Expert Doctor

Butt Reductions

Alan Engler, MD

New York, NY

Butt Reductions

In reality, the more common procedure now performed is butt enlargement which is called either butt augmentation or Brazilian butt lift depending on exactly what is done by the doctor. However, butt reductions are still done as part of procedures such as liposuction or on their own.

In the case of butt reduction, a patient comes in and says they are not happy with the way they look. They are examined to make sure they are in good health and don’t have an underlying medical condition or problem. Once it is determined that the patient doesn’t have any medical problems, the doctor and the patient discuss what they hope to accomplish with the procedure. The surgeon also has to assess the surgical region and see what is causing the “deformity” that the patient wants altered.

In the buttocks area, the patient could have excess skin that is hanging. The excess skin might be the result of the patient losing weight with either a lap band procedure or on their own. Another case could be somebody who has a lot of fat in the region or connective tissue that is amenable to liposuction or another technique that doesn’t leave such wide scars.



Somebody who has a lot of extra skin or extra fat on the buttocks might not get much help from liposuction to completely reshape portions that are bone. For example, there are people who say their hips are too wide and most of it is underlying bone and muscle and not much can be done about that. If a patient is a good candidate for fat reduction then the doctor can discuss a liposuction.

Liposuction is a great procedure to shape and recontour specific areas. Liposuction is not really weight loss as much as contour altering. In the case of the buttocks, there is usually some fat in there and also some connective tissue. One of the things the plastic surgeon has to assess in the area that the patient wants reduced is how much skin, fat and connective tissue removal is the patient trying to achieve. A discussion between the patient and the surgeon is vital in making sure expectations are realistic and achievable and that the patient knows what is involved with the procedure itself. Liposuction is normally done under deep intravenous sedation for larger areas while smaller areas can be done under local. There are surgery risks and somebody has to stay with the patient for the first 24 hours of recovery. It’s not something that can be done one day and the patient is back at work the next day. With liposuction, it takes a while to see the final results. It takes four to six weeks to see 85% of the results, three months for 95% and six months for all the results. It’s sort of a gradual reduction and it doesn’t really look like a person had something done. The patient just starts looking better and better.

There are people who have had injections in the buttocks for various reasons (such as narcotics abuse) that have developed scar tissue. Scar tissue as a result of a previous trauma is usually not amenable to correction or liposuction at all. 



There are some variants of liposuction. There is one called ultrasonic liposuction that is occasionally used for more fibrous areas but there are greater risks with this procedure such as causing burns. The fibrous tissue doesn’t dissipate to heal as well as the fat does even though ultrasonic can melt some hidden fat and some parts hidden around the connective tissue.

A laser liposuction procedure delivers energy throughout the tissues but it’s still primarily better at targeting fat and not at removing fibrous tissue and scar tissue.



Butt reduction can be fat removal as well as skin removal. If people have excess skin, they can have big scars after the procedure. A lot of people are not willing to have the procedure because it will leave the scars. However, in order to have an improvement of the contour, the extra skin has to be removed. A big flap of skin has to be cut off in order to have an improvement.

If somebody wants skin removed from that area, they have probably lost enough weight to have some extra skin. The more hanging skin and redundant skin there is, the more the patient is a better candidate for the surgery. They will also be more willing to tolerate the less desirable effects including the scars.



Once a patient gets their final results, it won’t always stay that way forever. The body will normally stay like that as long as the rest of the patient is okay and in good shape. If the patient gains or loses weight, that’s a different issue. As a person gets older, things start to hang down and that’s true with the buttocks to a certain extent. When a person gets older they probably have a little more sagging in the buttocks.



Butt reductions are a way for patients who are not happy with their buttocks region to reduce or eliminate the issue in the area. Patients need to have a consultation with an experienced doctor in order to determine if they are a good candidate for a reduction in the buttocks. Once it has been determined that the patient is eligible for a butt reduction procedure, the patient can discuss the final results they want to achieve with the surgeon.


Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Alan Engler, MD in New York, New York