This post originally appeared in VICE UK
I'm at the Queen Anne Street Medical Center near Harley Street, talking to Dr. Foued Hamza. He's a charming Parisian plastic surgeon with the voice of Zinedine Zidane and the remarkably taut face of the Baby Eric–era Simon Cowell.
"I was one of the first surgeons in France to do the Brazilian butt lift," he tells me, excitedly. "Now I do a hundred and fifty of them each year, mostly here in the UK."
One butt every two-and-a-half days: It's a lot of cheek for one man to handle. That said, as there aren't enough clinics in the UK to meet the rapidly increasing demand for butt-lift surgery, you can't really blame Foued for cramming in as many as he can before the rest of his peers catch up.
It's hard to put an accurate figure on exactly how many butt jobs are performed in the UK each year, as there are clinics that don't belong to (and so don't report their procedures to) the British Association of Aesthetic Plastic Surgeons (BAAPS). However, this summer there was a reported 13 percent rise in fat-transfer operations—where fat is taken from the stomach or thigh area and squeezed into the buttocks—among clinics that fall under the BAAPS banner.
"I do a lot of liposuction—I've done it for years," says Dr. Hamza, flicking through his photo scrapbook of past patients. "Three years ago I began doing butt lifts, and I can tell you that, since then, I've never done liposuction alone without doing the butt-fat injection afterward. It's completely amazing."
He's showing me dozens of butts he's re-sculpted. I nod and say, "Wow." Occasionally he points to a particularly successful case and I say, "Yeah, I like that one," like a judge at a competitive bake sale.
"It's like an art form, really," says Hamza, as if reading my mind. "I'm an artist."
I look up at a Matisse print hanging on the clinic wall, then at a photo of a Filipino woman's re-upholstered butt, and I say, "Yes, I suppose you are."
Hamza is a skilled surgeon. For the Brazilian butt lift he sucks out fat from the stomach, back, arms, and thighs in volumes of between 20 ounces and 1.2 liters using a cannula (a long-handled needle attached to a length of suction tubing). Then he cleans the fat and re-injects it into your ass cheeks, like sausage meat.
He's a good salesman, too; the surgery isn't cheap ($7,900 to $12,500, depending on your desired volume), and although some patients come in well aware of how much cash they're going to be parting with, he also manages to sway all sorts of women who may still be deliberating whether they want the procedure or not.
I'm interested in what kind of women make up the client base of Foued and other butt technicians working in the UK. Earlier in the week, his secretary and nurse, Lamia Chouedli, told me, "Black girls like to go really, really big, whereas white girls just want a bit of help down there." Which might be anthropological gold, but doesn't really tell me all that much about their motivations.
On Foued's desk are the files of three patients who've had pre-surgery consultations today. He reads their dates of birth: One is just 19, the other two are 30. One of the names looks Eastern European; the other two are very much Anglo-Saxon.
Will they actually go ahead with it?
"Oh yes, absolutely," says Hamza. "Two of them already booked a date, and the other is waiting for her bank loan to come through."
And who would be his average client? What kind of age, or background, or profession?
"All kinds of women are doing it: waitresses, nurses, fashion professionals," he says. "They want to feel good and dress well, without a masculine shape. Maybe for their weddings—things like that."
You'll have probably already come to the realization that, in post-Kardashian Britain, a shapely butt is seen as a much more positive attribute than it was ten years ago. But if you needed further proof, just look to tastemaker and modern cultural icon Chloe Sims off The Only Way Is Essex, who described her own ass as a "granny bum" and spent more than $6,300 getting it pumped up. Unfortunately for Chloe, her enlarged behind only lasted a couple of weeks before deflating again.
Ash Mosahebi, a BAAPS spokesperson and cosmetic surgeon at Spire Healthcare hospital in Bushey, explains this derriere disaster, telling me that 40 percent of fat cells transferred into your bum get re-absorbed.
"If a patient is slim and doesn't have enough fat elsewhere on their body, you can use an artificial filler called macrolane," he says. "It's similar to Botox, but it only lasts for a maximum of six months at full volume."
The other method—silicone butt implants—isn't supported by BAAPS. "We're talking about hard implants under a lot of muscle," Ash explains. "That's a lot of blood, and they're difficult to put in and take out."
Dr. Hamza agrees: "It's not a clean area of the body, and they are foreign objects—there's a high chance of infection."
According to the Daily Mail, the Kardashian influence is responsible for 45 percent of all butt-lift surgeries in the UK this year. "They say, 'Give me Kim's body,'" confirms Lamia. "She's hugely influential."
Of course, having a large ass isn't anything new—an oversight that earned Vogue a fair amount of criticism when they declared this year the "Era of the Big Booty," simply because white celebrities like Iggy Azalea, Rose McGowan, and Kim Kardashian all exist in 2014 and have larger-than-average butts. In places like Colombia, Jamaica, and Nigeria, though, big bums have been desirable for centuries, and dancehall and reggaeton videos have featured big-bottomed girls in bikinis for years.
In the Caribbean, women with big bums and thighs are "thick" (it's a compliment), whereas skinny women are "hard" (it's not). In Brazil, 63,925 women had butt lifts in 2013. Then, obviously, there's hip-hop, where asses are as vital now as they were 20 years ago, when Sir Mix-a-Lot first announced his fondness for big butts.
In the same way that the Big Bang Theory has inexplicably found a British audience, the globalization of modern pop culture has also brought the UK closer to lots of other stuff—like the idea that having a big butt can definitely, 100 percent be synonymous with having a positive body image.
"Women want to look like Betty Boop cartoons," Amy Martin (not her real name) tells me in the treatment room of a hotel on Kensington High Street. Amy, who manages recording artists, lives between London and LA, and has just had her ass done. "The doctor took some fat from my belly, hips, and back and transferred a bit to my boobs and a lot to my booty."
The 28-year-old is just 5' 2" and weighs 90 pounds. She shows me old photos of herself looking incredibly thin, almost unrecognizable, and says she was thinking about surgery for a few years. "I was afraid of implants, so when I found I could do it with my own fat I thought, Yes, it's less dangerous and it's part of me anyway, not a foreign object," she explains. "I was working out a lot at the gym and wanted to work on my booty, but I couldn't do squats [good exercises for a toned butt] because I had a back problem."
I ask whether LA influenced her desire to change her body shape, but she says Miami played a bigger role: "In LA, everyone gets surgery, but they're tall, slim women. In Miami, it's all curves."
Amy is very happy with the results of her surgery. "It's exceeded my expectations and I've seen the difference with men," she says. "My type of men—black men—prefer curves. I feel more attractive."
Genevieve Richards, a British-Nigerian, had her butt done even more recently and is still waiting for the full results to become visible. Her hips and stomach are still swollen and she dieted post-surgery, against doctor's orders, so some of the fat has been re-absorbed.
She traveled to Neuilly-sur-Seine, an upper-class suburb of Paris, to have it done at a beautiful private clinic with a 24-hour nurse (it's cheaper in France).
"My arse needed peaching out," she says. "I was just going to get liposuction, but the doctor showed me photos of my bum and said I could have a rounder bottom. My friend had just had it done and I got a bit jealous."
Unlike Amy, who felt no post-surgery pain, Genevieve says, "After I woke up it felt like I'd been run over by a truck. I'd done a lot of research online, but nobody talked about the pain. I saw people saying they went back to work in two days. Bullshit! I was in bed for two weeks!"
Genevieve thinks social media has driven the butt-centric trend and that different ethnicities want the opposite of how they look. "I've got white friends who are squatting like crazy," she says. "Black people bleach their skin and straighten their hair; white people get tanned and now they want big booties."
So it seems that the rise of butt enlargement surgery in the UK is down to a multitude of factors—the most obvious (and perhaps problematic) being the recent mainstream emphasis on the power of the booty, stretching all the way down to idiosyncratic personal reasons, like Amy's quest to appeal more to the men she's attracted to.
Before I leave Dr. Hamza's clinic I ask him for a final piece of advice for anyone thinking of augmenting their ass.
"When you've had the surgery," he says, "don't sit down for a week."
Follow Josh Surtees on Twitter.