La anterior hip expansion It's the missing component in most surgical plans for straight bodies. Liposuction narrows the waist. Buttock implants add posterior projection. But neither, on its own, creates the hourglass figure. That effect emerges from the relationship between waist reduction and lateral hip expansion, and that's exactly what this case demonstrates with a BBL 360° with anterior hip expansion.
The essential things you need to know
- La anterior hip expansion It fills the hip dips area with the component that liposuction and buttock implants alone cannot provide.
- Three techniques were combined in a single session: 360° liposuction, double-plane buttock implants, and fat transfer to the anterolateral hip.
- Validated infiltration rate: fat is infiltrated at 700 ml/min with vibrating cannulas, the optimum rate from the study published by Dr. Aslani at ASJ 2023 (n=30, 58% volume retention).
- The fat is always placed in the subcutaneous plane, never intramuscular, according to the safety protocols of the ASERF Task Force.
- The hourglass effect is not created by the gluteal projection alone, it is created by the geometry between the narrow waist and the expanded lateral hip.
Anterior hip expansion with BBL 360° — Dr. Alexander Aslani, Cirumed Clinic Marbella
What is anterior hip expansion?
La anterior hip expansion It's the targeted volumetric enhancement of the anterior and anterolateral hip region—the area popularly known as hip dips—to create lateral convexity and a true hourglass silhouette. On its own, it's not enough: it needs to be combined with 360° liposuction to create the waistline and with gluteal implants for posterior projection.
The difference between this procedure and a standard BBL is geometric: the standard BBL works on a single axis—the posterior projection. Anterior hip expansion works on three axes simultaneously. The result isn't more volume; it's a completely different silhouette.
The anatomical problem: waist-to-hip ratio of 1,0
In the clinical case described here, the patient presented a completely straight body contour: the waist measured practically the same as the width of the hips, with no visible indentation at the waist, no lateral projection of the hip and with a column-like silhouette.
In patients like these, liposuction alone is not enough. Removing fat doesn't create curves where none exist. Feminization requires both waist sculpting and volume restoration of the sides and buttocks. Therefore, no single procedure will produce the hourglass figure in this type of anatomy.
The surgical strategy: three axes, three techniques, one session
Cirumed's approach combines three procedures, each acting on a different geometric axis of the silhouette. All three are necessary—none is sufficient on its own.
360° Liposuction
Circumferential sculpting of the waist: anterior abdomen, flanks and lumbar area
Double-layer gluteal implants
Posterior projection and central volume of the gluteus maximus: Aslani technique published in PRS
Anterior hip expansion
Lateral convexity and hourglass geometry are the axis that the other two do not cover.
Why anterior hip expansion changes the entire silhouette
Waist reduction alone makes the torso smaller, but the silhouette remains visually straight. Without lateral hip projection, the result is not an hourglass figure; it is simply a narrower, straighter body. The hourglass optical illusion only emerges when waist reduction is combined with controlled lateral expansion on the same surgical axis.
Fat infiltration technique: 700 ml/min with vibrating cannulas
The anterior hip region is anatomically demanding for fat transfer. It requires controlled distribution, optimal preparation of the recipient bed, and smooth, homogeneous contour integration.
The Cirumed protocol uses vibrating basket cannulas at approximately 6.000 oscillations per minute, with a calibrated flow rate of about 700 ml/min. This technique has two objectives: the mechanical optimization of the recipient site through controlled tissue dissociation, and the homogeneous microdistribution of the grafted fat in the recipient bed.
Published scientific basis
A flow rate of 700 ml/min is the optimal value identified in Dr. Aslani's prospective study published in Aesthetic Surgery Journal 2023 (n=30 patients, comparing 300, 700, and 1000 ml/min). At 700 ml/min, the balance between graft viability, recipient bed preparation, and operative efficiency is optimal. Mean volume retention: 58%.
ASERF safety: fat always in the subcutaneous plane
All autologous fat grafting at Cirumed is strictly placed in the subcutaneous plane—never in the muscle—in compliance with the ASERF Task Force's international safety standard for gluteal fat transfer. The Aslani double plane refers exclusively to the implant pocket. The fat is always placed superficially, above the gluteal muscle fascia. This separation of planes is non-negotiable and exists to prevent fat embolism.
To better understand the difference between hip dips and pouches And why the correct diagnosis changes the entire surgical plan, see our specific article on this topic.
The result in this case: three transformed axes
Before surgery, the patient presented with a straight trunk, no waist indentation, and flat lateral hips. After:
- Clear definition of waist visible in front view
- Improved anterior hip convexity visible in three-quarter view
- Balanced gluteal projection in posterior view
- Feminized silhouette consistent from all angles
The change in body language and posture alone reflects the structural change in proportion. Patients in this category frequently describe a psychological adaptation to walking and standing in a body with a new center of gravity. See more cases in our before and after gallery.
Is this anterior hip expansion procedure right for you?
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✓ Ideal candidate
- Straight or rectangular body shape, waist-to-hip ratio close to 1,0
- Minimal lateral hip projection
- Sufficient but limited available fat
- Objective: structural feminization of the body
- Stable weight for at least 6 months
· She is not the ideal candidate if…
- It seeks extreme projection beyond the limits of the fabric.
- It has significant skin laxity that requires surgical excision.
- The lateral tissue is rigid and inelastic.
- The volume expectations are unrealistic.
- Active smoker (compromises graft survival)
Biomechanical limit: the tissue determines what is possible
Anterior hip expansion is biomechanically limited by the elasticity of the skin and subcutaneous tissue, not by the surgeon's ambition or the patient's preference. Tight, inelastic lateral tissue with little subcutaneous laxity mechanically restricts high-volume fat transfer. Surgical planning must consider these limitations, not just aesthetic desires.
Dr. Alexander Aslani Cirumed Clinic Marbella
- 30 years of total surgical experience · 16 years of specialization in body contouring
- More than 14.000 procedures performed · More than 7.000 specialized cases at Cirumed
- Supercharged BBL Technique Best Aesthetic Product PRS 2020
- Dual-plane technique for gluteal implants published in PRS 2022
- Series of 533 patients with cohesive gel PRS Global Open 2025
- Fat infiltration rate study ASJ 2023
- Contributing member of the ASERF Task Force on Gluteal Fat Grafting Safety
- Read 962 verified reviews on RealSelf →
Do you want to know if your anatomy is a candidate for anterior hip expansion?
Anterior hip expansion is highly individualized—tissue elasticity, available fat, and body geometry determine what is achievable. Dr. Aslani It offers personally reviewed video consultations without an intermediary evaluator. You can also see the procedure on our website. before and after gallery.
No commitment required. Also available for international patients.
Frequently Asked Questions about Anterior Hip Expansion with BBL
About the procedure and technique
What is anterior hip expansion in plastic surgery?
Anterior hip expansion is the targeted volumetric enhancement of the anterior and anterolateral region of the hip, the area known as hip dipsUsing precise fat transfer techniques, the surgeon adds controlled volume to create lateral convexity and a true hourglass silhouette, in combination with 360° liposuction and buttock implants.
How does anterior hip expansion differ from a standard BBL?
Un BBL standard It primarily works on the posterior projection of the buttocks using fat transfer or implants. Anterior hip expansion works specifically on the lateral and anterolateral regions of the hip to correct hip dips and create lateral convexity. The two procedures act on different geometric axes—most cases of true hourglass figures require both in the same session.
Why is a speed of 700 ml/min used for fat infiltration?
A flow rate of 700 ml/min is the optimal value identified in Dr. Aslani's prospective study published in ASJ 2023 (n=30 patients, comparing 300, 700, and 1000 ml/min). At this speed, the balance between graft viability, recipient bed preparation, and operative efficiency is best. Vibrating basket cannulas at 6.000 oscillations/min allow for homogeneous microdistribution of the fat.
Regarding the results and the candidacy
Can hip dips be permanently corrected with surgery?
When fat transfer is combined with 360° liposuction and buttock implants, hip dips can be corrected in a single combined procedure. Long-term stability depends on tissue elasticity, graft retention (average of 58% volume according to Dr. Aslani's 2023 ASJ study), and weight stability. Significant weight fluctuations (more than 5-7 kg) affect both fat volume and skin tissue.
Is fat transfer to the anterior hip safe?
When performed strictly in the subcutaneous plane, never intramuscularly, and following the international safety guidelines of the ASERF, anterior hip fat transfer has a good safety record. Cirumed uses validated infiltration rates (700 ml/min, from Dr. Aslani's published study) with vibrating cannulas to simultaneously optimize tissue dissociation and graft viability.
Who is the ideal candidate for the hourglass procedure at Cirumed?
Patients with a straight or rectangular body shape, a waist-to-hip ratio close to 1,0, minimal lateral hip projection, and available, albeit limited, fat are the most suitable candidates. Patients with rigid lateral tissue, significant skin laxity, or unrealistic volume expectations are not ideal candidates, and Cirumed will advise against the procedure before proceeding with compromised results. See also: candidates for a BBL.
What makes Cirumed Marbella's approach to anterior hip expansion different?
Cirumed specializes exclusively in body contouring and buttock surgery—16 years of focused expertise and over 7.000 specialized cases. The protocol is defined by Dr. Aslani's published techniques (Supercharged BBL, PRS Best Aesthetic Article 2020; dual-plane implant placement, PRS 2022; cohesive gel series, PRS Global Open 2025; fat infiltration velocity, ASJ 2023). Combined procedures are performed in a structured, single-session workflow adhering to EU regulatory standards.
