MEDFORD — Ellen Carmichael’s tiny ass had taken its toll on her self-image and self-esteem for nearly 23 years. But six months ago, on the recommendation of her boyfriend Richard, she underwent voluntary booty enhancement surgery.

The surgery, which added 17 inches and 14 pounds to Carmichael’s rump, was deemed a success by both Richard and her surgeon, Dr. Ernst Sayer — not to mention Carmichael herself, who reports that she’s "never felt wider or better."

Bootyplasty, the clinical term for the procedure, involves emptying tubs of lard through a catheter into shopping bag-sized balloons that are surgically implanted under the skin of the buttocks. The overall process can take up to four hours and 12 gallons of lard, depending on the desired booty size.

For Carmichael, the procedure brought closure to a youth filled with emotional strain.

"In high school, I’d get off the bus and people would say, ‘Where’s the rest of your behind? Must not have made it to school today!’" recounted Carmichael. "The guys in class would always go for the girls with the biggest booties. I just wanted to be like them."

Tears well up in Carmichael’s eyes as she recounts padding her jeans with loaves of Wonder Bread — a phenomenon now referred to as "breading the booty."

For the past two years Carmichael had been meeting regularly with Dr.Guidry Herbut, a psychologist who specializes in booty therapy. Herbut was helping her cope with her booty-related anxiety.

"Ellen basically needed to be reassured about her ass," says Herbut. "Since she felt it was being overlooked, we would spend countless hours in therapy just staring at it,

talking about it, addressing its needs. Finally we hit an impasse, and decided that what it really needed was to be a whole lot bigger."

Carmichael learned about bootyplasty from her boyfriend Richard, a self-proclaimed "ass-man" who had spent months researching various approaches to booty enhancement.

"I saw everything from booty growth hormones to therapeutic booty rubs," says Richard. "It wasn’t until I read about Doctor Sayer’s technique in More Ass Magazine that I realized there might just be hope."

Scientists agree that while all women have "an ass," very few actually have the "big ‘ol fat ass" that today’s men are looking for. Carmichael’s boyfriend Richard agrees.

Sayer believes that bootyplasty can potentially bring hope to thousands of women with small or average behinds.

"Many women feel insecure with the butts that they have," says Sayer. "It’s understandable: I too love a woman with a big ‘ol fat ass. If I can make an ass fatter I’m helping people everywhere [except on the bus]".

So how has Carmichael’s life changed since the surgery? "When I walk up to a club I can see the bouncers staring at my ass," she says, "because they know they’re going be the ones who help me squeeze through the door!"