November 11, 2026 | Ask Dr. Agullo, Brazilian Butt Lift
Most of the people who write to me about a Brazilian butt lift already want one. What they want to know is whether they are a candidate at their current weight. Is five foot seven and 130 pounds too skinny? Is five foot two and 275 too heavy? Should I lose a few more pounds first, or gain a few? Is 500 cc enough, and how much of it stays?
I have answered some form of these questions more than a hundred times on RealSelf. Six of them follow, paraphrased with the identifying details removed, with my answers lightly edited for the page. The short answer runs through all of them: the fat has to be available, the fat has to survive where I put it, and the weight you have on the day of surgery is the weight you keep.
“Should I lose weight before my BBL with lipo 360? I am 150 pounds and used to be 115 to 120.”
Answered on RealSelf, Nov 2023.
When it comes to procedures like a BBL with lipo 360, weight plays a big role in deciding the right time to have surgery. At 150 pounds your BMI is 26.5, which technically puts you in the overweight category, but just barely.
If you are unsure what weight you should be at before the procedure, think about the weight you are most comfortable at and most likely to maintain after surgery. If 150 pounds is a weight you are happy with and can keep after your BBL and lipo 360, then this is a good weight to have the surgery at (knowing that you will probably lose about 5 pounds from the fat removed). On the other hand, if you feel you will likely return to your earlier weight after the procedure, it is best to wait until you are closer to that weight. Big weight changes after a BBL or lipo 360 can alter your results, so having the procedure close to the weight you will keep gives you the most stable, longest-lasting result.
“I am 5’2″ and 275 pounds. How much weight do I have to lose to get a BBL?”
Answered on RealSelf, Jul 2018.
I recommend a BMI less than 35, although some exceptions can be made. To get to this BMI, your weight should be 190 or less. At your current weight you are at very high risk for complications. Your current BMI is 50, which makes you a candidate for a bariatric weight loss procedure.
A reader asked the related question a few months later, whether there is any liposuction or surgery for a BMI over 30 without losing weight first. My answer then, which is still my answer:
It is true that your BMI should be ideally under 30 for plastic surgery. In my practice, I recommend for the BMI to be under 35, as I have not seen increased complications for most procedures. You should understand that your results may not be comparable to somebody with the BMI under 30. You should still see an improvement, and this often motivates you towards a healthier and more active lifestyle. Remember that the amount of liposuction is limited to about 5 liters, which translates to just under 5 pounds. The size reduction is often larger than the weight reduction.
“Am I too skinny for a BBL at 5’7″ and 130 pounds?”
Answered on RealSelf, Sep 2018.
This really depends on your expectations and goals. At your current height and weight, it is possible to obtain enough fat to fill in the indentations in the lateral hip. I would estimate being able to obtain 250 to 300 cc for each buttock. The amount of fat that can be obtained would definitely increase with a 20 pound weight gain, but keep in mind that you would have to remain at that weight after surgery in order to keep the volume.
A smaller patient, 5’2″ and 115 to 120 pounds, asked me the same thing the next spring:
You can obtain nice results at your current weight. I would think at least 500 to 700 cc per buttock, not 1,000 or more. You can gain weight. The downside with gaining weight is that you would have to maintain yourself at the new weight even after the BBL. In your case, we are talking about 10 to 20 pounds. You could also consider a combination of BBL and implants. Implants can be placed inside the muscle, avoiding the complications often seen on the internet like double bubbles and being able to flip them.
“Is 500 cc per side enough for a natural butt?”
Answered on RealSelf, Oct 2018.
The amount of fat to be injected into the buttocks and hips is determined by your current body composition and your objectives. With 500 mL, you will definitely improve the projection and contour. Most of my patients have 1,000 mL or more during their BBL. Keep in mind 30 percent of the volume will go away during the first four to six weeks.
When someone sends me a wish photo with a lot of projection, my answer tends to be short. To achieve the look you show, you would need at least 1,000 cc to each buttock.
“Does an over-the-muscle BBL limit how much fat you can inject? What are the chances of the fat surviving?”
Answered on RealSelf, Nov 2023.
Where is the best place to put the fat in a Brazilian butt lift, into the muscle or over it? There has been real concern about putting fat into the muscle because of fat embolism (fat getting into blood vessels and traveling to the lungs), so the guidelines now recommend placing fat over the muscle. Some surgeons think the result may be better with fat placed into the muscle (more lift, a better scaffold for the graft), but for safety I recommend grafting over the muscle.
Will you still get a good result without fat in the muscle? Yes. There is a finite amount of space over the muscle, but a large Brazilian butt lift can still be achieved in experienced hands. Depending on the study, fat survival over the muscle runs 50 to 70 percent, and the rest is reabsorbed by the body. So depending on the amount and quality of fat available, the technique used and the post-operative care, your goal of wider hips and a larger buttock can be reached.
That answer is three years old and I would add one thing to it now. In my practice the fat goes above the muscle only, and I place it under ultrasound guidance so I can see the cannula the whole time. The wash we use to protect the fat cells is part of why survival in my patients runs 50 to 80 percent; the recovery post below covers how.
“Is it okay to lose 15 to 20 pounds after a BBL?”
Answered on RealSelf, Jun 2017.
It is okay to lose weight after a BBL. Keep in mind that after a Brazilian butt lift your new shape is locked in. With weight loss your buttock is likely to get smaller but would maintain the same curves.
The GLP-1 version of that question arrived this summer, from someone who gained 10 pounds two years after her BBL and wanted to take a weight loss injection:
There is certainly the option of taking a weight loss medication. You do need to be aware, however, that your grafted fat in the buttocks is still living fat, so if you shed pounds, your buttock fat will shrink right along with it. Ten pounds is actually a minor amount, and a gradual, slow rate of loss is more forgiving to your BBL’s overall aesthetic compared to rapid or crash weight loss. You will probably notice a slight decrease in your buttock’s prominence.
The Short Version
| The question | What I look at | What I usually say |
|---|---|---|
| Am I too heavy? | BMI, with 35 as my working ceiling | Under 30 is ideal, under 35 works, above 35 means weight loss first |
| Am I too thin? | Flanks, lower back, abdomen, inner thighs | Thin patients still have 250 to 700 cc per side; gaining weight only helps if you keep it |
| How many ccs? | Your frame and your wish photo | 500 improves shape, most of my patients take 1,000 or more, and about 30 percent settles out |
| Over or under the muscle? | Safety first | Above the muscle only, under ultrasound |
| What if I lose weight later? | The fat is living fat | The shape stays, the size follows your weight |
Who qualifies on BMI alone has its own post, BMI and eligibility for plastic surgery. What happens to a BBL when the weight comes off fast is in 360 deflation after weight loss. The recovery, including how the fat is washed and why survival runs 50 to 80 percent in my hands, is in BBL recovery week by week, and the fee is in BBL cost in Texas. The procedure itself is on my Brazilian butt lift page. My commentary on why the weight question is the real candidacy question is on Dr. WorldWide, and the practice’s version, with the thin-patient and graft-volume answers, is on Southwest Plastic Surgery.
Why Choose Dr. Agullo
I am certified by the American Board of Plastic Surgery and the American Board of Surgery, completed my plastic surgery fellowship at the Mayo Clinic, and serve as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has listed me as a Top Doctor every year from 2014 through 2026. I was a founding vice president and later president of the World Association of Gluteal Surgeons, and the ultrasound-guided, above-the-muscle technique I use is the one I have published on.
Ready to Talk?
Bring your height, your weight and the weight you can actually keep. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. You can also read my answers on RealSelf. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
