Buttock Implants (Gluteoplasty)
Many men and women are simply dissatisfied with the size, shape and contour of their buttocks. Underprojected, flat and/or sagging buttocks do not fit their ideal self-image. Body-image is an important part of feeling good, desirable and confident. For many this surgical procedure can make a dramatic impact in the quest for the body beautiful.
Buttock implants, also known as gluteal augmentation, gluteal implants or gluteoplasty, is a surgical procedure designed to add fullness and projection to the underprojected or flat buttock area. This procedure involves inserting a soft high grade, solid silicone implant into the muscular space of the buttock area. To the touch, it has the feeling and consistency of a flexed muscle. Unlike breast enlargement, after this procedure is properly completed and healed, there is no reason to require additional surgery in the future. These implants can be round or oval and come in a variety of sizes. A consultation and physical exam is needed to determine the appropriate size and shape for each individual.
It is important also to understand that the definition and contour of the buttocks is due in great part to the size and shape of the surrounding tissues. Excess and localized fat deposits of the hips, waist, low back and upper thighs may obscure the definition and shapely contour of the buttocks. Frequently liposculpture of any combination of the hips, waist, low back and upper thighs is done simultaneously with buttock implants to further enhance the shape and contour of the buttocks.
For those who have excess sagging of the skin or folds of the buttocks, a buttock lift from above or a local skin excision from the crease below may be desirable. This is generally reserved for more extreme cases with the understanding that more extensive scarring will result. Generally, these scars are easily hidden within the bikini, bathing suit or undergarment lines.
An ideal candidate for buttock implants (gluteoplasty) is a man or woman dissatisfied with the underprojection or flat appearance of their buttocks who is free of any complicating pre-existing medical conditions including heart disease, high blood pressure, diabetes, skin/connective tissue disorders, etc.
The Consultation
The initial consultation is extremely important to review the patient's medical history, goals and expectations as well as build mutual trust and rapport. Before and after photos are reviewed. The procedure is carefully explained and the alternatives discussed. Understand that each patient has different buttock/gluteal contours, projection and sizes as well as different expectations and requests. No one procedure can be expected to fulfill each individual's needs. A complete evaluation and physical examination is performed for each individual patient to ensure that expectations can be met as well as to determine the best choice of procedure(s) and the size and shape of the implants to be used. The surgical plans as well as the incision/scar placement are reviewed. It is important to understand that every effort is made to accomplish the desired set of goals, however, no guarantees as to the exact size, projection and contour of the buttocks can be made by any surgeon.
Prospective patients are encouraged to speak with previous patients about their surgery and results. Dr. Gershenbaum and his staff are always available for questions. Following the initial consultation and after appropriate time for reflection and decision-making, an appointment is scheduled for routine preparation and informed consent. Additional questions and concerns may also be addressed. Routine blood analysis and medical clearance is required prior to surgery.
The Operation
This surgical procedure is generally performed in our state-of-the-art out patient facility under general anesthesia. Epidural (spinal) anesthesia may also be used at times. This surgical procedure takes approximately one and one-half to two hours to perform. Liposculpture and/or lifting procedures can add an additional one to three hours or longer. The surgical plan including implant placement and liposculpture is outlined prior to surgery. While in the sitting position, it must be assured that the implant is positioned above the weight-bearing area. After speaking with the anesthetist/anesthesiologist, the patient is brought to the operating room. After asleep, local nerve blocks combined with a medication that shrinks blood vessels and capillaries to reduce any bleeding are instilled.
A 5 to 7 cm incision is made vertically in the midline between the upper aspect of the buttocks. A "pocket" or space is created under each gluteal muscle of the buttocks corresponding to the plan outlined on the skin. The implants are then inserted. Prior to the closure, a long acting anesthetic is poured around the implants, which dramatically reduces post-operative discomfort. The incision is closed with sutures below the level of the skin to avoid cross hatching and suture marks.
Liposculpture, if planned, is next performed corresponding to the areas outlined on the skin for further enhancement and definition. (see liposculpture under "procedures").
A buttock-thigh lift is reserved for more extreme cases of excessive drooping of the buttock area and can be performed in conjunction with buttock (gluteal) implants (see buttock-thigh lift under "procedures"). Other times, for excessive sagging along the buttock folds a more simple local skin excision can be performed with the incision/scar following the crease below. These two additional procedures are reserved for more extreme cases with the understanding that more extensive scarring will result.
At the conclusion of surgery a light dressing and an elastic compression garment is applied over the surgical areas.
The Recovery Period (Post Operatively)
After surgery, patients will experience some swelling and soreness/pain around the surgical area. The uncomfortable part of recovery generally lasts 7 to 10 days in which pain is controlled with oral medications. Gentle stretching exercises with knee raises begin immediately after surgery. The patient will remain on their stomach and sides for the first 48 hours. Compression garments are generally worn for two to three weeks. Routine activities may resume at two weeks and exercise started at 8 weeks post-op. Recovery and healing will vary from patient to patient and depend on the extent of surgery. It must be remembered that complete healing takes time and patience, taking several months before realizing the final results of surgery.
Complications
As with most cosmetic surgical procedures, complications are unlikely when performed by a skilled and competent surgeon. Complications include, but are not limited to anesthesia risks, bleeding, infection, fluid accumulation under the skin (seroma) which may need to be drained, nerve damage, poor wound healing and unsatisfactory scars. Also possible is asymmetry, displacement, hardening of scar tissue around the implant and need for revisional surgery or even removal of the implants. Also rare, but possible, are blood clots or emboli (blood clots which dislodge and travel in the blood stream to distant sites) which can be fatal.
At Aventura Center for Cosmetic Surgery, Venodyne calf compression devices are used for every buttock (gluteal) implant surgery (as well as many other surgeries). Venodynes are pressure cuffs that fit over each lower leg from the ankle to the knee circulating every one to two minutes to reduce the pooling of blood in the lower extremities and further reduce the possibility of blood clots or emboli. In addition, smokers must stop smoking well in advance of surgery. Smoking seriously decreases blood circulation in the skin, which increases the risk of complications and poor healing.
Contact our cosmetic surgery office to schedule a buttock implant consultation.
