I have seen an increase in women desiring a more distinct gluteal contour. We have chosen to employ a combination of liposuction and fat grafting to the buttocks. The more excess fat you have the more volume you can graft. Typically i use from 75cc to 400ccs per side depending on the size of the patient and their desire. When I have 'limited material' to harvest my fat from, I concentrate the grafting in the superior medial edge of the newly delineated butt cheek. This area that I call the 'sausage roll' of the buttocks, is mostly responsible for giving the butt a pleasing 'hardbody' shape. recovery is fast ( a few days) but final results will take up to 3 months and require form fitting elastic compression garments.
When the skin is the problem then an excision of extra skin is necessary. We are essentially pulling up the buttocks and loose skin much like one pulls up a pair of jeans. Some times the fat that would be thrown away is 'turned down as a flap' and used to fill and shape the upper portion of the buttocks. This is the only 'Butt Implant" I like to use and it's your own tissue! Recovery for this will be measured in the weeks (a couple) and activities will be significantly restricted in the first couple of weeks.
Whichever way you go you can be proud to fill out your clothes in the way you always dreamed