“More butt, more money.” That’s how some of the butt augmentation patients at the Los Angeles clinic of plastic surgeon Dr. David Matlock describe their desire for a bigger derriere.
“Some in various professions state that they make more money with a lot of junk in the trunk, as the song goes,” says Dr. Matlock, M.D., MBA, FACOG.
Whatever happened to the days when slimmer female behinds were the ideal? Will they ever return? And what about implants, male patients and other butt augmentation statistics?
As cosmetic surgeons embrace the surging interest in the gluteus maximus, here’s a look at the past, present and future on the butt front.
From the Pages of Playboy
Millions of American men may have, um, "studied" the history of American ideals of feminine beauty by reviewing old issues of Playboy. But few have actually been paid for it like San Diego journalist and author Damon Brown.
Brown, who specializes in sexuality, is author of the 2012 book “Playboy's Greatest Covers.” He understands how Playboy always viewed the feminine form: With an emphasis on the front above the waist. “The focus has always been on the bust, not the behind,” he says. “Playboy’s emphasis has never been the behind.”
Even so, the archives of Playboy offer insight into changing American ideals of the female rear end. Brown sees trends in the curves and a bit of a return to the past in the present.
In the 1950s, the ideal was Marilyn Monroe. “Her body type isn’t much different than Kim Kardashian’s,” he says. “Kardashian is a bigger woman, but it’s the same kind of ideal.”
But a decade later, tiny waists and exaggerated hips were in. Then the 1970s brought a revolution. “You get into heroin chic and women being more svelte, thinner and less curvy,” he says. “It’s connected to Studio 54, not eating and doing a lot of cocaine. All that is reflected in Playboy.”
In the 1980s and 1990s, pornography and plastic surgery produced the “trifecta” of Jenny McCarthy, Anna Nicole Smith and Pamela Lee — augmented and proud of it. But these three women weren’t known for their well-equipped rears. What happened to move buttocks into our modern era of bigger-is-better?
From Fringe to Mainstream
Brown, who also happens to be African American, points to an evolution in the influence of minorities in the U.S.
“Within Latino cultures and African-American cultures, we’ve always been accepting of — and even interested in — women who have a curvier body, a bigger chest and/or a bigger behind, perhaps because of the way women in our communities are built,” he says. “But as far as mainstream America goes, it’s been a more capricious relationship.”
Indeed, a decade ago, butt augmentation patients made up a “pretty tight demographic,” recalls San Diego plastic surgeon Dr. M. Mark Mofid, a pioneer in butt augmentation. “They were primarily ethnic patients or patients that were within the gay community.”
Then things changed with the rise in popularity of stars like Jennifer Lopez and, later, Kim Kardashian. “It’s become much more mainstream now,” Dr. Mofid says. “You could have schoolteachers, soccer moms or male professionals in heterosexual relationships. That’s not something I would have expected.”
But, Dr. Mofid says, the trend makes sense in the history of plastic surgery. “Many procedures started out relatively fringe-like and became more mainstream,” such as breast augmentation, first performed on women in the entertainment industry like strippers, and rhinoplasty, largely used earlier on to alter ethnic-looking noses, says Dr. Mofid, M.D., FACS, associate clinical professor (voluntary) of plastic surgery at the University of California at San Diego.
Butt Augmentation By the Numbers
Interest in the derriere, which has been growing for years, shows no sign of hitting bottom. According to the American Society of Plastic Surgeons, in 2015 U.S.-based cosmetic surgeons performed buttock procedures, on average, once every 30 minutes of every day. Additionally, buttock augmentation with fat grafting procedures was up 28% from 2014 to 2015, reaching 14,705 procedures. While some plastic surgeons have left implants behind in today’s era of sophisticated and safe fat grafting, even buttock implant procedures are on the rise, up 36% to 2,540 in 2015.
So the question now is, what do patients want today? Dr. Matlock says 98% of his female liposculpture patients come in for Brazilian-style butt augmentation that makes the rear larger. Other plastic surgeons report similar interest in larger sizes.
“Patients wish for a sculpted narrow waist and round- or heart-shaped buttocks with significant projection,” says Samir Shureih, M.D., FACS, a plastic surgeon in Baltimore. According to him, patients often come in and pull up photos of celebrities to explain how they want to look.
Dr. Shureih performs butt augmentation procedures with implants when patients don’t have enough fat deposits for grafting. But there’s disagreement within the plastic surgery community about the wisdom of turning to implants in the age of fat grafts.
In Los Angeles, Dr. Matlock says he has never used implants because he thinks they look and feel unnatural. But he says about 20% of his patients don’t have enough fat for effective grafting in a butt augmentation. His fix? Make them fatter. “Now we have a regimen for the women to gain weight in a healthy manner,” he says.
The Big Business of Butts
It’s not just young women — the mainstays of butt augmentation — who come to Dr. Matlock for better behinds. He says he also sees men who want what he calls “male pattern buttocks” that look more like footballs. “And we see older people coming in to enhance the fullness of a dropped buttocks,” he says. “They are not seeking the trends of the big screen and reality TV stars.”
But most of his butt augmentation patients continue to seek larger rear ends thanks to the influence of celebrities. “I have treated patients from all 50 states and over 70 countries. Over the past 5 years, I have operated in Dubai and Riyadh, Saudi Arabia,” he says. “I thank Jennifer Lopez, Kim Kardashian, Beyoncé, Vida Guerra, Nikki Mudarris, Nicki Minaj, Iggy Azalea, Ashanti, Jessica Biel, Sofía Vergara, etc., every day for the business.”
But is this a lasting trend? Will the interest in bigger rears ever come to an end and bring the demise of peak butt?
Brown, the author and journalist, says there may be a backlash similar to the one that arose when men began to debate the value of natural vs. artificial breasts: “Are you into real? Are you into fake? Or does it matter? Soon, if not already, that will be a discussion in regard to other parts of the body. I’ll guess the ass is the next one, and I think it’ll be a more heated argument.”
What will that mean for cosmetic surgery? “The impact of people being more self-conscious — about how their partners might feel about an exaggerated or augmented behind — might cause customers to get more subtle augmentation,” Brown says.
That kind of trend could make a big difference in the world of plastic surgery. But only time will tell if the current obsession with bigger butts is a temporary boom or a permanent boon.