The most commonly used materials are silicone implants and fat.
Buttock augmentation aims to increase the volume of the buttocks. It is addressed to patients who feel their buttocks are too small, and wish to add volume to them. The procedure requires the insertion of material that will provide the desired volume and curves. The technique employed for such an operation depends upon the type of material employed.
The use of silicone implants is the most frequently employed method. Recent years, however, have seen major developments in the use of fat to enhance the buttocks.
However, no matter which method is used, it is particularly important to utilize materials and techniques that have been verified and approved as safe, in order to prevent problems from occurring, as sometimes happens when, in order to cut costs, uncertified materials are used.
BUTTOCK AUGMENTATION TECHNIQUES
BUTTOCK AUGMENTATION VIA IMPLANTS
As in breast augmentation, silicone implants are employed in buttock augmentation. After all, before the manufacture of implants especially designed for the buttocks, plastic surgeons tended to use breast implants for this operation. Today, implants are available that have been designed for use on the buttocks. Their particular qualities pertain to their shape, and the density of the silicon.
As far as shape is concerned, there are two categories, round and shaped. As far as the density of the silicone is concerned, it is much more cohesive than the ones used for the breasts, and even solid on occasion. The choice of the implant’s type, as well as its size, is made after a consultation between doctor and patient and is entirely based on the particulars of the buttocks’ construction, as well as the patient’s wishes.
In order for the implant to be inserted into the buttocks, an incision must be made. This incision is vertical and is performed near the ilium. It is, therefore, on the upper end of the buttock groove. The incision is 6-8 centimeters long and a section of it situated between the buttocks, whilst the rest continues above them. Following suture and recovery a mark will remain, but it will not be particularly noticeable. Via this incision, the plastic surgeon creates a pocket in each buttock, where the implants are placed.
This has to do with the level between tissues, where the implant will be placed. The difference between them lies in the placement level, in relation to the gluteus maximum. This muscle is a fairly large one, which encompasses the entire area of the buttocks and is situated directly underneath the fat and skin of that area. The levels of placement which are generally used, ordered from the shallowest to the deepest, are the following four:
Above the Muscle
The implant is placed between the fat and muscle. This placement is the closest to the surface. Its advantages are that it causes little to no post-operative pain, and that the implant may be placed wherever we wish on the surface of the buttocks. The disadvantage is that precisely because the implant is quite close to the surface, it had been noted on multiple occasions that after some time it will begin to grow visible, resulting in a deformation.
Under the muscle’s fascia
The surface of the muscle is covered by a durable membrane. It is under this membrane that the implant will be deposited. The implant, therefore, is covered not only by skin and fat, but also this membrane. The advantages offered by this method are that it also causes little to no pain, the implant may be deposited anywhere in the buttock, and the fascia offers a more robust cover. On the hand, many practitioners claim that the cover offered by the fascia is not strong enough, and that after some time the implant will again begin to grow visible. This, of course, is not a point that is generally agreed upon.
Within the muscle
In this case, the implant is deposited within the muscle itself, meaning that approximately as much muscle is above the implant as there is under it. This method offers the advantage of being able to place the implant at any point of the buttock, but not as much possible as is the case with placements above the muscle. At the same time, of course, it provides the advantage of covering up the implant with muscle. This cover gives the buttock a more natural shape, and prevents the implant from growing visible after some time has passed. The main disadvantage of this method is the longer recovery time, i.e. the long period of time that is required to pass before the patient can return to their daily activities.
Underneath the muscle
In this case, the implant is placed even deeper, underneath the muscle. The advantage offered by this method is that it provides more cover for the implant, preventing it from becoming visible. On the other hand, of course, there is the disadvantage that this method can only be employed when we wish to fill the upper part of the buttock. The implant cannot be placed in the lower region of the buttock, as the very important sciatic nerve is placed there, and an implant in such proximity would cause it trouble. Of course, a youngster’s buttock is characterized by bulk in its upper regions, and therefore a placement in this area would not seem unnatural.
As each technique has its idiosyncrasies, it is best for the plastic surgeon to employ the technique best suited to the aesthetic demands of the patient, who wishes to improve the appearance of their buttocks.
The surgical procedure
Patients undergoing this procedure must be healthy and fully informed of the potential results of the operation. There must be no consumption of aspirin up to a week before the operation, or of alcohol up to two days before.
The operation lasts between approximately 1.5 and 2 hours.
While consulting with the doctor, the size and shape of the implant must also have been determined, based on the patient’s wishes, and the particulars of their case.
After the operation is complete, the patient is placed in a corset.
The required recovery period is usually one day. In some cases, an overnight stay at the hospital may not be necessary.
BUTTOCK AUGMENTATION VIA FAT TRANSFER
The patient’s own fat is a material that has seen increasing application within plastic surgery, in recent years. The plastic surgeon may use fat when we wish to add volume to an area that is lacking it. Fat is used to augment the size of the breasts and buttocks, improve facial contouring, and others. Fat is a completely safe material, as it originates from the patient’s organism. It can be obtained from the body usually in relatively large quantities.
How Buttock Augmentation is performed using Autologous Fat Transplantation
First, the plastic surgeon obtains fat from the patient through liposuction. The preferred areas for liposuction are the stomach and inner thighs. This is because these areas possess a greater quantity of stem cells. If, however, this fat is insufficient, the plastic surgeon can obtain it from any other part of the body. Special cannulas are used to collect the fat, which are harmless to the fat in comparison to those used in standard liposuction.
Once the plastic surgeon has obtained the required quantity of fat, he enters the second stage of the procedure, which involves processing the fat. This processing can be performed either using a particular centrifugation or via other methods of filtration.
Once this particular processing of the fat has been completed, the third stage follows. During this stage, the plastic surgeon implants the fat into the area of the buttocks. The amount of fat used will vary depending on the wishes of the patient, as far as the degree of augmentation is concerned, but also depending on the skin’s ability to distend in that area.
Buttock Augmentation Advantages via Fat Transfer
• The basic advantage is that fat can be deposited in any part of the buttock, which is sometimes impracticable when using implants.
• There are no visible incisions, leaving only a few faint marks, which will become indiscernible after some time.
• There is no particular pain following the operation.
• The recovery time is quite short.
• Two plastic surgical operations may be performed at the same time, as while the buttocks are being augmented using fat, unwanted fat may be removed from other parts of the body.
• The chance of complications arising is minimal and inconsequential, as fat is a material produced by the organism itself and there is no chance of rejection, since the organism recognizes it as its own.
The main disadvantage of this method is that the patient must possess a certain amount of fat for the surgeon to harvest. In addition, the amount of fat that can be deposited in this area is not unlimited, and if a patient wishes for a greater degree of augmentation he/she may well need to undergo the operation a second time. Also, a fraction of the deposited fat will be absorbed, while the rest will of course remain permanently in place.
The process of augmenting the buttocks using the autologous fat transfer method (also known as fat transplantation) is performed either using local or epidural or general anaesthesia. The patient needs only to remain in the hospital for a few hours after the operation.
Buttock augmentation via fat transplantation is a particularly demanding method, which has been used with increasing frequency recently, yielding acceptable results and requiring only a short recovery time. In particular, the evolution of techniques for obtaining and depositing the fat has ushered it into central stage as one of the major options of this sector, with satisfying results.
FOLLOWING BUTTOCK AUGMENTATION
The recovery period, as well as the period required before the patient can return to work, depends on various factors, such as placement level and the type of work each patient performs. Usually, this period totals between 3-10 days. Particular care should be taken when sitting, which should be avoided altogether for the first few days. The buttocks will be completely presentable after approximately 20 days. The final result will be visible after six months. The corset will need to be worn for approximately 30 days. Athletic activities can be resumed after approximately two months. In addition, provided the augmentation has been achieved through silicone implants, in future intramuscular injections to the buttocks must be avoided, so as not to rupture the implant.
Augmentation and Sagging Buttocks
Many patients who wish to augment their buttocks also wish to correct sagging. If the degree of sagging is small, then the augmentation alone may improve it. Middle to larger degrees of sagging require more than the augmentation itself; a buttock lift will need to be performed at the same time. The lift, of course, carries the disadvantage of incision, which after some time develop into scars or unsightly markings. Since these markings will improve over time but can never disappear completely, the patient should be made aware of this disadvantage and have come to terms with it.
In contrast, when augmentation only is being performed by using implants, the scars and markings are much smaller and more acceptable.
When augmenting via fat transfer, of course, the markings are very faint and frequently indiscernible.
On the other hand, of course, there is no point for a patient to attempt to achieve a buttock lift only by adding bulk to the buttocks, if their buttocks are already of a satisfactory size. Buttock augmentation is aimed at patients who have little volume in their buttocks, and not to patients who are simply experiencing sagging and wish to correct it, whilst having regularly-sized buttocks.