As the demand for bigger buttocks increases, we will see more untrained individuals attempting "garage" surgery. A woman in New York was just found guilty of injecting silicon into several individuals buttocks who subsequently became ill and developed serious and even life threatening (As well as deforming) complications. As a plastic surgeon performing cosmetic surgery primarily for 23 years, I find it mind boggling that anyone would let these untrained individuals perform surgery on them. This problem is not new. I remember breast implants being placed in people's bedrooms using cooking spatulas in a case in Miami about 12 years ago. In a more recent case acrylic cement was used to fill the buttocks (undoubtedly trying to obtain a "hardass", he, he). These cases are too numerous to mention in full. One of the reasons for this demand is the lack of enthusiasm by American Plastic Suregons in embracing buttocks augmentation using implants. I personally have attended five courses in our national meeting trying to convince myself that I should be performing this operation. To this day, I cannot justify starting to perform this operation in this country with the legal system as it stands today. Now I love the Brazilian Butt lift (Fat grafts to buttocks and aggressive liposuction to waist and lower back). My patients who have a little extra fat get a great result. The contrast is really the key. It is all about getting a 7/10 ratio of waist to buttocks measurements that have been found to be the most favorable. Whatever you do… don't let a hack near you with a scalpel or a needle. I guarantee you will regret it.