We published this case some time ago, and it generated a huge number of comments. Everyone was asking the same question: what exactly was done here? The answer isn't simple because the solution wasn't either. It involves a young patient with square hipsProminent iliac crest and lack of lateral projection. surgery It was not a single procedure but a precise combination of techniques: hip expansion with our exclusive technique, gluteal implants and BBLThe goal wasn't just to add volume—it was to completely change the body's proportions.
The essential things you need to know
- Square hips with a prominent iliac crest are one of the most difficult anatomies to transform and cannot be resolved with a single technique.
- In this case, three procedures were combined in a single session: hip expansion, buttock implants, and BBL with the patient's own fat.
- The key wasn't the added volume, it was changing the proportion of the body. Waist, hips, and buttocks have to work together.
- The hip expansion technique used at Cirumed is unique and allows results that cannot be achieved with fat transfer alone.
- The result takes time, but when the planning is correct, the transformation is complete and lasting.
Clinical case: square hips with prominent iliac crest Dr. Alexander Aslani, Cirumed Clinic Marbella
The starting anatomy: what makes square hip surgery so difficult
square hips They describe a specific anatomical configuration: the iliac crest, the bone that defines the upper edge of the hip, is positioned high and laterally, creating a visible protrusion. Instead of a smooth transition from waist to hip, what is seen is a kind of "step" or "corner" that interrupts the natural curve.
This anatomy is particularly difficult to correct because the problem lies not only in the amount of tissue but also in its shape. The fat of the iliac crest creates an irregular contour, and simply adding volume underneath can result in an even more striking contrast between the prominence of the crest and the lower hip area. Therefore, surgery for square hips requires a multi-pronged approach.
Starting Anatomy
- High, square hips
- Prominent iliac crest visible "step"
- Lack of lateral hip projection
- Waist-to-hip transition without a natural curve
- Undefined female silhouette
Result achieved
- Full and rounded lateral hip
- Iliac crest integrated into the outline
- Smooth waist-to-hip transition
- Added posterior gluteal projection
- feminine and proportionate silhouette
The strategy: why it was necessary to combine three techniques
A single technique wouldn't have solved this case. Each part of the plan addressed a specific anatomical problem—and all three had to work together for the result to make sense as a whole.
surgical plan
Hip expansion
Cirumed's exclusive technique for adding volume and lateral projection to the hips. It creates the missing curve between the waist and buttocks without relying solely on available fat.
Gluteal implants
Posterior structural projection. Essential when the available fat is not sufficient for the desired level of result or when a permanent result independent of weight is desired.
BBL with own fat
The fat extracted by liposuction It is redistributed to create shape, smoothness, and natural transitions around the implants. The BBL completes and refines what the structure creates.
Single session
All three procedures were performed in a single surgical session in a certified hospital operating room under specialized general anesthesia.
Why order matters
The hip expansion creates the structural foundation. The gluteal implants add posterior projection. And the BBL, which is always done last, softens, connects, and gives a natural look to everything that came before. If it were done in reverse, the transferred fat could interfere with the implant placement. The sequence is not arbitrary; it's part of the technique.
The result: more than volume, a new proportion
What's most impressive about this result isn't the size. It's how it has changed the relationship between the partiesThe iliac crest, which previously interrupted the contour, is now integrated into a continuous lateral curve. The waist appears narrower not because it has shrunk, but because the hips now frame it. And the silhouette from behind, which was previously flat, has a natural projection that was not there before.
That's exactly what the Dr. Aslani As described in the video, the goal wasn't to add volume, but to completely change the body's proportions. And that requires working on structure, contour, and precision simultaneously. See more real-life examples in our gallery.
Is hip surgery for square hips right for you?
Square hips or hips with a prominent iliac crest are among the anatomies that generate the most questions in consultations and are also among the most underestimated in terms of surgical complexity. Not all patients with this body type require the same approach. The choice between hip expansion, BBL with own fat o Supercharged BBL It depends on the amount of available fat, the desired level of projection, and the starting bone structure. See also: types of glutes to understand which anatomies respond best to each technique.
- You have good fat available and the problem is mainly the form → the BBL It may only be sufficient in moderate cases
- The iliac crest is prominent and you want a defined lateral hip → Hip expansion is necessary to create the structure
- You're looking for significant gluteal projection in addition to lateral hip enhancement → the combination with implants produces the most complete result
- You have little available fat. → Buttock implants are essential to achieve volume without relying on fat.
It tienes square hips and you've been looking at procedures for a while without finding a clear answer, including whether you've researched the hip dipsThat's because no single procedure will likely resolve your case. A consultation with Dr. Aslani always begins with your specific anatomy—not a list of generic options.
Dr. Alexander Aslani Cirumed Clinic Marbella
- Over 16 years of experience in gluteal surgery and body contouring; over 7.000 documented procedures
- Co-developer of the dual-plane gluteal augmentation technique, published in Plastic and Reconstructive Surgery 2023
- Contributing member of the ASERF Task Force on Gluteal Fat Grafting Safety
- Publications in PRS, Aesthetic Surgery Journal, PRS Global Open and Clinics in Plastic Surgery
- Member of ASPS, ISAPS and EBOPRAS
Do you have square hips and want to know what's possible for your anatomy?
En Cirumed Clinic, Dr. Aslani It will assess your bone structure, your available fat, and your goals to honestly tell you which combination of techniques produces the best result for you and which one doesn't make sense for your anatomy.
No commitment required. Also available for international patients.
Frequently asked questions about square hips and surgery
On anatomy and diagnosis
What exactly are square hips?
Square hips describe an anatomical configuration in which the iliac crest—the bone that forms the upper edge of the hip—is positioned high and laterally, creating a visible bulge. Instead of a smooth transition from waist to hip, a "step" or corner is formed, interrupting the natural curve. This shape is especially common in women with a more android fat distribution and can be accentuated by exercise if oblique muscles are developed without compensating for the lateral hip volume.
Can square hips be corrected with exercise alone?
Exercise can improve overall muscle tone and reduce fat in specific areas, but it cannot change the position of the iliac crest or add lateral volume to the hips where it doesn't structurally exist. In many cases, intense lower back and abdominal exercises can even accentuate the visual contrast of square hips. Surgery is the only way to structurally change the waist-to-hip ratio in this type of anatomy.
Regarding the procedure and recovery
What is hip expansion and how does it work?
Hip expansion is a surgical technique that adds volume and lateral projection to the hip area between the iliac crest and the greater trochanter, creating the curve that is missing in square or flat hips. At Cirumed, we use an exclusive technique that allows for more precise and longer-lasting results than simple fat transfer to this area. It can be combined with buttock implants and a Brazilian Butt Lift (BBL) in the same session for a complete body contouring result.
Is it necessary to combine buttock implants with hip expansion?
It depends on the goals and anatomy of each patient. In cases where the aim is simply to improve lateral proportions without increasing posterior projection, hip expansion alone or combined with a Brazilian Butt Lift (BBL) may be sufficient. However, when the goal is also to achieve significant gluteal projection, as in this case, gluteal implants add the structure that fat alone cannot reliably provide. The consultation determines which combination is appropriate. See also: candidates for a BBL.
How long does recovery take after this type of combined surgery?
As it is a combined procedure, recovery is somewhat longer than that of a standard BBL. For the first 2-3 weeks, relative rest is recommended, and sitting directly on the buttocks should be avoided. compression belt The procedure takes between 4 and 6 weeks. Strenuous activity should be avoided for at least 6 weeks. The final results, especially the integration of the transferred fat, are noticeable after 3-6 months. However, the structural improvement from the hip expansion and implants is visible from the outset.
Do you want a personalized assessment?
Every patient is different. At Cirumed Clinic Marbella, Dr. Aslani's team will study your case individually to explain which options are safe, realistic, and suitable for your anatomy.
You can send us your goals and some photos via video consultation. We'll guide you through the procedure, recovery, and the most suitable plan for you.
