The buttocks have a fundamental role in the female and male silhouette, the set formed by the prominence of the buttocks and the sinuosity created between the waist and the hip are the main characteristic of the female contour and these curved lines and with rounded volumes is the main difference in the posterior contour with respect to the male body that presents straight lines and square volumes.
The shape of the buttocks:
Their morphology depends on age, sex, weight, constitution (bone structure) and race. In women with normal body mass index most of the volume of the buttocks is provided by the amount and distribution of fat, while in men this area has little fat and its volume is mainly muscular.
The important role of the buttocks:
The female buttocks cannot be denied an important role as a sexual attractiveness for the male sex and the greater the more differentiated from the male: that is, more curvilinear and rounded. The buttocks play the same role in the back of the body as the breasts play in the front. The most relevant characteristics of both coincide: projection and rounded shapes, essential attributes of femininity.
Butt Augmentation for Men:
In the case of men, an increase in volume is usually sought, maintaining the male proportions and without totally correcting the trochanteric depressions, although there are patients who also request an increase and correction of the lateral depressions characteristic of the male sex.
Butt Augmentation: The Alternatives
There are basically two alternatives for buttock augmentation: Butt implants and the injection of the patient’s own fat or lipoinjection. In very thin patients in whom fat deposits are minimal, silicone implants are preferred. When the patient has sufficient fat deposits, liposuction can be done with gluteal lipoinjection, obtaining as an additional benefit the improvement of the contour in areas neighboring the buttocks. This technique is known as lipostructure.
Injections of liquid silicone, biogel or other foreign substances sometimes called “biopolymers” can leave extremely unwieldy sequelae and are not recommended.
Buttock implants:
The buttock implants used for augmentation are constituted by a smooth or textured silicone elastomer membrane filled with silicone gel of high cohesiveness with the consistency and resistance necessary for the region. They occur in the oval and round bases and in low or high projection.
Choice of implant:
Different types of implants can be chosen. There are round and oval prostheses, high or low profile and each of these prostheses have their indication.
Oval implants can be very effective for selective augmentations if we use the intramuscular technique that allows us a lot of variability in placement to correct specific defects.
The choice of implant varies according to the sex of the patient and what we want to achieve.
Butt implants for men:
In men, having less subcutaneous fatty tissue, the differences between oval or round prostheses become more evident, being a precise choice: oval implant if we want to maintain male characteristics while preserving trochanteric depression and more athletic buttocks; round if we want to obtain some feminine characteristics.
Butt implants for women:
In women it depends on the amount of adipose tissue: round prostheses offer greater projection but if the adipose tissue is very thin it is better to place low-profile oval prostheses so that the prostheses are not visible during movement.
The size of the prosthesis can be chosen depending on the patient’s pelvis and her wishes.
Butt implant placement:
As for the placement technique there are three techniques described: the submuscular (below the muscle), the intramuscular (inside the muscle) and the subfascial (below the muscle fascia and above the muscle). We recommend only the intramuscular technique.
Planning butt augmentation surgery:
First visit, expectations, measurements.
After making a first complete visit where the patient will be asked all the background and habits. It is important to perform a complete examination of the entire posterior contour of the patient.
The most important factors to assess are: the projection, the gluteal groove, the firmness of the tissues, the quality of the skin and above all the anterior the posterior contour.
Factors to be assessed in the posterior contour of the patient: the different areas of the posterior vision of the body must be evaluated together:
- Excessive fatty deposits on the hips seem to decrease the projection of the buttock.
- The cartridge cases give the feeling of excessively heavy buttocks.
- Lack of waist and excessive fat deposits in the sacral area also visually decrease gluteal projection.
Thus, in the first visit, those factors that associated with the buttock implant or the filling with fat can improve the results will be assessed, as well as those cases that will not be tributaries of an augmentation with prosthesis.
Postoperative care:
- In the hospital
The patient should be in the room on his back or side avoiding upside down placement that can cause irritation of the sciatic nerve by blood secretions and edema (inflammation).
When the patient is on his back, he should be placed in the Fowler position with flexion of the torso and knees with pillows placed in the sacral region and in the upper part of the thighs thus avoiding compression on the buttock especially on the implant.
We usually leave the drainage for 48 hours thus avoiding blood collections that can irritate the sciatic nerve and cause significant pain in the postoperative period.
Hospital admission is 48 hours from admission. During this period the patient carries an epidural catheter with analgesia.
During the first day of admission the patient remains in bed.
From the day after surgery the patient begins ambulation to facilitate the accommodation of the prosthesis and extend a little the muscles that will be contractured. The patient continues until the day of discharge with the epidural catheter and is reinforced with oral medication.
- At home
The patient can sit, shower and even sit normally in the service. After going to the bathroom it is advisable to clean with soap and water and then apply an antiseptic on the wound.
You can drive from 10 days and start light exercises from the month. The patient should avoid heavy exercises, strength in the muscles of the buttock and great flexion of the trunk during the first two months to prevent the space created for the gluteal prosthesis from widening more than the account.