Gluteal augmentation, often referred to as the Brazilian butt lift (BBL), is a popular procedure used to enhance the shape and size of the buttocks. This procedure is most commonly performed using buttock implants, fat grafting, or injection of fillers. BBLs first originated in the 1960s when Dr. Ivo Pitanguy, a Brazilian surgeon, published his article "Body Contour" in the American Journal of Cosmetic Surgery. 1 Pitanguy's first buttock lift procedure, which awarded him recognition as the pioneer of BBL surgery, was aimed toward correcting body contour anomalies. Over the following decades, this lifting technique was further developed into modern BBL techniques.In 2019, there were 28,076 BBL procedures performed in the United States, which represents a 117% increase from the previous year. 2 It can be assumed that the rising popularity of the BBL is paralleled by an evolving obsession with social media "aesthetics." 3 Statistics show that patients have increasingly used social media as reference, arguably as a way to achieve Background: Gluteal augmentation is used to improve the size and shape of the buttocks. Unlike other anatomical areas, such as the breasts, where there are classification systems for size and projection, no standardized methods for classifying gluteal size and shape exist. Patients seeking augmentation rely on photographs to communicate their desired result to surgeons. The authors' study objectively reviews this topic and proposes a novel classification system for the buttocks that can provide an organized framework for patients and providers. Methods: A systematic of the literature was conducted on March 17, 2021, using various combinations of the following terms: "gluteal augmentation," "classification," "size," "gluteoplasty," and "Brazilian butt lift." All eligible articles were included for analysis. Results: The PubMed/MEDLINE searches yielded 49 articles and abstracts. After review, eight publications were chosen for analysis. All publications were found in plastic surgery journals, with the most common journals as follows: Aesthetic Surgery Journal (n = 4), Clinics in Plastic Surgery (n = 2), Annals of Plastic Surgery (n = 1), and Plastic and Reconstructive Surgery (n = 1). There are no articles in the plastic surgery literature that provide a standardized classification system for gluteal size determination.
Conclusions:The authors' study revealed the need for a standardized classification system for gluteal size and shape. Although the publications analyzed discussed various techniques for related procedures and provided ways to improve aesthetic outcomes, none presented a system for reproducibly classifying size and shape. By introducing a classification system, we hope to enable plastic surgeons to more accurately and efficiently discuss their patient's goals. (Plast.