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Procedure guide · Buttocks & Hip
Hip AugmentationHip augmentation widens and rounds the outline of the hips, usually by grafting the patient’s own fat into the area over the greater trochanter, and occasionally with a silicone implant. It suits narrow hips, a straight outline from waist to thigh, or hollows at the side. Fat is preferred wherever there is enough to harvest; implants are uncommon here and carry a higher complication rate.
Hip augmentation fills and widens the outline at the side of the hip, over the area of the greater trochanter. It is asked for by patients whose hips look narrow, whose outline runs straight from waist to thigh, or who have a hollow at the side, and in nearly every case it is done by grafting the patient’s own fat.
As with the buttock, the harvest contributes as much as the graft. Fat is taken from the abdomen, waist, lower back and inner thighs, and narrowing those areas sharpens the contrast that makes the hips read as fuller. A surgeon treating the liposuction as merely a way of obtaining material, rather than as contouring in its own right, will produce a result that is wider without being better proportioned.
What hip augmentation cannot do is change the skeleton. The width of the pelvis sets a framework, and the operation fills and rounds the soft tissue over it. That limit is worth hearing clearly, because the difference between a surgeon explaining it and a clinic implying otherwise is the difference between a satisfied patient and a disappointed one.
The tissue here is thin, and that governs much of what follows. There is little padding between skin and bone at the outer hip, so grafted fat that fails and forms a nodule of necrosis tends to be felt rather than hidden, and irregularity shows more readily than it would on the buttock. It is an argument for fine-layer injection over bulk placement and for accepting a modest volume well distributed.
Hip implants exist for patients with no fat to harvest, and they are genuinely uncommon. A soft silicone implant placed beneath the fascia over the outer hip sits under very little soft tissue, so the edge is frequently palpable and sometimes visible, lying on that side is uncomfortable, and the revision rate is high. Relatively few surgeons place them, which is itself informative.
Hip augmentation with fat does not carry the specific danger that makes gluteal grafting so demanding, because the large veins that can carry fat to the lungs run through the gluteal muscle rather than the outer hip. Where the same operation also grafts the buttocks, which is common, that part of the procedure is exactly as demanding as it would be alone and the injection plane questions apply to it unchanged.
Graft survival follows the same rules as anywhere else: roughly half to two thirds survives, settled by 3 to 6 months, and what survives is permanent and behaves like ordinary body fat thereafter. Surgeons graft slightly more than the target to allow for absorption, so the hips look fuller immediately after surgery than they will at the end.
The recovery is defined not by sitting but by side-lying. The outer hip takes your body weight whenever you lie on your side, and pressure kills fat that has not yet established a blood supply, so sleeping is on the back or front for 2 to 3 weeks. Habitual side-sleepers find this genuinely disruptive, and it is worth practising the position before the operation rather than attempting it for the first time while sore.
Where the hips and buttocks are grafted together, which usually gives a better outline than treating either alone, both restrictions apply at once. No sitting directly on the buttocks and no lying on the side leaves very few comfortable positions for the first fortnight, and the combination also requires considerably more donor fat than either area alone.
Surgeons look for these points at the consultation.
Hip augmentation suits adults at a stable weight with narrow hips, a straight outline from waist to thigh, or hollows at the side of the hip, who have enough donor fat to harvest or accept an implant, are in good health and do not smoke.
Reasons a good surgeon will ask you to wait or choose something else.
Hip augmentation is avoided in smokers who will not stop, in patients too lean to provide donor fat where grafting is planned, in unstable weight or active weight loss, in a history of blood clots, and where expectations of width exceed what the tissue will hold.
Ask your surgeon which technique they recommend for you and why.
Fat harvested from the abdomen, waist or thighs is injected into the layer beneath the skin over the outer hip, filling the hollow and widening the outline.
A soft silicone implant is placed beneath the fascia over the outer hip, for patients with no fat to graft who want permanent widening.
Fat is grafted to the hips and buttocks in one operation, treating the outline as a whole rather than filling one area in isolation.
Volume is built across two sessions months apart, so each graft sits in tissue that can supply it with blood rather than being over-filled.
Step by step, from arrival to discharge.
Before hip augmentation the surgeon examines the outline standing and establishes how much fat can be harvested, since that sets the achievable width.
The hip hollow and the waist and flanks are marked standing, because narrowing the waist contributes as much to the outline as filling the hip.
Fat is suctioned at low pressure, since cells damaged during harvest do not survive the transfer and are simply absorbed.
Fat is placed in many thin passes over the outer hip, which matters more here than elsewhere because thin tissue cover makes any lump easy to feel.
The two sides are compared during the operation, since hips frequently differ to begin with and asymmetry is easier to prevent than to revise.
Garments are fitted over the harvested areas but not over the grafted hips, because pressure on fresh graft reduces how much survives.
Frequencies follow published guidance; your personal risk depends on your health and the surgeon.
Hip augmentation with fat avoids the specific danger that makes gluteal fat grafting so demanding, because the large veins that carry fat to the lungs run through the gluteal muscle rather than the outer hip. Fat is still placed in the layer beneath the skin rather than deep, and a surgeon grafting hips and buttocks in the same operation is working in both territories, so the injection discipline that matters for the buttock applies to that part of the procedure unchanged.
What limits hip augmentation instead is soft tissue cover. The outer hip has little padding over the bone, so grafted fat that does not survive tends to be felt as a firm lump rather than absorbed invisibly, and an implant placed here is frequently palpable and sometimes visible. It is also the surface you lie on, which makes side-sleeping uncomfortable for weeks and is the practical complaint patients raise most often. Implants at the hip have a markedly higher revision rate than fat and are performed by relatively few surgeons, which is worth knowing before treating them as an equivalent option.
A third to a half of fat grafted during hip augmentation is absorbed over the first months, so volume is judged at 3 to 6 months rather than immediately.
Marked at the hips and at the liposuction donor sites after hip augmentation, settling over 6 to 8 weeks.
The two sides absorb different proportions of the graft, or an implant sits at a slightly different height, which a top-up can correct at 6 months.
Grafted fat that fails to establish a blood supply dies and forms firm lumps, which occasionally need draining or removing.
Specific to hip implants. There is little soft tissue over the outer hip, so an implant edge is frequently felt and sometimes seen.
The outer hip takes your weight when you lie on your side, so hip augmentation makes that uncomfortable for weeks, and longer with an implant.
Dents or waviness where the fat was harvested, which is the commonest reason for revision after fat-based hip augmentation.
The restriction that defines hip augmentation is not sitting but side-lying. The outer hip takes your weight whenever you lie on your side, and pressure there squashes grafted fat before it has a blood supply, so sleeping is on the back or front for the first 2 to 3 weeks. Patients who habitually sleep on their side find this the hardest part, and it is worth practising before the operation rather than discovering it on the first night.
The donor sites behave like ordinary liposuction and are frequently more uncomfortable than the hips themselves: firm, bruised and swollen, with compression worn for around 6 weeks. Where the buttocks were grafted at the same operation, the sitting restriction applies as well, and the combination of not sitting and not lying on your side is considerably more limiting than either alone.
Days 1-3
Usually a night in hospital. Sleeping on the back or front rather than the side. Compression on the donor sites. Walking encouraged from the first evening.
Days 4-7
Donor site bruising peaks and settles. Side-lying is still avoided. Flying is usually cleared at around day 7.
Weeks 2-4
Desk work at around 10 days. Sleeping on the side resumes gradually at 2 to 3 weeks. Compression continues on the donor areas.
Weeks 6-8
Swelling settles enough to judge width. Exercise resumes gradually. With fat, the surviving proportion becomes apparent.
Months 3-6
Graft survival is established, or the implant has settled into its pocket. Hip augmentation should be judged at this point.
Hip augmentation produces a rounder, wider outline from waist to thigh, and the narrowed waist from the harvest is a substantial part of what the eye reads.
The result should follow the body’s own curve rather than appearing as a separate mass, which fine-layer grafting achieves better than an implant.
Volume settles over 3 to 6 months as part of the graft is absorbed, so the hips look fuller immediately after surgery than at the end.
Surviving fat is permanent and behaves like ordinary body fat, so weight change afterwards will enlarge or shrink the result.
Hip augmentation is priced largely as liposuction plus grafting, so the number of donor areas treated is the main variable. It is rarely quoted alone, because it is usually done alongside buttock grafting in the same operation.
Where a second session is likely, and for a noticeable increase in width it often is, the realistic cost covers both. For an international patient that also means a second trip, which is worth establishing before the first operation.
Hip implants, where offered, are priced quite differently and involve a longer stay. Given their revision rate and how few surgeons place them, the relevant question is whether grafting is possible rather than which is cheaper.
Why quotes for the same procedure differ, so you can compare packages fairly.
Options to weigh before deciding, surgical and non-surgical.
The same operation described from the graft rather than the goal, and what hip augmentation almost always means in practice.
Where the complaint is specifically the hollow at the side rather than overall width, the same grafting is targeted differently.
Treating hips and buttocks together usually gives a more balanced outline than filling either alone, at the cost of more donor fat and a harder recovery.
Worth considering. Much of what reads as wider hips is a narrower waist, and for some patients contouring the waist achieves enough on its own.
Ask the same questions at every consultation so you can compare answers.
Hip augmentation widens the outline by adding volume over the outer hip, which is what produces the curve from waist to thigh. Fat grafting does this in most cases, and the effect is amplified because the waist is narrowed by the liposuction that harvests the fat.
What it cannot do is change the bones. The width of the pelvis sets a framework, and augmentation fills and rounds the soft tissue over it rather than altering the skeleton. A surgeon who explains that limit while showing you what is achievable is being accurate rather than discouraging.
Fat wherever there is enough to harvest. Hip augmentation with fat looks and feels natural, nothing can become infected or displace, and the waist is narrowed at the same time, which contributes as much to the outline as the volume added.
Hip implants are for patients too lean to donate fat. They sit in an area with little soft tissue cover, so the edge is frequently palpable, they make lying on that side uncomfortable, and their revision rate is high. Relatively few surgeons place them, which is itself informative.
Hip augmentation with fat leaves roughly half to two thirds surviving, settled by 3 to 6 months, which is similar to fat grafted elsewhere. Surgeons allow for it by grafting slightly more than the target, so the hips look fuller immediately after surgery than they will at 6 months.
What survives develops its own blood supply and is permanent, behaving like the rest of your body fat. That makes a stable weight the thing that protects the result, and it is a reason to reach the weight you intend to stay at before the operation rather than after.
Two to 3 weeks after hip augmentation, and it is the restriction patients find hardest. Lying on your side puts your body weight directly onto the grafted area, and pressure kills fat that has not yet established a blood supply.
Sleeping on the back or front is the alternative, and a pillow arrangement that stops you rolling over in the night genuinely helps. Where an implant was used, the restriction is about the pocket healing rather than graft survival, and discomfort on that side can persist longer.
Combining hip augmentation with buttock grafting is common and usually gives a better result than treating either alone, because the hip and buttock read as one outline rather than two separate areas. One anaesthetic, one harvest and one recovery.
The practical cost is that both restrictions apply: no sitting directly on the buttocks and no lying on your side, which between them leave very few comfortable positions for the first fortnight. It also needs more donor fat, so a lean patient may have to choose one or stage them.
Fat for hip augmentation usually comes from the abdomen, waist, lower back and inner thighs. The choice is deliberate rather than convenient: removing fat from the waist narrows it, and that narrowing sharpens the contrast that makes the hips look fuller.
It also means the donor areas matter when you judge a surgeon’s results. Dents and waviness at the waist and flanks are the commonest reason for revision after this operation, and they are far easier to create than to correct, so look at those areas in any photographs you are shown.
7 days for most fat-based hip augmentation, longer where an implant was placed or where large-volume liposuction was needed for the harvest.
An aircraft seat does not press on the hips the way it presses on the buttocks, so the flight is easier than after gluteal grafting. Wear the compression garments, walk the aisle regularly, and follow whatever clot prevention the surgeon advises, since the operation involves liposuction and reduced mobility.
Filling the hollow is exactly what hip augmentation does, and fat grafting is the usual method. The dip is filled rather than removed, because it arises from the shape of the pelvis and the way muscle attaches to it rather than from a lack of fat in that spot.
That distinction matters for expectations. The result is a smoother, rounder outline rather than the elimination of an anatomical feature, and in very lean patients with prominent bony landmarks a complete fill is not achievable in one session.
The fat that survives the first 3 to 6 months is permanent, since it is your own tissue with its own blood supply. Implants do not degrade either and need no routine replacement.
What changes a fat result is weight: significant loss shrinks it and gain enlarges it. What ends an implant is mechanical, such as displacement, discomfort or a palpable edge that the patient stops tolerating. In both cases the first year tells you most of what you need to know.
Hip augmentation is moderately painful, usually less than patients expect, with most people off prescribed painkillers within 4 or 5 days. The donor sites are frequently more uncomfortable than the hips themselves.
The difficulty is positional rather than painful. Not lying on your side for 2 to 3 weeks disrupts sleep for people who habitually do, and that is the complaint patients raise most often afterwards rather than pain.
Hip augmentation by grafting can be repeated, and staging across two sessions is a legitimate plan rather than a failure of the first. Each session grafts only what the tissue will support, so a large increase is built rather than forced.
The limiting factor is donor fat, since each harvest uses some up. A top-up at around 6 months is also the usual way to correct asymmetry, once survival has settled and the difference between the two sides is clear rather than a matter of uneven swelling.
Ask a hip augmentation surgeon for results at 12 months rather than 6 weeks, photographed standing and from the front as well as the side, since hip width reads differently from each angle. Look at the waist and flanks in those photographs as carefully as the hips.
If the same operation will include grafting to the buttocks, ask the gluteal safety questions as well: in which plane they inject, whether they ever place fat in or below the gluteal muscle, and whether ultrasound is used. Those apply to that part of the operation regardless of the hips.
Hip augmentation adds less width than most patients imagine, because the limit is what the tissue will support with a good blood supply rather than what would look best in a photograph. Forcing in more volume produces less surviving fat, not more.
A modest change is usually achieved in one session; a noticeable change in outline frequently needs two, months apart. Asking the surgeon to describe the expected result in terms of how clothing will fit is more useful than asking for a measurement in centimetres.
Hip augmentation needs grafting to add width, but liposuction alone changes the outline more than patients expect. Removing fat from the waist and flanks narrows them, and a narrower waist makes existing hips read as fuller without anything being added.
For some patients that is enough, and it is a considerably smaller operation with no graft to protect and no side-lying restriction. A surgeon who raises it as an option is worth listening to rather than assuming they are avoiding the work.
Hip implants exist and are placed beneath the fascia over the outer hip, but hip augmentation with an implant is uncommon and few surgeons offer them. The outer hip has very little soft tissue cover, so the implant edge is frequently palpable and sometimes visible.
Lying on that side is uncomfortable, and the revision rate is high. They are reserved for patients with no donor fat at all. Where one is proposed, ask how many the surgeon has placed, their revision rate, and what it will feel like to sleep on that side.
Hip augmentation lasts because the fat surviving the first 3 to 6 months is permanent: it is your own tissue with its own blood supply, and it behaves like the rest of your body fat from then on.
That makes weight the variable rather than time. Significant weight loss reduces the width and weight gain increases it, so reaching a stable weight before the operation is what protects the result and also makes the surgical planning accurate.
Hip augmentation corrects uneven hips well, because different volumes can be placed on each side and the fill can be shaped to the specific deficit rather than to a standard form.
Hips frequently differ to begin with, more than patients realise until they are photographed. A surgeon who points out an existing asymmetry before operating is setting expectations properly, since a top-up at 6 months is often what finally matches the two sides.
Hip augmentation is moderately painful and usually less so than patients expect. Most are off prescribed painkillers within 4 or 5 days, and the liposuction donor sites are frequently more uncomfortable than the hips themselves.
The difficulty is positional. Not lying on your side for 2 to 3 weeks disrupts sleep considerably for habitual side-sleepers, and that is the complaint patients raise most often afterwards rather than pain.
Ask any hip augmentation surgeon for results at 12 months rather than 6 weeks, photographed standing, from the front as well as the side, in patients with a build similar to yours. Hip width reads completely differently from each angle.
Look at the waist and flanks in those photographs as carefully as the hips, since dents there are the commonest reason for revision after this operation and are far easier to create than to correct. A gallery that shows only rear views is concealing the half you should be checking.
Hip augmentation can follow earlier liposuction, and it is a reasonably common request from patients whose hips were over-reduced. Grafting fat back in is the standard correction for that.
The tissue behaves differently, because scarring from the previous operation makes the layer less uniform and graft survival can be patchier. Expectations should be more modest than for a first operation, and staging across two sessions is more often needed.
Fitted clothing is comfortable again around 3 to 4 weeks after hip augmentation, once swelling has settled enough that pressure from a waistband or fitted trousers is not uncomfortable. Very tight clothing over the grafted hips is best avoided for the first 6 weeks.
The reason is the same as for the compression instruction: sustained pressure on newly grafted fat reduces how much survives. Loose clothing over the hips with compression on the donor sites is the arrangement most surgeons ask for.
Hip augmentation can be worth doing alone, where the complaint is specifically a narrow or hollow outline at the side and the buttocks are already the shape the patient wants. In that situation treating the hips alone is the targeted answer.
More often the hip and buttock are assessed together, because they read as one outline and filling one while leaving the other can create a mismatch. A surgeon who examines both before recommending either is approaching it properly.
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