Before we get into the specific issues of buttock augmentation, let us clarify the similar but different issues in regards to lower body procedures.
We have lower body lift, we have back lift we have Brazilian lift, we have buttock lift we have buttock enhancement and augmentation.
Lower body lift usually refers to a procedure whereby an incision is made somewhere at the level of the upper underwear and excess skin from the buttocks is removed.
Back lift is similar in incision but the goal is to remove the redundant skin in the lower back rather than the buttocks.
Brazilian buttock augmentation usually refers to large volume fat grafting to the buttock area.
In buttock augmentation, the goal is to provide more fullness in the buttock area.
In buttock enhancement we take a more comprehensive look at the lower back and buttock area and upper lateral thighs, and analyze how we can make it more harmonious and esthetic.
For that purpose we are going to look at the hip area, the buttock area itself in term of fullness tissue quality and fat distribution, and we are going to look at the trochanteric areas (saddle bags area).
We will see where the proportions need to be improved and formulate a plan that may include implant, liposuction, fat grafting or skin resection.
There are two ways to go about achieving a fuller " derriere.
" One is by using implants the second is by putting fat taken from another part of the body and placing it in the buttock area.
At times both procedures are needed in order to achieve the expected outcome.
First let us talk about the implants themselves.
The implants are made of a very soft silicone solid.
They are not a liquid and not gel either.
They are different than the implants used for breast augmentation.
And because they are made of a very soft solid even if it was cut torn or pierced for instance during a medication injection, no untoward effect would result.
There are different sizes available and there are different shapes available.
I only use a round implant.
The principal reason is that if the implant was to rotate and it was oblong the position then a significant deformity would result, but when it is round and it rotates then no visual difference would result.
The implant pocket is made exactly to the size of the implant so there is not too much possibility for the implant of moving and within 3 weeks after the surgery the body will have created a sufficient amount of scar tissue around the implant that will prevent the implant from migrating.
The incision is 7cm in length it is placed in the buttock fold and it is made in a specialized way as to provide adequate healing and sealing of the space created.
The care of that incision is very simple: after shower or after the use of the bathroom the incision and the tape that is on top of that are painted with an iodine based antiseptic.
If the shape that needs to be added to the buttock is not exactly round then we do a combination of procedures, the implant providing the central part of the enhancement and the fat grafting providing the contouring.
This is also very applicable in a situation where there is not enough fat to provide the projection needed so that an implant in combination with fat will be able to enhance the result achieved.
Fat transfer grafting is the other way we can achieve fullness in the buttock area, some people have advertised it as a Brazilian buttock lift.
There is no agreed definition as to what constitutes a Brazilian lift.
When fat is transferred from one part of the body to another (in this situation the buttocks) it is transferred without its nourishment.
In order for the fat to survive in its new location nourishment has to come from the recipient site.
This is a most important concept because in order to ensure survival of fat it has to be placed in small quantities all over the area to be enhanced.
Placing large pools of fat in an area will not lead to a successful "take" and the fat will die causing potential infection, hard masses and discomfort.
This means that the limiting factor in augmentation with fat is the size of the recipient area as much as it is the availability of fat to be transferred.
If the recipient area is thin and small then a limited mount of fat can be successfully placed.
And in that situation we would need an implant possibly in combination with fat grafting.
Harvesting the fat properly is also important.
It needs to be done in a septic technique in a "no touch technique".
What is meant by that is that the fat is aspirated, kept in a container and never exposed to air, and never manipulated directly by surgical instruments.
In order to ensure the consistent and predictable amount of fat placed in a given area, I have designed a device that allows me to place a preset amount of fat at a specific depth in the tissue and at a preset distance from the area that was just injected.
This in my mind is the best way to have the graft fat survive in its recipient area.
This equipment has also streamlined the process and allows me to place larger amounts of fat in a shorter period of time.
This is important because survival of the fat is enhanced by shortening the amount of time it is kept outside the body.
Post operatively it is very important to stay off the area that was grafted to allow the area proper circulation for the survival of the grafted tissue without the interference of pressure and weight.
All these procedures are done as an outpatient under general anesthesia it takes approx 2 to 3 hours.
After surgery the patient can lie on their back provided they place a rolled foam or pillow in the lower back area in order to keep the pressure off the buttock area.
For the first few days when the patient needs to use the bathroom, they will rest on their thigh rather than on the buttock.
After the surgery a leotard type garment is placed and it is recommended that it be used for the first 3 weeks all the time.