Buttock Augmentation - Surgical Procedures

Surgical Procedures

Medical therapy

The resolution of the defects and deformities of the muscles of the gluteal region (the buttocks and the thighs) of the human body cannot be realized with medical therapy; thus, for example, a treatment with cellulite-diminishing cream is ineffective for correcting the corresponding physical faults respectively presented by the man and by the woman patient.

Surgical therapy

The resolution of the defects and deformities of the gluteal region can be realized surgically; yet, the assessment of the degree of severity of the injury organizes treatment therapies into three types: (i) buttocks augmentation, (ii) buttocks reduction, and (ii) contour irregularity treatments that combine surgery and liposculpture (fat-removal and fat-injection).

I. — Buttocks augmentation treatments

Gluteal implants

The augmentation of the buttocks is realized with a gluteal implant, which is emplaced under each gluteus maximus muscle; the insertion of the buttock prosthesis is through a midline incision (5–8-cm-wide) over the tailbone (coccyx). Augmentation with a gluteal implant is the method most effective for enlarging the buttocks of the man or of the woman whose body possesses few stores of excess adipose fat in the lower portion of the trunk, the buttocks and thighs, the anatomic regions where the human body usually stores excess body fat. Post-operatively, because of the cutting (incising) into the flesh of the tailbone muscles, the full healing of the augmented tissues can be approximately 6–8 months, in the course of which the gluteal-muscle tissues relax, and the settled buttocks prostheses are integrated to the gluteal region. The implantation procedure can be performed upon a patient who is either sedated or anaesthetized, either under general anaesthesia or under local anaesthesia. The usual operating-room time for a buttocks augmentation procedure is approximately 2 hours; and the medical procedure can be managed either as an overnight in-patient treatment, or as a hospital outpatient treatment. Given the nature of the surgical incisions to the gluteus maximus muscles, the therapeutic management of post-surgical pain (at the surgical-wound sites) and normal tissue-healing usually require a 4-6-week convalescence, after which, the patient resumes his or her normal-life activities.

Lipoinjection

The augmentation and contouring of the buttocks with autologous-fat transfer (lipoinjection) therapy is realized with the excess adipose-fat tissue harvested from the abdomen, flanks, and thighs of the patient. The gentle liposuction applied to harvest the autologous fat minimally disturbs the local tissues, especially the connective-tissue layer between the skin and the immediate subcutaneous muscle tissues. Then, the harvested fat is injected to the pertinent body area of the gluteal region, through a fine-gauge cannula inserted through a small incision, which produces a short and narrow scar. Lipoinjection contouring and augmentation with the patient’s own body fat avoids the possibility of tissue rejection, and is physically less invasive than buttocks-implant surgery. Therefore, depending upon the health of the patient, the convalescence period allows him or her to resume daily, normal-life activities at 2-days post-operative, and the full spectrum of physical activity at 2-weeks post-operative. Furthermore, the liposuction harvesting of the patient’s excess body fat improves the aesthetic appearance of the body fat donor-sites. Nonetheless, physiologically, the human body’s normal, health-management chemistry does resorb (break down and eliminate) some of the injected adipose-fat tissue, and so might diminish the augmentation. According to the degree of diminishment of the volume and contour caused by the fat-resorption, the patient might require additional sessions of fat-transfer therapy to achieve the desired size, shape, and contour of the buttocks.

Body contouring

The augmentation of the buttocks, by rearranging and enhancing the pertinent muscle and fat tissues of the gluteal region, is realized with a combined gluteoplasty procedure of surgery (subcutaneous dermal-fat flaps) and liposculpture (fat-suction, fat-injection). Therapeutically, such a combined correction-and-enhancement procedure is a realistic and feasible lower-body-lift treatment for the man and for the woman patient who has undergone massive weight loss (MWL) in the course of resolving obesity with bariatric surgery. In the case of the man or woman who presents under-projected, flat buttocks (gluteal hypoplasia), and a degree of gluteal-muscle ptosis (prolapsation, falling forward), wherein neither gluteal-implant surgery nor lipoinjection would be adequate to restoring the natural anatomic contour of the gluteal region, the application of a combined treatment of autologous dermal-fat flap surgery and lipoinjection can achieve the required functional correction and aesthetic contour.

II. — Buttocks reduction treatments

The methods for reducing the size of the buttocks include the varieties of liposuction, such as lipectomy (with and without ultrasonic enhancement) to reduce excess body fat, and superficial liposculpture, to reshape, refine, and re-establish the natural contour of the body. The usual buttocks-reduction treatment is lipectomy with applied tumescence and anaesthesia, wherein the body fat is harvested by aspiration (suction) through a small-gauge cannula (2-4 mm) that is inserted through a small incision, either to the intergluteal sulcus (the butt-crack), or to the upper area of the gluteus maximus muscle proper.

Ultrasonic lipectomy

Ultrasonically-assisted liposuction can quickly remove a large volume of body fat for the correction of a notable occurrence of lipodystrophy, a deposit of adipose fat to the buttocks and related anatomic areas. The ultrasonic liposuction machine liquefies the excess fat tissue, and so more readily facilitates its removal with conventional suction-lipectomy. The quick fat-harvesting allowed by the ultrasonic lipectomy technique has eliminated the larger (long and wide) surgical incisions that once were required for removing a large volume of adipose tissue. Nonetheless, because of the sensitivity of the gluteal-region tissues, the skin of the pertinent donor-site is cooled in order to prevent ultrasonic heat damage caused by the liquefying and removal of the excess adipose fat.

Superficial liposculpture

Reshaping the buttocks with liposculpture is performed with a small cannula (2 mm) specifically for contouring superficial body fat, the configuration of which (number of open ports) is determined by the type and the degree of gluteal correction to be realized. To sculpt rounded contours to square-shaped buttocks muscles, superficial liposculpture allows the plastic surgeon to control the injection-rate of the fat-volume. Moreover, superficial liposuction can be combined with other treatment methods for contouring the gluteal region to achieve the required functional, anatomic correction, and the aesthetic enhancement sought by the patient, such as reshaping the lateral area of the buttocks into an athletic form. The study Contouring the Gluteal Region with Tumescent Liposculpture (2011) indicated that effective, gluteal-region contouring is best achieved by tailoring the liposuction-reduction and the lipoinjection-augmentation techniques to the anatomic topography of the body areas to be corrected. Furthermore, the study Contouring of the Gluteal Region in Women: Enhancement and Augmentation (2011) indicated that natural contours of the buttocks and the thighs are effectively achieved with a combined gluteoplasty of selective liposuction and lipoinjection, which reduces the need for aggressive surgical procedures, decreases the risk of medical complications, abbreviates wound-recovery-time, and lessens post-operative scarring. Combined with any buttocks-correction method, superficial liposculpture facilitates the treatment of contour irregularities, the surgical revision of scars, and the correction of gluteal-region contour depressions.