"Paying for Booty" Stukin

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It's Tuesday night at Sue's Rendezvous in Mount Vernon, N.Y. Even torrential October rains can't keep the voyeurs away from this suburban gentleman's club, where Grey Goose and Moet are the chilled beverages of choice. Men in Avirexes and jerseys kick back and admire the sights. Although Sue's is 20 miles north of Manhattan, it still attracts rappers, athletes, and label executives. Mirrored walls reflect dancers and servers with names like Spice, X-Tasy, and India as they jiggle their booties to the beats provided by Funkmaster Flex. They wear Lucite platforms and skimpy getups.

When a girl gets on hands and knees to make her thong-clad booty "talk" in a patron's face, the dollar bills come fluttering out. "Guys like to see that big butt shaking," says one of the dancers, Joselle Pluviose, "and they'll spend their whole paycheck to look at it." And the bigger the butt, the better the bucks. At strip clubs like Sue's, cosmetic surgery can be a way of life—almost a professional necessity. "Every girl wants to be thick. When the girls with the fat asses get all the cash, the others say, `I want some of that,"' says Sean Gray, a promoter for Sue's. "Once you get the fake ass, you start seeing more money."
In many ways, Sue's is a metaphor for what is happening in the real world, where celebrities like Beyonce and J.Lo are as famous for their bangin' backyards as they are for their other God-given talents, and even noncelebrity girls with luscious rumps get the lion's share of male attention. This fact is not lost on the rising number of women who are getting plastic surgery to plump up their own posteriors. These women aren't just rich Hollywood wives but working girls willing to cash in 4o1Ks, negotiate home equity loans, or take on massive credit card debt to finance their physiques. Though some feminists are concerned that yet another invention by the plastic surgery establishment exploits and exacerbates women's insecurities, others see the trend as a welcome sign of a more diverse beauty standard. Before the J.Lo age, only a narrow-hipped fashion-model figure was considered beautiful in the mainstream. Now the curvy hip hop ideal has finally gone pop.

Lisa Johnson (not her real name), 25, had the surgery last July. "It was a lifelong dream come true," she says with a broad smile. Johnson, a graduate student, has been trying to figure out how to get some junk in the trunk since she was 13 years old. Sitting in a diner on the Upper West Side of Manhattan and wearing a pair of Levi's and a cashmere sweater, she is a far cry from the strippers in money-earnin' Mount Vernon. She admits she could lose some weight. Her presurgery girth wasn't in the right location, which she
made her a rarity in the African-American community. "Most of us have hips and butts—sometimes too much," she says. "I was just flat." Tired of the taunting—she heard nicknames like "pancake butt" Johnson was determined to boost her booty, but when she went to plastic surgeons for consultations, she says, they looked at her like she was crazy. "They didn't understand that not everyone wants to be flat."

All that is rapidly changing. In 2002, there were 614 buttocks augmentations performed in the United States, according to the American Society for Aesthetic Plastic Surgery, and they expected many more in the future. They predicted that the "popularity of thong lingerie and swimwear will stimulate an increase in cosmetic surgery... including lipoplasty for contouring of full buttocks and buttocks augmentation for adding curves" to flat buns.

When Johnson found Dr. Thomas L. Roberts III online, both she and her sister signed up. He is one of a handful of U.S. doctors who practice microfat grafting for buttocks augmentation. He uses liposuction to remove excess fat from the back, thighs, and stomach, then reinjects it into the butt cheeks to contour a whole new bottom. "It's a win/win," Roberts, 58, says from his surgery center in Spartanburg, S.C. "Women can get rid of the fat they don't want and get fat where they want it."

Roberts and other plastic surgeons also realize that as more and more nonwhite Americans opt for cosmetic surgery, the profession must acknowledge that one size or shape does not fit all. Roberts, who is white, has performed more than 200 buttocks augmentations, and about two-thirds of his patients have been women of color who traveled from places as varied as Queens, N.Y., and Pakistan. He prides himself on innovating shaping techniques that cater to ethnic desires. "African-Americans want it full everywhere, they want a shelflike Serena Williams's," he says. "Hispanics want a bubble butt like J.Lo. Caribbean women go more in the direction of African-Americans, and Asian women want more butt, but they're concerned about sculpting it so their legs look longer."

In addition to microfat grafting, implants are an option. But according to Roberts, results can be iffy; they can slide or rupture. And since they're best placed in the upper portion of the buttock, it's limiting for women who may want augmentation in the lower part of their derrieres. Some worry about possible side effects. Both procedures carry a risk of infection, explains Rhonda Hatchette, the buttocks augmentation patient coordinator in Dr. Roberts's office. (Roberts performed the microfat-grafting buttocks procedure on Hatchette three years ago.) "Making a big incision near the anus exposes the area to bacteria. There's also the risk of bleeding."

Unfortunately, the quest for the perfect butt has also led to nightmarish tales of underground surgery centers where unlicensed practitioners inject industrial-grade silicone into back-sides. The side effects: oozing infections or even death. In 2001, Vera Lawrence, a 53-year-old Miami woman, died during one of these illegal "pumping parties" after silicone was injected into her buttocks. Her autopsy showed that the deadly substance had infiltrated her organs and her blood stream. In Boston, two transgender men were admitted to Boston Medical Center after silicone injections caused gross abscesses that needed surgical draining. In both cases, those who performed the procedures were criminally prosecuted.

Roberts is a board-certified plastic surgeon, and he feels strongly that his method is safe. He claims he's never had anyone suffer serious complications from the procedure. In fact, he published an article in the Aesthetic Surgery Journal that touted the safety of buttocks augmentation as well as its ability to effectively enhance the "gluteal aesthetic unit" when implants fail. "Grafting feels totally real because it's real fat," Roberts says. But he also cautions that this surgery is no boob job. While breast augmentation surgery can take as little as an hour, building a new behind can require the patient to be under anesthesia for up to six hours.

Lisa Johnson's sister had the procedure a week before she did, and when Johnson saw the results, she said she couldn't wait to hop on that operating table. Afterward, all she could remember was waking up and asking, "How does it look?" She doesn't recall lying on her back naked, her face obscured by a paper sheet, her torso covered with a swirl of green and red marker lines. The red areas denoted where the fat was extracted, the green where fat was injected.

Roberts considers himself a bit of an artist. He is an accomplished sculptor, and at his South Carolina home, he has a Japanese garden with a world-class bonsai collection. Creating buttocks enables him to think in three dimensions, like sculpting. He begins by harvesting the fat with a long metal tube through tiny incisions. With aggressive movements, he shoves the apparatus in and out. The body in his care moves corpselike from the momentum. "I try to get it out gently," he says while vacuuming the fat from the back of a 48-yearold woman from Texas. Over the operating room sound system, Rod Stewart croons "Forever Young," while Roberts rubs and massages the body to tease out the fat. It makes a gurgling noise as it's suctioned out, and orange, pulpy material oozes through plastic tubes into a cone-shaped beaker hanging off the side of the operating table. It's filled with a mixture of a protective fluid, blood, natural oils, and living fat cells.

Meanwhile, as many as six nurses are standing by, four of them to separate the living fat cells from the other fluids. (More than half of them have breast implants courtesy of Roberts. One has breast and buttocks implants.) This stage is crucial to the success of buttocks enhancement. Though it's time consuming, it helps guarantee that the surgery's effects will be durable.

M MicroFat grafting isn't for everyone, especially women with little body fat. Even those with enough fat to contour a new bottom should be prepared for the booty to shrink to its ultimate expected size after a year. Around to to 40 percent of the injected fat is reabsorbed by the body. Because the surgery is relatively new, doctors don't yet know how long the augmentation can last, but patients can expect to hold on to their renovated backyards for at least a few years.

The nurses in gloves, scrubs, and face masks begin to put the fat into smaller syringes. They're mostly silent, but every once in a while, chatter erupts into playful laughter. These syringes will be used later to contour the new booty as the fat is injected through one-eighth inch incisions around the butt. Nearly four hours later, Roberts begins contouring. He rapidly injects each syringe. Results are visible almost immediately. Within a half hour, new rear cleavage emerges. He has injected a pound of fat. "Imagine the size of a nice big steak," he says. He continues as the left cheek grows and grows. He pats it. Walks around the table to look at it from different angles. Meanwhile, the patient remains a faceless, passive participant.

By the time it's over, Roberts will have sucked out more than eight pounds of fat and reinjected about two pounds into each cheek. A woman who had a boxy torso has not only a waist but a visible rib cage and, of course, a round, perky butt.

Afterward, patients find out for themselves how difficult healing can be. "It was really painful. It was kind of like having a baby. But you forget about it after it's over," says Kiki Norse (not her real name). "I couldn't sleep on my back for a couple months. During the first week, you cannot lie on your back or sit. In the lipo part, your body gets stiff. I couldn't put my clothes on by myself for a couple weeks." Many patients say that, after the surgery, they get a giant bruise that stretches from breasts down to the thighs. "Your whole body aches," Johnson recalls.

While Johnson and Norse are pleased with their new figures, liposuction and microfat grafting can be dangerous. "The major complication risk is infection, and these infections can be severe," says Manhattan plastic surgeon Thomas Loeb, who has performed liposuctions on more than 2,000 patients. Also, when the fat gets reabsorbed, it can cause asymmetry if one side absorbs more than the other. "Most plastic surgeons want to be more precise when it comes to plastic surgery," says Loeb, "and buttocks augmentation is not a precision procedure."

Despite the pain and the risk, some women are prepared to borrow a lot of money to get what they think is a sexier physique. A buttocks augmentation can cost between $13,000 and $19,000, and insurance coverage is generally out of the question. Johnson and her sister paid for the operations with help from their mother, but over the last five years or so, there has been a proliferation of plastic surgery finance companies. Maurice Schmid, the marketing director of one such firm, Irvine, Calif.–based Combined Acceptance Corporation, says his typical borrower is a woman, age 22 to 35, who earns between $24,000 and $50,000 annually. "They take out loans, put it on their credit card, or get financing," Dr. Roberts says. "Do you want a better body or a new car?" he asks. "A car is a status symbol, but this is about you. This is your body, and it makes you feel good. It's totally real. It's all you. There's nothing fake about it."

Why has booty worship become so prevalent that women are willing to go under the knife and into debt? The easy answer is the rise of J.Lo But the allure of her delectable onion is no revelation to blacks and Latinos. Ka cy Duke, a celebrity trainer at Equinox Fitness in New York City, puts it this way: "I've had clients come in and act like J.Lo was the only ass they'd ever seen. I see them all over the city on black and Hispanic women. All of a sudden white America goes crazy for ass."

Fat booties have long been valued in hip hop (see "Ass Kissers," page 144). Just as J.Lo went from Bronx-bred Fly Girl on In Living Color to red carpet superstar, hip hop sensibilities, too, have gone mainstream. Back in '87, whites were scandalized by the 2 Live Crew's bootylicious video for "Move Somethin'," but it aired occasionally on the hip hop video show Yo! MTV Raps. Fast forward to 2004, and the majority of rap videos are heavy on curvaceous women and can be viewed 24 hours a day on cable music channels. "Black folks were excluded from TV for a long time," says video director Little X. "Now we have influence, and we're able to set a new standard of beauty. We've flipped the mirror. The old standard of the superskinny white woman doesn't really apply."

But these newly pervasive images of perfectly shaped apple bottoms may also create yet another reason for women, regardless of race, to be as critical of themselves as ever. Some view going under the knife as the ultimate act of self-hatred. "Plastic surgery is kind of masochistic," says Virginia L. Blum, author of Flesh Wounds: The Culture of Cosmetic Surgery. "We go into these surgeries to measure up to an ideal that we can never measure up to."
Norse, who's white, insists she wasn't trying to become a perfect J.Lo doll, she just wanted to lose the 30 pounds she gained while on antidepressants. And she wanted to feel better about herself. "I wanted the lipo," she says, "so I thought while I was at it, I might as well make my butt bigger." Her African-American boyfriend was more than willing to finance the operation. "I appreciate the Latin aesthetic," she says during a phone call from Hollywood, Calif., where she is trying to pursue an acting career. At times, she admits, her new figure gets her noticed. "People think I'm Spanish or mixed," she says. "But I don't care. I love it."