Real Patient Results

At Butts By Design, our mission is to empower expression, help achieve goals and improve happiness through body contouring and sculpting. The term “body contouring” refers to cosmetic procedures that help sculpt your body into its optimal shape.

The process begins with a consultation with our board-certified plastic surgeon either virtually or at our office locations in Newport Beach, California or Upland, California. During your consultation, we discuss your body goals and learn what procedures need to be done to achieve your desired results. Your personalized treatment plan will guide us toward sculpting a better-proportioned figure with smoother, fitter contours and a more youthful appearance.

What Is Hourglass Body Contouring?

Body contouring is lifting, tightening and re-sculpting the body. It does not help patients lose weight, but instead helps shape specific areas where diet and exercise are ineffective or where weight loss has left behind excess skin.

Most body contouring procedures include a form of liposuction to sculpt and mold the figure. After liposuction, butt or breast augmentation can be performed using implants or the fat removed from the liposuction (fat grafting) to create an hourglass figure. In addition, we may recommend a tummy tuck (abdominoplasty) to achieve a flatter, tighter abdomen and a sculpted waist. 

What Procedures Can Be Included in Hourglass Body Contouring and Sculpting?


Liposuction is highly effective for torso sculpting and therefore is almost always included in a body contouring procedure. We utilize a proprietary sequence and method to provide optimal lipo-sculpting results.

Because liposuction is typically the main sculptor in body contouring, let us discuss the basics of the procedure and the different liposuction technologies available.

Breast Implant Augmentation

We commonly use breast implant augmentation to help sculpt the top portion of the hourglass.

Breast implants come in two main types: saline (saltwater) or silicone (“gummy bear” implants). In cosmetic breast augmentation, the implants are typically placed below the muscle (also called sub-muscular placement).

Breast implants can be placed via various incision techniques: in the inframammary fold (breast fold), around the areola, in the armpit (axilla) or around the belly button (umbilicus). While a number of options exist, we recommend the areola and inframammary fold incisions as they produce the most reliable and consistent results.

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Tummy Tuck

Are you not seeing the flat tummy or defined abs you want from sit-ups, crunches or pilates? Sometimes excess skin or stretched-out muscles from childbearing make it impossible to get a flat stomach through diet and exercise alone. The tummy tuck (also called an abdominoplasty) tightens the abdominal muscles and tightens and removes excess tummy skin. We typically combine liposuction with the tummy tuck to improve the shape of the waist and back (hourglass sculpt).

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Fat Transfer to the Breast

Also known as natural breast augmentation, fat transfer or fat grafting to the breasts enhances breast shape and volume without breast implants. Typically, the maximum achievable breast volume increase is one cup size.

Fat Transfer to the Butt

Liposuction with fat transfer to the butt, commonly known as a Brazilian butt lift or BBL, is one of the most rapidly growing cosmetic surgeries worldwide. A Brazilian butt lift begins with liposuction of excess fat from one or more areas of the body (often the abdomen, flanks and back to help define the curves of an hourglass figure). The harvested fat is processed and cleaned, and then it is injected into the buttocks for shape and volume.

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Butt Implants

We see patients of all shapes and sizes at Butts By Design. Some have a lot less fat than others, and we need to utilize a butt implant to provide volume and shape to their buttocks. We also recommend this approach for patients who want significant butt projection beyond what a single round of liposuction and fat transfer can achieve. We can use a buttock implant by itself or in combination with liposuction and fat transfer.

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What Type of Anesthesia Is Used With Liposuction?

We give our patients the option of having liposuction while under general anesthesia (asleep) or using a local anesthetic and sedatives (awake). Each option has benefits. Awake liposuction avoids being asleep. However, awake liposuction limits the number of areas we can treat.

General anesthesia is a better choice for larger or multiple areas of the body because it ensures a more relaxed and comfortable experience than awake liposuction. Your board-certified plastic surgeon will discuss which option is best for you.

What Type of Liposuction Is Best?

Today’s surgeons have many types of liposuction to choose from. Dr. Nykiel will select the appropriate technique based on the area of your body being treated and your aesthetic goals.

VASER® Liposuction

VASER liposuction uses a precise and minimally invasive ultrasound technology to improve liposuction results and recovery. VASER technology increases the selective removal of fat cells (adipose cells) from the surrounding tissue using powerful ultrasound waves to disrupt the bonds between fat cells. Does it sound like futuristic technology? Well, it is real!

Some of the key benefits of VASER liposuction over traditional liposuction include easy removal of large amounts of fat, decreased blood loss, decreased bruising, decreased pain, improvement in skin firmness and tightness, and refined appearance of muscles. This single surgery leaves you with smooth and beautifully contoured results.

Dr. Nykiel is a key opinion leader for VASER and also a physician/surgeon trainer for VASER. In our practice, we incorporate this form of liposuction into the majority of our body contouring procedures.


Power-Assisted Liposuction

Power-assisted liposuction (PAL) uses a special cannula that produces rapid, tiny vibrations (1,000s of vibrations per second) to loosen fat cells for easy removal. This allows surgeons to use a smaller cannula than the size used with traditional liposuction methods, which means a smaller and less noticeable incision for the patient. 

Power-assisted liposuction also takes less time and helps us achieve a better result than standard liposuction due to the vibrations. A quicker surgery typically means a quicker recovery.

We also utilize PAL for liposuction revision cases, as the added power helps us sculpt through the old liposuction areas. 

Power-assisted liposuction has great synergy in combination with VASER liposuction. We utilize PAL with all of our liposuction cases. 

LASER Liposuction

LASER liposuction uses light waves to create heat that helps melt the fat. However, while the LASER does make fat removal easier, it can also melt or burn the soft tissues, muscle and/or skin. Additionally, LASER liposuction typically creates more scarring than traditional liposuction, which can be seen in the form of contour irregularities and/or fibrosis. 

For these reasons, we do not recommend LASER liposuction. In our opinion, PAL and VASER offer many of the benefits of LASER, but with less of the negative risk frequency.


Renuvion is one of the newer technologies for body contouring. Renuvion (formerly known as J-Plasma) tightens the soft tissue after liposuction with helium plasma and radiofrequency. This technology further improves the results of liposculpting by shrinking the soft tissue envelope after the fat volume is removed by liposuction. The soft tissue and skin tighten about 30% over six months.

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Traditional Liposuction

While we can perform traditional liposuction, we don’t typically recommend it with all of the “newer” techniques available. Traditional liposuction removes fat with a cannula (hollow tube) and an aspirator (suction device). This method involves the doctor pushing and pulling the cannula in and out of an incision to break up the fat and remove it with suction. In our opinion, it is an old technique that does not give the best results.

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Schedule a Body Contouring Hourglass Sculpting Consultation at our Newport Beach or Upland Practice Today!

If you are interested in transforming your body with body contouring, liposuction, tummy tuck, breast augmentation, butt implants or fat transfer, contact our board-certified plastic surgeon Dr. Matthew J. Nykiel to schedule a consultation. We offer in-person and virtual consultations for patients who do not live in the area. We can be reached by phone at (949) 416-0038 or via our online scheduling page.