Black women have been both criticized and praised for having ample, shapely behinds—-but we're not all lucky enough to be born with a curvaceous booty.  For years, the only option for changing the size and shape of your butt has been to go hard in the gym, which is excellent for your health, but can't always provide the hourglass look that so many of us desire. However, the last two decades have seen tremendous change in the field of cosmetic enhancements, from the dangerous and often-deadly backdoor (no pun intended) butt injections that are performed in hotel rooms and shady clinics, to the development of butt enhancement surgeries that are said to be safe, successful and responsible for more than a few entertainment industry careers.

The American Society for Aesthetic Plastic Surgery says that in 2013 alone, butt augmentation surgeries increased by a whopping 44%. One of the most sought out practitioners in the field is Dr. Matthew Schulman, who performs some 6-8 surgeries per week—-more than any other doctor on the East Coast. His signature "Scoop Lift" has brought clients to his Park Avenue office from places as far as Nigeria and the Middle East and the before and after pictures are astounding; flat-bottomed women of all shapes and sizes are transformed into curvy girls, without the droopy, unnatural look seen in far too many music videos. The procedure, which is performed in a private surgery center, can cost between $10-15k.

We caught up with Dr. Schulman to talk about the risks associated with the procedure, how he turns flatties to fatties and why Black women are beating down his door:

EBONY: How long has this procedure been around? And why do you think it's gaining so much popularity now?

Matthew Schulman: It’s been around for probably about 15 years but it’s really been increasing in popularity within the last 3 to 4 years. While we’ve been doing it for the longtime,  it’s really the last 3 years where it’s spiked in popularity.

There’s obviously a shift in trends. Just like fashion trends, I think that body trends shift as well. I think that we’re not in the time of the super thin waist type of model. Now people are embracing curves. That kind of cultural acceptance has increased demand for it. The other thing, the technique that I used which is a fat transfer has really improved over the past several years. I think that it’s almost a perfect storm. A combination of a changing trend of what people find attractive and desire and what’s more acceptable. Maybe it wasn’t accepted to like curves, but now people are more open to be curvy. I think that the improvement in technology has made it take off.

EBONY: What sort of looks do women ask for? Are they asking to look like certain big-bottomed celebrities?

MS: I mean, there’s always famous people that people will tell me about in consultations. Kim Kardashian, Nicki Minaj. Some women want to go as big. Some women mention their names and don’t want to look like that and I encourage that. When I see women in consultations, I specifically say ‘What look are you going for?’ and when they make appointments I often tell them to bring in pictures of what you like and what you don’t like. We all know what Kim Kardashian and Nicki’s butt looks like her. It’s easy for us to communicate. What happens is I see women and sometimes they say I don’t want to look that big and just want to be curvy and rounder. But they show me the picture of what they want and show me Nicki Minaj. I can give you that but that’s not what you tell me you want.

EBONY: What's the difference between what you do and the other butt enhancement procedures?

MS: There’s really three ways of increasing your butt size. Implants, silicon. Solid silicon rubber. It’s not the same type of implants we put in breasts. There’s butt injections with synthetic materials. With materials that will dissolve like in the face. There’s fat transfers. Each has its advantages or disadvantages. The butt implant may be good for someone who has no fat but I find that the buttock implant just makes your butt bigger. It doesn’t change the size, it doesn’t do much. You have the butt you start with, it’s just bigger. There’s a risk of an implant. It can move, it can shift, it can become infected. If it’s infected, it has to come out. The complication is raised significantly. It can be 10–20% complication rate. If you get a complication rate with a butt implant, it needs to come out. With injections, it’s not FDA-approved. No certified plastic surgeon will do butt injections. So anybody who’s doing butt injections are getting illegally in this country with a non-certified person, not even a doctor in some hotel room near an airport. We’ve heard about those stories. Those risks are potentially fatal. These fillers, you don’t know what you’re getting. It can cause blood clots. Loss of limbs, lost of life. The third alternative is fat transfer. The reason I do fat is because you get two procedures in one. Liposuction. It’s around the butt, the flank, the thighs. That itself is going to shape the butt because a lot of times the butt is fine. The fat around it needs to go away. I use that fat and inject it into the hips and change the size. You get the advantage of the liposuction and you get the advantage of me being able to change the butt and make it bigger, give you more hips. Butt implants don’t do hips. They just do the volume in the back not the side. The fat is your own. The risk of infection is no higher than the risk of liposuction.

EBONY: How safe is this procedure? What are the risks associated with it? And what does recovery look like?

MS: Bleeding, infection, anesthetic. They’re all single digit percentages of risk. It really hasn’t been a problem assuming you’re doing it with a board certified surgeon in a credited facility with the proper support team.

It hurts. Depending how much liposuction I do and how much fat I put in, I tell my patients to expect a lot of pain for the first five or six days. They’ll still have pain but feel much better over the second week but most of my patients will be back to work by the next week. But there’s definitely some healing that needs to happen .THere’s swelling so the butt can be bigger than they want it to be for the first 4 weeks and it probably takes 6 weeks to a few months to see the full advantage of the liposuction. So it definitely a harder recovery than just the regular liposuction.

EBONY: Who are the women coming in to have this done? 

MS: It’s very diverse. I don’t think the patients who've done this with me are the typical serial plastic surgery patients. You see that more in face work. If they’ve had their eyes done, they want their face done. That seems to go with the face. In general, these patients are younger. 18 to 35 years of age. I’ve done this procedure for 60 year old women. So there’s a lot of variety in general my patients are younger so maybe they haven’t quite caught the bug yet and they’ll come back for more so it’s always possible. But it’s not uncommon for this to be their first procedure.

I see a lot of Black women, a lot of Hispanic women. I think that Black and Hispanic probably make about 75% of my patients for this procedure. The other 25% percent could be the Upper East Side Jewish woman, someone you wouldn’t think would be the classic patient for this. So it’s really diverse. But I think clearly Black and Hispanic women make up the vast majority of my patients.

EBONY: Why do you think you see so many Black women?

MS: It’s unbelievable because so many people come in and say "I’ve been thinking about doing this my whole life." They just didn’t know there was a way to do it. There are some doctors who have  been doing this for ten years. I don’t think the technique was as great 10 years ago. I don’t think they got great results. Things are different now. I have Black women come in and say I never had a Black butt and it’s a big deal. It’s for family and community. They just didn’t feel they fit in. It’s life changing. Yeah, it’s cosmetic surgery but with any surgery you can’t underestimate the effect it has on someone’s self esteem and their relationships with other people.

EBONY: What sort of things should your patients consider before having this procedure? What are they dealing with after the transformation?

MS: A lot of my patients come in and they’re not looking for a subtle increase in their butt. Some come in and say "Make me as big as possible." I tell them that people are going to notice. You can’t hide a big butt when you’ve been flat. It’s very common in my patients, I do about 6 to 8 of these in a week, than anybody in the East Coast so I do more than in a week than most do in their whole career for this procedure. My wait list for the surgery may be four or five months. I tell them go get yourself some butt pads and start to set the stage for when your butt isn’t so flat because you’re going to show up to work and go to a family event and notice something’s different. So a lot of my patients will go and wear butt pads and increase them and set the stage and working out and doing a lot of squats so it’s not such a culture shock to their friends and co-workers.

In terms of after, I think there’s definitely some adjustment because I think it’s not uncommon to see relationships improve but it can also be the flip side. Relationships can deteriorate. I have just as many patients who come in and say ‘I got engaged,’ ‘I met a man,’ everything’s great. Or they may come in and say ‘Me and my boyfriend broke up.’ ‘I’m getting divorced.’ It happens. There’s no way to really prepare people for it. I’ll tell them they’re going to feel much better about themselves. That may change them.