The "Topeka tush" rises as the exaggerated Brazilian butt lift shrinks

The Brazilian butt lift (BBL) used to trend big, especially in coastal cities like Los Angeles and Miami and among celebrities and influencers who took the "bigger is better" approach. But yesterday's BBL has shrunk, and styles have shifted to the "Topeka tush" with its understated Midwestern aesthetic.

"In the Midwest, we do not have near the demand for the larger volume," said Ryan Diederich, MD. "Most patients are looking for a smaller volume BBL."

There's no buts about it. While the BBL remains popular, we're saying hello to a new procedure arriving from middle America – the Topeka tush. BBLs involve liposuctioning areas of the body with excess fat, such as the abdomen, and transferring that fat to the buttocks to improve shape and projection. The Topeka tush does it a bit differently, but results are just as effective, if not elevated.

Aesthetic preferences in the heartland

Unlike American coastal cities, which tend to push the envelope in plastic surgery, the Midwest has long favored a subtle aesthetic when it comes to contouring curves. The large-volume BBLs associated with LA and Miami never truly migrated to middle America.

"The whole time in the Midwest, most of our patients have wanted conservative," said Dr. Diederich.

Now, the rest of the country seems to want what the Midwest has had all along – a butt lift that is as understated as the town it is named after.

What exactly is the Topeka tush?

Topeka, Kan., is just about as "middle" of the United States as you can get – geographically and culturally. Dr. Diederich said he's been giving his patients the Topeka tush before he knew it had a name. He does it by subtly grafting fat to the buttocks and filling in "hip dips" without tipping anyone off that the curves are surgically enhanced.

This Topeka tush approach is less about size and more about shape.

"People were thinking BBL was just 'make bigger,' said Dr. Diederich. "The reality is that fat grafting 'contours.'"

The shift toward subtle

The understated bum contouring that Midwesterners tend to favor is catching on in other parts of the country. Patients are asking plastic surgeons for modest butt lifts, and celebrities and influencers seem to have moved away from the overfilled derriere in favor of the Topeka tush for the prefect peach.

According to Dr. Diederich, that's a good thing.

"You don't see good lip filler – it's not obvious," said Dr. Diederich. "The same thing I'd say with this (Topeka) butt lift. You don't see it, it's not obvious, it's a subtle improvement with contouring and shaping."

Sculpting starts with subtraction

According to Michael Lynch, MD, strategically removing fat in key areas, such as the lower back, helps shape the surrounding body parts to improve the projection of the buttocks.

"I don't think people understand that to do this operation properly, you're trying to sculpt the buttock by making the lower back much more narrow," said Dr. Lynch. "So, now you've built a shelf, and the buttock is already looking bigger before you ever put any fat into it."

Improving the look of the buttocks is about more than increased projection, as many people also want their surgeon to balance out irregularities, such as one cheek being larger than the other, to make their backside more symmetrical and aesthetically pleasing.

Shaping confidence, not just curves

Dr. Lynch said the subtle Topeka tush approach gives patients a more proportional body shape, and they often report that their clothes fit better afterward.

"It's for somebody looking for a better definition of the buttocks, a better waistline and hip shape," said Dr. Lynch. "That's what the operation does the best: not creating some overdone-looking buttock area."

Less is the new more

The "bigger the behind, the better" version of the BBL once was the star of body contouring, but the understated elegance of the Topeka tush is quietly stealing the spotlight. This Midwestern-inspired approach to buttock enhancement redefines the large BBL aesthetic, favoring a silhouette that prioritizes harmony and shape over sheer size.

The Topeka tush proves that sometimes, less really is more – and it's okay for surgically enhanced curves to whisper instead of shout.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.