesthesia or have the treatment done under local.  Usually, if large areas are being contoured and large volumes injected, a general anaesthetic is preferred.  The donor area (tummy, hips, back, thighs) is filled with large volumes of diluted numbing fluid with adrenaline to reduce bleeding. Regular lipo, or lipo using vibrating cannulas or ultrasound to break up the fat, allows the fat to be sucked into special sterile bottles where the fat is stored.  Several commercial fat harvesting receptacles are used to either filter or spin the fat to get a nice, golden “graft”—millions of living fat cells ready for their new home! 

The technique of injection is particularly important, both to ensure most of the fat survives, but also for safety.  A long blunt-tipped tube or “cannula” is used to place tiny threads of fat under the skin and above the glute muscles.  Injecting deeply into the muscle is practiced by some surgeons but thought to considerably increase risk since that’s where most of the big blood vessels reside.  If fat finds its way into a blood vessel, it can travel up to the heart or lungs.  Safer techniques, advocated now by most plastic surgeons who offer this procedure, limit injection of fat to the layers above the muscle.  After you recover from the initial surgery, you’ll need to adhere to postop instructions like wearing special garments and avoiding pressure on the butt for a few weeks. 

MORE THAN MEETS THE EYE

Whether its fitness, fashion or filling with fat, butt augmentation has become big business.  Firm, voluptuous, round butts are beautiful, right? That’s the whole idea—we’re biologically attracted to larger butts and slim waists that render a waist-to-hip ratio a “perfect” 0.7.  That’s not the full story though.  The male species is certainly attracted to the curves, biologically, since they are cues to reproductive health and potential.  Psychologists and scientists have analysed the curves, though, and as it turns out, it’s not the butt that contributes to the most aesthetically pleasing female curves¹⁴.  It’s the spine! 

Spinal ‘wedging’ between the third and last lumbar vertebrae creates a more acute angle between the lower back and buttocks; and the most beautiful, attractive angle is 45.5°.  This wedging is an evolutionary adaptation to the biomechanical demands on bipedal females during childbearing to shift the centre of mass backwards over the pelvis.  If this wedging of the lumbar vertebrae did not occur, huge physical demands on the muscles would have made foraging and survival challenging.  The arched back—so called lumbar lordosis—projects the buttocks somewhat and is an attractive feature that is also, not surprisingly, a cue to reproductive health.  So you can build all the muscle you want with squats and lunges, maybe even undergo surgery to redistribute body fat and create a fuller butt.  But what can possibly be done to shift the centre of mass and change the curve of the spine to get closer to the 45.5° sweet spot?  Well, it turns out that high heels can do a lot more than make your feet hurt¹⁴!

THE POWER OF HIGH HEELS

“A woman’s beauty lies, not in any exaggeration of the specialized zones, nor in any general harmony that could be worked out by means of the sectio aurea or a similar aesthetic superstition; but in the arabesque of the spine.”  John Updike

One study from France revealed that men’s helping behaviour toward women increased proportionate to the height of the heels they were wearing¹⁵.  Men also approached women who were wearing 9cm heels twice as quickly as they did when they were wearing shorter heels or flats. The result led one commentator to muse, “there’s just something about those “jutting buttocks” that drives men wild¹⁶”. 

That something just may be the 2° greater lumbar curvature exhibited when women wear high heels.  And knowingly or not, women often manipulate their lumbar curvature in ways that increase perceptions of attractiveness. So there you have it:  high heels recreate the aesthetically ideal lumbar curvature that is a cue to reproductive potential and health and that feature that men are most attracted to, whether they are aware of it or not.  And if you’re not quite at 45.5° even in those stiletto heels, there’s always the butt blaster or booty builder or butt enhancement to get you those curves you’re looking for.  But be forewarned:  cosmetic butt surgery is not allowed at Miss BumBum World!

References

1. https://historydaily.org/victorian-buns-the-obsession-with-enormous-bustles
2. https://www.surgery.org/sites/default/files/ASAPS-Stats2018_0.pdf
3. Visual cues to female physical attractiveness.  Tovée MJ, Maisey DS, Emery JL, Cornelissen PL. Proc Biol Sci. 1999 Jan 22;266(1415):211-8
4. Waist-to-hip ratio affects female body attractiveness and modulates early brain responses. Del Zotto M, Framorando D, Pegna AJ. Eur J Neurosci. 2018 Oct 22
5. Assessment of waist-to-hip ratio attractiveness in women: an anthropometric analysis of digital silhouettes. Kościński K. Arch Sex Behav. 2014 Jul;43(5):989-97
6. https://www.theguardian.com/lifeandstyle/2018/nov/19/butt-seriously-how-bottoms-became-a-fitness-obsession
7. https://www.organicauthority.com/energetic-health/how-to-build-stronger-and-bigger-glutes
8. https://www.harpersbazaar.com/beauty/health/a14478122/silicone-injection-danger/
9. Complications of Silicone Cosmetic Procedures Among Medical Tourists from the Bronx, New York: A Retrospective Analysis.  Zheng C, Quentzel J, Brust JCM. J Clin Aesthet Dermatol. 2019 Oct;12(10):24-28
10. https://www.vice.com/en_us/article/4399yp/butt-injections-new-york-cosmetic-surgery-illegal
11. https://baaps.org.uk/media/press_releases/1630/the_bottom_line
12. Staying Safe during Gluteal Fat Transplantation. Villanueva NL, Del Vecchio DA, Afrooz PN, Carboy JA, Rohrich RJ. Plast Reconstr Surg. 2018 Jan;141(1):79-86
13. The Art of Gluteal Sculpting.  Mendieta CG. Thieme 2011
14. Lumbar curvature: a previously undiscovered standard of attractiveness. Lewis, D. M. G., Russell, E. M., Al-Shawaf, L., and Buss, D. M. (2015). Evol. Hum. Behav. 36, 345–350
15. High Heels Increase Women’s Attractiveness. Guéguen N. Archives of Sexual Behavior. 2015; 44: 227–2235
16. https://www.theloop.ca/science-proves-high-heels-have-power-over-men/