‘Does my butt look big in this?’ was once the question asked by millions of women with body image issues. Now, a bigger backside is all the rage.

A record 28,600 women in the US had a cosmetic procedure to enhance their butts in 2022, figures show, up 54 percent in five years.

Their popularity is thought to have been driven by Instagram, alongside the rise of hip-hop culture and the ‘Kardashian effect’.

Plastic surgeons told DailyMail.com that while some transformations are more obvious — such as for rappers Nicki Minaj and Cardi B, and Kim Kardashian — a more subtle form of BBL has emerged in recent years.

KIM KARDASHIAN: Pictured above in 2008 (left) and in recent years. She has now gone for reductions to her alleged BBL

Larsa Pippen pictured before and after her alleged BBL. She has denied reports that she had surgery previously, saying her buttocks was down to ‘working out seven days a week’

IGGY AZALEA, shown left in 2013, was one of the surgeons’ favorite examples of a BBL. She has previously admitted to having the surgery

They speculated that celebrities including Jennifer Lopez and Latina singer Becky G have had ‘tweakments’ – where only a small amount of fat implanted into the buttocks to slightly accentuate natural curves.

The Brazilian Butt Lift (BBL) — also known as butt augmentation with fat grafting — rose to popularity in the mid-2010s.

Costing $8,000 to $10,000 per procedure, it is done by extracting fat from one area of the body — such as the waist or inner thigh — and implanting it into the buttocks.

The most common technique involves making four incisions into the buttocks and using a cannula — small tube-like medical instrument — to ‘plant’ fat cells into the area of the buttocks patients want to become more plump.

Women who receive BBLs will also have liposuction to reduce the amount of fat in their waist and accentuate their curves.

Some surgeons also use other techniques including silicone butt implants to accentuate the buttocks – though this technique is notoriously dangerous.

Dr Christopher Costa, a plastic surgeon and owner of Platinum Plastic Surgery in Las Vegas, said the best BBLs are those that ‘get the curves while maintaining their more natural look’.

He pointed to Iggy Azalea, 33, as having had one of the best BBLs in the business.

MADONNA pictured in 2016 (left) and 2022 has also gone for a BBL, according to the surgeons. The star, 65, has not previously confirmed that she had the procedure

JAMES CHARLES pictured above in 2017 (left) and 2023. He has confirmed he underwent a BBL

CARDI B, shown in two photos from Instagram, has also admitted to having a BBL. She later got her butt reduced after complaining about an odor

‘One of my favorites of all time is probably Iggy Azalea,’ he said.

‘She just had the right foundation for it, as she was carrying most of her weight in the lower part of her body and had a wider hip size

‘I use her photos to help my patients visualize what they may look like, when they come in and say they want a dramatic posterior.’

Others the surgeon pointed to included Nicki Minaj and Cardi B, who he said had both likely undergone multiple BBLs to achieve their large butts.

Iggy Azalea and Cardi B have both admitted to receiving a BBL, while Nicki Minaj previously said she had received illegal butt injections.

Both Nicki Minaj and Cardi B have previously expressed regret over their large posteriors, with Cardi B saying the operation led to her butt not smelling right.

But the surgeon said there has recently been a shift away from the larger buttocks, with more women now coming forward seeking only slight enhancements to their derrières.

Dr Costa said: ‘I still have patients coming in saying they want to get their butt as big as possible, and bringing in photos of stars like Nicki Minaj and Iggy Azalea.

‘But there is also a group coming for BBLs but moving away from the much larger buttocks.

‘They have seen women with big BBLs walking on the beach, and thought, “oh gosh, I would never want a BBL you know”.

‘But they are still coming in for the operations to get body contouring, or curves — to achieve that perfect hip-to-waist ratio.’

Among celebrities, surgeons suggested that Jennifer Lopez may be among those who has gone for the more subtle enhancements.

The 54-year-old star is famous for her pert bottom, but physicians say that as she got older they would have expected it to shrink — which hasn’t been the case.

NICKI MINAJ pictured above in 2001 (left) and 2015. Plastic surgeons said she likely had two or three operations to achieve her larger posterior

BECKY G (pictured above in 2015, left, and 2016) may be an example of someone who got a more natural BBL, surgeons said, which only slightly accentuated her figure. Becky G has not said she previously had a BBL

La La Anthony pictured in 2004 (left) and 2021, she is alleged to have received a BBL

Dr Daniel Barrett, a plastic surgeon in Beverly Hills, said: ‘She even commented herself on losing her nice butt that she is known for.

‘I think that is why it is possible that some sort of maintenance procedure was carried out — to help her get back to the same look.’

He added: ‘Often, with patients over the 50s who come in for a tummy tuck or liposuction, I say that we might as well do a fat transfer procedure to their butts because later in life they are going to regret not doing that.’

But those who get BBLs into their 60s and beyond risk their rear looking unnatural, according to Dr Barrett.

As an example of this, the surgeons pointed to Madonna, 65.

Dr Costa said: ‘If you look at her results, she got a lot of criticism that it didn’t look very good, that it looked a bit odd and out of proportion.

‘[That has] a lot to do with her age. Anyone who is in their 60s, they are not going to have the thickest skin and the best ligaments to hold up the tissue that has been transplanted.

‘And so, if you inject a lot of fat, then it is difficult to get a really good-looking and natural result.’

BBLs are also asked for by some men in the gay and trans community, both the surgeons said.

YouTube star James Charles is an example of this, and he has now admitted to a BBL to get a larger derrier.

Dr Costa said: ‘I have definitely done a lot of male BBLs. This trend has always been there though.

‘It’s pretty common that most of the men that are doing it are from South America and Colombia, and it leans more towards the LGBT community.

‘They want to make the butt look more sculpted and more muscular. However, there is a group too looking to make the butt look more feminized.’

KYLIE JENNER, pictured in 2013 (left) and 2019, is also alleged to have had a BBL. Kylie Jenner has not confirmed whether she received a BBL

Jennifer Lopez, 54, may also have had a BBL according to surgeons. They said that this was likely to maintain her buttocks, because they shrink as a person ages. Jennifer Lopez has not confirmed whether she had a BBL

Another celebrity in the smaller, more subtle BBL club may be Latina singer Becky G, according to Dr Costa.

He said: ‘I do now have people coming in saying I don’t want these big crazy butts, I just want to try and get these curves… more like Becky G.

‘It’s a very natural looking booty, and I think she may well be a good example of someone who had a subtle BBL.’

Becky G has also never confirmed rumors that she had a BBL.

One of the most worrying complications from BBLs is fat embolism, which is when fat cells get into the blood stream and travel to a vital organ like the heart or lungs where they may trigger internal bleeding and can prove fatal.

Other complications from the surgery include fat necrosis, or tissue death, and fluid retention — where fluids build up in certain areas and need further surgery to be removed.

Earlier this year, the CDC warned over butt lifts in the Dominican Republic — saying a total of 93 Americans had died their since 2008 after heading to the country in pursuit of a cut-price BBL.