Can I Get Hips if I’m Skinny? Skinny BBL and Hip Augmentation

For many women with a low Body Mass Index (BMI), the dream of having a « snatched » waist and rounded hips feels out of reach. You may spend hours in the gym doing « hip abductor » exercises or eating a surplus of calories, only to find that the weight goes to your midsection or face rather than your hips.

The answer is yes, you can get hips if you are skinny, but it requires a specialized approach that combines anatomical precision, fat-harvesting technology, and skin-tightening science.

The Anatomy of the « Skinny Hip »

To understand how to get hips, we must first understand why they are missing.

The Skeletal Factor

The width of your hips is primarily determined by the width of your iliac crest (the top of your pelvic bone). If you have a narrow pelvis, your silhouette will naturally be more vertical.

The Trochanteric Depression (Hip Dips)

Even women with wider pelvic bones often suffer from « Hip Dips. » This is the inward curve located between the iliac crest and the greater trochanter of the femur. In skinny patients, there is very little subcutaneous fat to « fill » this gap, making the dip look like a hollow « violin » shape.

The Fat Distribution Problem

Genetics determine where your body stores fat. « Skinny » individuals often have « stubborn » fat in non-aesthetic areas (like the inner knees, the chin, or the lower belly) but lack fat in the « aesthetic » zones (the hips and the upper-outer quadrant of the buttocks).

The Solution : The « Low Hip » Skinny BBL

The Skinny BBL (Brazilian Butt Lift) is a procedure specifically designed for patients with a BMI between 18 and 23. It is not about making you « big »; it is about reallocating your natural resources.

How it Works for Thin Patients

In a traditional BBL, a surgeon might inject 1,000cc of fat per side. A skinny patient might only have 300cc of fat available in her entire body.

• The Secret: It’s not about the quantity of fat; it’s about the contrast. By removing fat from the waist and injecting it into the « Low Hip » (the hip dip), the surgeon creates a visual curve that didn’t exist before.

Dr. Youssef Gam Approach : RF-Assisted Sculpting

For a skinny patient, the biggest risk of a BBL is « loose skin » or « irregularities. » If you remove fat from a thin area, the skin may not retract perfectly. This is why experts like Dr. Youssef Gam use Radiofrequency (RF) Assistance.

VASER Lipo (The Harvest)

Instead of traditional liposuction, which can be aggressive, VASER (Ultrasound) is used. It vibrates the fat cells loose while leaving blood vessels and connective tissues intact. This produces « Liquid Gold »—high-quality, viable fat cells that have a much higher survival rate once injected into the hips.

BodyTite (The « Snatched » Waist)

To make hips look wider, the waist must be as narrow as possible. BodyTite uses RFAL (Radiofrequency Assisted Liposuction) to heat the internal tissues. This causes the skin to « shrink-wrap » around the muscles.

• The Result: A tighter waist creates the illusion of much larger hips, even with a small amount of fat transfer.

Morpheus8 (The Texture)

Thin patients often have visible cellulite because their skin is closer to the underlying structures. Morpheus8 (Fractionated RF) is used to smooth the transition between the new hip volume and the thigh, ensuring the curve looks natural and « un-operated. »

Where Does the Fat Come From? (The « Treasure Hunt »)

The most common question from skinny patients is: « I don’t have any fat, so what will you use? »

A skilled surgeon can find « hidden » fat in areas you might not notice:

1. The Flanks (Love Handles): Even very thin women usually have a small deposit here.
2. The Inner Knees: A classic « stealth » donor site.
3. The « Banana Roll »: The small fold just under the buttock.
4. The Bra Roll: Fat on the back, near the shoulder blades.
5. The Chin/Submental area: Small but high-quality fat.

By combining fat from 4 or 5 different areas, the surgeon can usually collect enough to fill the hip dips and create the « Pearl » projection.

The « Diamond Buttocks » Technique

In the « Skinny BBL, » the goal is often the Diamond Shape. This involves:

• Aggressive sculpting of the Sacral Triangle: Creating a deep V-shape in the lower back.
• Filling the Low Hip: Smoothing the « violin » dip.
• Central Projection: Adding a « Pearl » of fat directly behind the muscle to create a « pop » in profile view.

Des fesses perles en Tunisie : Skinny BBL RF, Diamond Buttocks

Non-Surgical Alternatives: Can You Get Hips Without Surgery?

If you are not ready for surgery, there are « Biostimulator » options, though they are less permanent.

Sculptra & Lanluma (PLLA)

These are not « fillers » in the traditional sense. They are injections that stimulate your body to produce its own collagen in the hip area.

• Pros: No downtime, no surgery.
• Cons: Requires multiple sessions (3-4), is very expensive, and the results take 6 months to appear. It adds « firmness » but rarely the same « projection » as a Skinny BBL.

Hyaluronic Acid (Genefill/Maxyfill)

Body fillers can be used to fill hip dips.

• Pros: Instant results.
• Cons: They last only 12–18 months and can feel slightly « gel-like » if too much is used in a thin patient.

The Role of Exercise : Can You « Grow » Hips?

You can grow the Gluteus Medius and Gluteus Minimus (the muscles on the side of the hip).

• Exercises: Weighted firehydrants, lateral lunges, and cable abductions.
• The Reality Check: While you can thicken the muscle, you cannot change where your skin attaches to your bone. If you have deep hip dips, exercise often makes the muscle harder, which can actually make the « dip » look more pronounced because the muscle above and below it grows, but the « hole » remains.

Recovery : « Feeding the Fat »

For a skinny patient, the first 30 days post-op are critical. Since you don’t have much body fat, your body will try to « burn » the newly injected fat for energy.

1. The « BBL Diet »: You must eat a surplus of healthy fats (walnuts, avocado, olive oil, salmon) to ensure the fat cells « take » (revascularize).
2. No Pressure: You must use a BBL pillow. If you sit on your new hips, you will « suffocate » the fat cells, and they will be reabsorbed by the body.
3. Compression: Wearing a specialized Faja is mandatory to ensure the skin tightens correctly thanks to the RF (BodyTite) treatment.

Why Tunisia for Hip Augmentation?

For patients in Europe (Italy, Spain, UK), Tunisia has become the premier destination for the Skinny BBL RF.

• Expertise: Surgeons like Dr. Youssef Gam specialize in the « European Look »—athletic, refined, and natural.
• Technology: Access to VASER and BodyTite is often more integrated into the surgical packages in Tunisia than in many European clinics.
• Discretion: Recovery in a luxury setting allows the swelling to go down before returning home.

The Advanced Science of the Skinny BBL RF & Hip Reconstruction

The « Golden Fat » Theory: Quality Over Quantity

In a traditional BBL, the surgeon has an abundance of fat. In a Skinny BBL, the surgeon must be a « gold miner. »

The Harvesting Physics

Using VASER (Vibration Amplification of Sound Energy at Resonance), the surgeon targets the deep and superficial fat layers differently.

• Deep Fat: This is the « bulk » fat used for projection.
• Superficial Fat: This is « High-Definition » fat. It is rich in Adipose-Derived Stem Cells (ADSCs).

For a skinny patient, Dr. Youssef Gam focuses on harvesting from the « fibrous » areas (like the back or the « saddlebags ») because this fat is more resilient. Once harvested, the fat undergoes Closed-System Processing. It is not exposed to air, preventing oxidation.

Viability Index=Intact AdipocytesTotal Aspirate\text{Viability Index} = \frac{\text{Intact Adipocytes}}{\text{Total Aspirate}}Viability Index=Total AspirateIntact Adipocytes​

In the Skinny BBL, we aim for a Viability Index of >90% to ensure that the small amount of fat injected doesn’t simply disappear after three months.

The Physics of RFAL (Radiofrequency Assisted Liposuction)

Why is the « RF » part so critical for the « Low Hip »?

Thin patients often have « skin laxity » that they mistake for « fat. » If you simply inject fat into loose skin, the result is a « droopy » hip. BodyTite (RFAL) solves this through Directional Thermal Contraction.

How it works:

1. Internal Electrode: Inserted under the skin, it delivers RF energy directly to the adipose tissue and the Fibro-Septal Network (FSN).
2. External Electrode: Glides on the surface, monitoring the skin temperature in real-time (usually kept at 38∘C38^\circ C38∘C to 42∘C42^\circ C42∘C).
3. The Result: The heat causes the collagen fibers to shorten immediately (Primary Contraction) and stimulates the production of new elastin over the next 6 months (Secondary Contraction).

For the « Diamond Buttocks, » this technology is used to « shrink » the skin of the lower back (the sacral area), making the transition to the buttocks look like a sharp, architectural « pop. »

The « Low Hip » Architecture: Filling the Trochanteric Void

The « Low Hip » is anatomically known as the Trochanteric Depression. In skinny patients, the skin is often « tethered » to the bone by fibrous bands.

The Subcision Technique

Before injecting fat, the surgeon may perform Subcision. Using a specialized cannula, they break the internal « tethering » bands that pull the skin inward.

• Without Subcision: The fat has no room to expand, and the « hip dip » remains visible.
• With Subcision: The skin is « released, » creating a pocket where the fat can sit smoothly, resulting in a seamless, rounded hip.

The « Diamond » vs. « Heart » vs. « Square »

A Skinny BBL is used to change the Geometric Frame of the body:

• The Square Frame: Common in skinny patients where the waist, hips, and thighs are the same width.
• The Diamond Frame (The Goal): The waist is the narrowest point, the « Low Hip » is the widest point, and the silhouette tapers back down toward the knees.
• The Heart Frame: Focuses more on the « top » of the buttock. For thin patients, this can look « top-heavy, » which is why the Low Hip focus is preferred for a natural, « born with it » look.

Safety: The « Sub-Muscular » Myth

In the past, surgeons injected fat into the muscle to get better « take. » This led to the risk of Fat Embolism.
Modern Skinny BBL Protocol (Dr. Youssef Gam):

• Strictly Subcutaneous: Fat is only placed between the skin and the muscle.
• Expansion Vibration Lipofilling (EVL): The cannula vibrates during injection, ensuring the fat is spread out like « butter on bread » rather than in large « clumps. » This prevents the formation of oil cysts and ensures every fat cell is close to a blood vessel.

The « Bio-Hacking » Recovery for Thin Patients

Because skinny patients have higher metabolic rates, they risk « burning off » their results. The recovery protocol is specialized:

The « Fat-Loading » Phase (Weeks 1–4)

Patients are often prescribed a diet high in Omega-3 and Omega-6 fatty acids. The goal is to keep insulin levels stable to prevent the body from entering a « catabolic » state where it breaks down the newly grafted fat.

Lymphatic Drainage with RF

Post-operative massages are combined with external RF treatments. This keeps the skin « glued » to the new contours and prevents the « wavy » look that can occur when thin skin heals over liposuctioned areas.

The « No-Pressure » Rule

The fat cells need to grow new blood vessels (Angiogenesis). Any pressure—even from a tight pair of jeans—can kill the cells.

• The Physics of Pressure: $P=F/A$. In a skinny patient, the area ($A$) is small, so the pressure ($P$) is higher. This makes the BBL Pillow non-negotiable for at least 3 to 6 weeks.

Long-Term Evolution: What Happens in 5 Years?

A common myth is that BBL results disappear.

• The Reality: Once the fat « takes » (usually after 3 months), those cells are permanent. They will behave like fat cells in any other part of your body.
• Weight Gain: If you gain weight, your hips will get even curvier.
• Weight Loss: If you lose significant weight, the fat cells will shrink, but the shape (the Diamond silhouette) will remain because the underlying « architecture » was changed.

Why « Skinny BBL RF » is the « Couture » of Surgery

Traditional BBL is « Ready-to-Wear »—it’s about adding size.
Skinny BBL RF is « Haute Couture »—it’s about:

1. Precision Harvesting: Finding fat where there is none.
2. Skin Tightening: Using BodyTite to ensure the skin fits the new frame.
3. Anatomical Correction: Specifically targeting the « Low Hip » to break the rectangular silhouette.

For patients traveling to Tunisia, the combination of Dr. Youssef Gam’s expertise and the availability of InMode (BodyTite/Morpheus8) technology offers a level of body contouring that was previously impossible for the « naturally thin » woman. You are not just getting a surgery; you are getting a structural redesign of your proportions.