Aah, to have a video vixen butt, or one like J.Lo’s, Kim Kardashian’s or maybe even raptress Nicki Minaj. If you’ve ever indulged those wishes, you’re not alone. And if you actually took the next step and consulted with a cosmetic surgeon about butt-enhancing procedures, you’re still in good company.

In 2000, nearly 1,400 people had butt lifts. By 2010, the number of procedures had more than doubled to almost 3,300, according to the American Society of Plastic Surgeons. And though more women than men usually opt for sculpted rear ends, men also go for improved assets: In 2009, for example, 223 men bolstered their backsides, as did 242 the following year. The reason for the overall uptick? Cosmetic surgeons say it’s because today’s improved butt enhancement procedures offer more ways and tools to enhance buttock shape for the best customized results.

Although it might seem like our interest in enhancing our backsides is taking a front seat for the first time, fact is our buns have always been on the forefront of beauty. Just look at artwork from the ancient world. Sculptures from the Paleolithic age, called Venus figurines, for example, appear to be preoccupied with curvaceous women or goddesses with “fat bottoms.” What’s more, when the Greeks built a shrine to Aphrodite, the goddess of love, beauty and sexuality, worshippers called the building the temple of Aphrodite Kallipygos (translation: “Aphrodite with the beautiful buttocks”).

Flash forward 2,000 years (give or take a century), and many modern women still want what Aphrodite Kallipygos had, and badly enough to shell out big bucks for it. Figure-conscious females want a more alluring silhouette, and a butt lift can give them that, says Constantino G. Mendieta, MD, a board-certified cosmetic surgeon based in Miami.

Mendieta performs more than 350 of these procedures annually and has a multicultural clientele. “Most of my patients are Latina or African American, although Caucasian and European women also see me for butt enhancement procedures,” Mendieta says. “But different ethnic groups tend to have their own sense of what constitutes booty beauty. For example, most Latinas want higher, rounder buttocks. Asians prefer their butt lifts higher up so their legs appear longer, and African Americans tend to want enhancements placed lower.”

Different ethnic groups may subscribe to unique ideals of the perfect butt, and yet one unified question could be posed to them all: Why mess with how much “junk in the trunk” they have? One of the main reasons, say cosmetic surgeons, may be because curves are in vogue and many people want whatever makes celebrity bodies stand out. (Think: Jennifer Lopez’s bubble butt.) Also, some people may believe their butts are too flat, too saggy or not shapely enough. They may feel self-conscious or hate the way their clothes fit.

Whatever the case may be, butt enhancement surgery---using fat injections, silicone implants or a buttock lift---can give you the assets you crave. And improving or correcting a perceived physical flaw can lift your self-esteem and self-confidence.

Up until a few years ago, most often plastic surgeons specializing in butt enhancement surgery used silicone implants. These implants became popular because they were available in many different shapes to meet patients’ individual needs and because they were tightly sealed to prevent silicone leaking into the body. Surgeons primarily used them to plump up the buttocks, but after a while, these implants could harden, become lumpy or even shift to a new location.

As a result, surgeons developed newer procedures, such as the Brazilian butt lift. For this procedure, a surgeon removes fat from other areas of the body, including the thighs and hips, and then re-inserts it into the buttocks.

Through the years, physicians improved on Brazilian butt lift techniques. When Mendieta performs his butt lift procedure he takes some of the needed fat from around the waist, “so a patient’s body will have a more curvaceous and sculpted appearance.”

Mendieta calls this variation a Miami butt lift. And if a woman doesn’t have enough fat to remove for the procedure, he recommends “booty camp” and asks the woman to gain about 10 pounds before having the lift.

Surgeons always remove more fat than will show in the butt lift’s final stage. This is because only between 60 to 80 percent of this fat will actually stay located in the butt, Mendieta says. The rest is reabsorbed by the body. These procedures usually take more than two to three hours and are done under general or regional anesthetic.

What does all this cost? Well, butt lifts performed by a skilled board-certified plastic surgeon don’t come cheap. It’s not uncommon for costs to reach $20,000. What’s more, medical insurance doesn’t cover this cosmetic surgery. That’s why it’s not unusual for patients to seek cheaper procedures overseas.

But some docs frown on this medical tourism. “This can be a problem,” says Frederick Lukash, MD, a New York-based board-certified plastic surgeon and author of The Safe and Sane Guide to Teenage Plastic Surgery. To illustrate the dangers, Lukash ticks off a list of questions: “What happens if something goes wrong and you are in another country? Can you be sure that the procedures used are safe? Will you be able to find a cosmetic surgeon when you get back home who will be able to correct problems that may have occurred?”

In fact, Lukash says, women whose offshore procedures were botched often ask him to correct their problems. However, he doesn’t do butt enhancement surgery so that’s one area he can’t rework. For women who consider going overseas he does offer this advice: You may be courting real trouble if you opt for cheap or quick procedures---here, there or anywhere.   

Take what happened earlier this year to 20-year-old Claudia Seye Aderotimi and three of her friends. These women came from the United Kingdom to the Philadelphia area to get silicone shots for their butts. Silicone is a chemical substance that, in injectable liquid form, is illegal for cosmetic use in the United States. But that hasn’t stopped countless women and transgendered people from seeking the injections. Often, those dispensing the shots are illegal practitioners working in seedy hotel rooms, spa back rooms, even in their homes, garages and basements. Some claim they use well-known non-silicone face fillers, such as Juvederm, to inject into patients’ butts. It’s not difficult to find these fly-by-night frauds performing procedures in what are called “pumping practices,” Mendieta says, because some social networks recommend them.

Silicone injections are illegal, but they’re a cheap rump plumper.

This wasn’t Aderotimi’s first visit to the same practitioner. Previously, the young women had gone to the same motel in November to get the butt-enhancing silicone shots. Aderotimi’s return for a second treatment may mean she needed a touch-up or wanted an even bigger booty. (There’s no standard amount of silicone illegal practitioners use, and the effects vary for different people.) Aderotimi yearned for a successful career as a hip-hop model and felt her natural assets would hurt her chances. But this time the wannabe video vixen’s ambitions would be the death of her.

A few hours after she and another young woman with her had silicone injected into their buttocks, Aderotimi was rushed to a Philadelphia hospital where, two days later, she died. Reports say the silicone used to inject Aderotimi was the industrial grade stuff---similar to caulking---not the medical grade silicone used in plastic and reconstructive surgery. Police believe the silicone may have traveled to Aderotimi’s lungs and heart and plugged a vein.

But this incident is not the first time an unsuspecting woman desperate for a cheap way to enhance her looks suffered a fatality. Solange Magnano, a 38-year-old former Miss Argentina and model, died after getting a substance injected in her buttocks in Buenos Aires in 2009.

Neither the U.S. Centers for Disease Control and Prevention nor the U.S. Food and Drug Administration keeps data on injuries or death from illicit injections. But a quick online search for “illegal butt injections” calls up many newspaper articles about women becoming ill or dying from these shots---and about law enforcement’s efforts to bust illegal providers.

Think about it, and be realistic. Is it safe to trust an unlicensed individual to perform a medical procedure in a motel room, back room of a spa or an unheated basement? Do you know if the syringes are clean---or what they contain?

Let’s do the math: One syringe filled with Juvederm typically costs between $800 and $1,300 per syringe, depending on the formula used and other factors. In some cases, you might need a second syringe to get the desired result. If your illegal procedure costs $1,500 total, do you actually believe you’re getting the real deal? Is your life worth the bargain?

But cosmetic plastic surgeons are also concerned about patients who have unrealistic expectations about procedures. As one doc puts it: A butt lift won’t make you look like Beyoncé or put you on the Victoria’s Secret runway.

Julius Few, MD, a Chicago-based, board-certified plastic surgeon and director of The Few Institute for Aesthetic Plastic Surgery, says most surgeons will screen patients for mental health issues. He also works with a psychologist who specializes in body image and cosmetic issues to make sure that patients are suitable for surgery.

He also reminds potential patients that people need time to recover from butt enhancement surgery. “If you don’t follow instructions for after the surgery, you might as well not have had the surgery in the first place. You need to follow your surgeon’s protocol for recovery.”

Few’s protocol includes sleeping on your stomach or side for two to six weeks, sitting for no longer than 45 minutes at a time and using a pillow when seated. In addition, he adds: “You also might not be able to shower for a few days after surgery; you won’t be able to work out at the gym for two weeks; and sex is not permitted for two to six weeks.”

Realistically, Few knows that many women don’t think beyond how good this surgery might make them look. But his bottom line for a butt enhancement procedure is this: Check with a board-certified cosmetic surgeon; ask for recommendations and before and after pictures; and be prepared for people to notice there may be something “different” about you these days.