There are many different procedures that can be performed to enhance the gluteal area all of which aim to achieve a better contour and nicer shape. In general, there are three major procedures for reshaping the gluteal area:
- Fat transfer (Brazilian butt lift)
- Butt implants
- Buttock lifting
The specific procedure used to enhance a patient’s buttocks will depend on the amount of projection desired, the quality and tone of the skin, the overall shape of the buttocks, and the amount of sagginess among others.
The most versatile procedure to transform such part of the body is the fat transfer or what is commonly known as the Brazilian butt lift. This procedure can be used to change the buttocks any way the patient wants. It helps increase the harmony of the buttocks to the waist ratio and their projection to the desired proportion. Not everybody is a good candidate for this procedure. If you have significant sagginess of your buttocks and/or your skin tone is poor, then, this procedure will not be able to lift your buttocks to the right level to achieve an acceptable outcome.
Performing buttock implants is an additional option that mainly increases the buttock‘s projection but does not necessarily shape the hips; it needs to be combined with liposuction and fat transfer to achieve the best results. However, like fat transfer, if you have significant flabby buttocks with excessive skin, then, this technique by itself will not correct this kind of deformity.
Finally, traditional excisional buttock lifting techniques can solve a wide range of problems associated with significant deformity secondary to excessive skin. In this particular procedure, reshaping is performed by rearranging the buttock’s soft tissue in such a way that it will have a better projection and will anchor the soft tissue to help achieve long lasting results.
THE BRAZILIAN BUTT LIFT
The famous Brazilian butt lift is in surgical terms a fat transfer procedure to the buttocks. The Brazilian butt lift is equivalent to butt shaping with fat transfer. In this procedure, areas with excess fat like the abdomen, flanks, thighs, arms, lower and upper back are sculpted. The fat that is removed is processed and re-injected or grafted into the buttock area. This procedure is a total body sculpting procedure through which, not only the shape of the buttock is made nicer, but the actual proportion of the hip to waist ratio is improved. This transformation creates, not only a nicer looking butt, but also a sexier figure. Although by augmenting the buttock the butt is actually lifted to some extent, the “butt lift” is an actual misnomer because long incisions are not done.
When we think about lifting an area of the body, we immediately think about long scars to reposition the butt to make it look more youthful. In this procedure, small incisions are done, not only to remove the fat with liposuction, but also to re-inject the fat into the buttock area. The butt is actually lifted to some extent by increasing its volume with fat injections. Think about the butt like a deflated balloon. When you inject air, it gets bigger and firmer and its overall shape is “lifted.”
Not everybody is a good candidate for this procedure though. There are many factors that are taken into consideration before doing a Brazilian butt lift and age is not one of them. It is well known that age by itself is not a contraindication for cosmetic surgery. The following is part of the criteria to determine if a patient is a good candidate for butt sculpting:
Amount of fat: We need fat and the bigger the desired butt, the more fat you will need. If you would also like to have relatively larger hips, then, you need to have more fat.
Location of the fat. The fat needs to be accessible.
Health: You cannot have any significant medical problems.
Shape of your body before your surgery. Not only the amount of fat will determine if you will have good results but also your hip to waist ratio, your bony/hip frame, the preoperative shape of your buttocks, and the length and width of your buttocks.
Quality of your skin: If your buttock skin is very saggy, then, you will not be a good candidate for just butt augmentation. You might need to have excision of the excess skin, which is a more traditional butt lift.
Realistic expectations: This procedure can do wonders to your body and can even transform you life, but you will need to be realistic on what to expect in terms of your goals and what the surgeon can provide. The results depend on a combination of multiple factors: your skin tone, shape of your body before surgery.
Overall, the main factor that determines if you are going to be a good candidate for the Brazilian butt lift will be your weight and the location of the fat in your body. In addition, the fat needs to be accessible, which means that it should be extra-abdominal fat, not intra-abdominal fat. Intra-abdominal fat is the fat around the liver and guts. This fat cannot be harvested. Only the fat that you can grab with your hand can be used for the procedure itself.
What if you do not have enough fat? Then, you will need to gain weight.
In order to do liposuction and harvest fat for any butt shaping procedure, small incisions (5 mm) are strategically placed in different areas. As part of the Brazilian butt lift, we can perform liposuction of the abdomen, flanks, thighs (if the patient wants this area to be liposuctioned) and upper and lower back.
- Local anesthesia is given with very fine needles.
- Small 3mm cannulas are used to inject the fat.
- Inject the fat in multiple passes.
- Inject the fat in different layers.
- Avoid excessive blood in the fat.
- Do not irrigate the fat with saline or any product. It has been shown that minimal handling of the fat gives better results than the “cleaning and washing approach.”
- Avoid the fat from being exposed to air for a long period of time.
- Avoid pressure on the buttocks that can damage the fat by not sitting for 10 – 14 days.
- Do not smoke.
- No sitting for about 2 weeks. This is very important because prolonged sitting will damage the fat.
- The fat behaves as a graft (no blood supply) during the first few weeks. Once the fat develops its own blood supply, then, sitting will be recommended.
- Walk and stretch your legs. You need to move, move, move… This will help to decrease the risk of developing clots.
- Do buttock stretching exercises. This will help with your recovery.
- Wear your girdle at all time. You can remove it to take a shower; then, wear the girdle again.
- After 2 weeks of sitting, use a cigar shape cushion when sitting. This will bump your buttock and avoid excessive pressure.
- Wear a compression stocking net the first day after surgery to help prevent clots. Drink plenty of fluid.
Implants are often used in plastic surgery to reshape and augment body parts like the female breast and the calf. Likewise, gluteal implants can improve the shape of patients’ buttocks. Not only do you look better, you’ll have more self-confidence and be more approachable, thanks to your shapely new figure.
The procedure is fairly straightforward and involves placing a single scar under the butt that, after healing, becomes so well-hidden, not even your closest intimate will be able to find it.
Many patients ask if an implant can leak. Breast implants which are filled with saline or silicone can leak, but the implants used to augment and shape the buttocks are made of solid silicone which cannot break or leak any fluid into your body.
The augmented rear end has a firm but natural feel, about like the feel of a person has who been working out with weights or exercising hard for many years. Moreover, you actually do not sit on the implant because it is placed somewhat higher than the bones on which you actually sit.
The actual surgical procedure can be done under a general anesthetic, a spinal, IV sedation, or an epidural block.
Evaluate The Buttock’s Shape
When undergoing butt augmentation with implants, patients will be presented with a variety of options. Some of these include shape (round and oval); filling (cohesive silicone or solid silicone); and surface (type, smooth or textured. Another important factor to consider is incision location. The three locations include: toward the top on both sides of the upper buttock; toward the bottom in both of the gluteal creases, where your “cheeks” meets the top of the thighs; and down the center of the sacrum, which is a vertical incision down the buttocks crease.
There are other variables, such as size, shape, and skin quality, that need to be considered before making any determinations about which butt augmentation procedure is best for you. If you are thin and wear a size two to four dress, you may not have enough bodily fat to spare for the fat transfer butt enhancement method; therefore, in order to create a new, curvier rear, you would have to receive butt implants.
When evaluating the shape of the buttock, we divide its anatomy into three sections; the upper buttock, the mid-buttock and the lower buttock. Each area needs to be evaluated and addressed separately to provide the best gluteal harmony.
When a gluteal enhancement is done, the implant is mainly augmenting the upper buttock and the upper portion of the mid buttock. It will not fill out the other areas. In the majority of patients, a careful analysis of the middle and lower buttock needs to be made. Complementary procedures may be required in order to improve the overall shape.
This type of operation involves placing an implant that is made of silicone (either cohesive silicone gel or solid silicone) in the buttocks to improve size, shape, and contour.
The implants are placed through a single, well-hidden incision that, when healed, nobody will ever see. In most cases, the implant is placed under the layers of buttock muscle and fat so it’s there to stay. Plus, there’s no danger of breaking and leaking because the implants are made of semi-solid silicone. After all, you sit on not the implants, but on the bones designed to support your weight. The actual implants are placed up higher in the buttocks.
Virtually all buttock implant patients say the new, curvy rear, along with its “wow” factor is worth it. Once healed, buttock implant patients love filling out new styles and really love filling out a bathing suit. Plus, you’ll have more self-confidence and be more approachable, thanks to your shapely new figure.
The final decision will be whether or not liposuction should be combined with the implant procedure to add further contour to the buttocks.
Most of the patients who were having the operation had flat buttocks, but they also had a role of excess fat in the upper-outer part of the buttock. They looked flat from the side but wide and flat from the back. After the augmentation, the patients had nice-looking results and a large wide look from all angles. We can combine the implant procedure with liposuction of the upper outer part of the buttock to improve the wide appearance. I then noticed a tremendous change in the contour and shape of the buttocks.
In some patients, liposuction of the lower buttock and outer thigh is also needed to improve the droopy look we can do buttock augmentations with liposuction.
The Operation: Buttock augmentation is done under local anesthesia with sedation or spinal anesthesia or general anesthesia that takes about an hour to perform. If liposuction is being done, then it may take an additional half hour.
You must be placed face down for the operation. A 5 to 6 cm (about ¼ inch) vertical incision is made in the well-hidden buttock center crease, the sacrum. The dissection continues on either side of the sacrum until the buttock muscle is reached. At this point, the muscle is incised and with careful dissection, a pocket is created for the implant within the muscle. Surprisingly, there is very little bleeding. The implants are inserted into the newly created pockets and the muscle closed over the implants.
The midline incision is then closed in layers. If liposuction is going to be done, it is performed through separate incisions.
Your New Look
After your butt implant procedure, you will need to wear a support garment for approximately two to three weeks. This will help the skin redrape properly and provide support to the augmented buttocks. Final results are noticeable three months after surgery. At this point, most of the swelling will be gone and the implants will be settled in their normal position.
At first, you will notice a definite difference in the gluteus contour, but because you are swollen, the buttock will appear very full, and will have a boxy appearance. You may also notice the implants sit quite high on the buttock. That is all normal, too; kindly remember that you are swollen. It will take at least three months for all the swelling to go down and for the implants to settle into their normal position. You may experience occasional temperature changes and numbness over the buttocks. But that will also improve over the next three months. You may feel a little timid and scared when sitting down, but remember the implant is much higher on the buttock than where you normally sit, so don’t worry.
TRADITIONAL BUTT LIFT
In the traditional butt lift, long scars are strategically placed around the gluteal contour to actually lift the buttocks and at the same time preserve soft tissue to augment them.
The range of problems that can be solved with a buttock lift requires careful analysis in order to tailor the solution using the most appropriate surgical techniques. The degree of sagginess, skin tone and laxity, amount of deflation of the buttocks, and location of the deformity are just a few of the many factors that must be taken into consideration.
- Upper buttock lift
- Lateral buttock lift
- Butterfly buttock lift
- Lower buttock lift
The upper buttock lift is one of the oldest procedures and is mostly used for those patients who have lost a lot of weight after a bariatric surgery. This is the only and most effective way to lift the buttock when the excess skin is severe. In this procedure, a long incision is done that follows the upper buttock contour. The buttocks are undermined and the excess skin and tissue are used to anchor the buttocks to the bone or deep tissue to avoid displacement of the scar and early sagginess of the soft tissues. In addition, the excess tissue is used to augment the buttocks. This procedure is like performing a tummy tuck in which a long scar is performed to remove the excess tissue but the scar is not a straight line; instead, it follows the superior roundness of the buttocks.
The lateral buttock lift is a technique that I use to enhance the buttocks when mainly the deformity of the buttocks is located on the sides and hips and the degree of sagginess of the butt is moderate. The incision is located around the hip buttock junction and the length of the incision is much shorter.
The butterfly buttock lift is a procedure that is very useful to enhance the buttocks in those cases where there is mild to moderate sagginess on the central buttocks. The incision follows the gluteal crease and extends to the sides following the junction of the lower back with the gluteus. This approach to buttock rejuvenation improves the actual sagginess but does not significantly lift the inferior gluteal crease.
The lower buttock lift is the procedure that I use to correct moderate ptosis in the area of the infragluteal fold by creating a new fold. In addition, it helps to correct the “banana role” in those patients who complain having either a double infragluteal fold or excess sagginess.