Sudden weight loss, improper development of the buttocks and ageing may give a flat appearance to the gluteal area. Even some medications can lead to a loss of fat in the gluteal region.
In cases where the loss is too much, and there is not much lax skin, the contours can be improved by an augmentation. Augmentation can be done using Autologus Fat Transfer (AFT) or Silicone Implants. Both women and men undergo the procedure. In men the position of the implant placement is a little higher as compared to women.
The “Brazilian butt lift” is actually transfer of fat from other areas into the buttocks (AFT) which helps in giving volume to the buttocks and hence a lift as well.
AFT is the same as for any other area. You can read about it here AFT
To improve the contours implants may be used, when either not enough fat is present or there is a need for specific areas of augmentation. The Implant maybe placed in two pockets viz. the sub cutaneous / sub fascial pocket or the sub/intra muscular pocket.
The approach is from the midline, with the patient in prone position going in between the gluteal folds. A plane is created on either side. The implant can be placed subcutaneously just under the skin and fat but above the muscle or intra muscularly, which is placement under the muscle fibers.
If the patient has enough subcutaneous fat then a subcutaneous implant can be inserted, but if the subcutaneous fat is less, a intra muscular placement is better so that the implant does not show. But the intra or sub muscular implant is usually smaller and gives better upper pole fullness – “Bubble butt”.
Similarly, if a patient is lean and thin and has a good lower pole fullness but flat upper pole, a sub muscular placement would give good results. But, if they are well built and need a more generalized or middle and lateral fullness then a sub fascial pocket is better.
Recovery time and pain are more in the submuscular placement.
Post-operative care is very important in buttock augmentations. The patient is usually prone for a week, sleeping on the tummy. Routine activities can be started after a day or two depending on his or her comfort.
No strenuous activity for around two to three weeks at least.
Till around 2-3 weeks, the patient has to sit on soft pillows and not on hard surfaces. A graded return to activity is preferred.
Planning, planning and planning are the three major pre requisites for a buttock augmentation more than anywhere else in the body. There are a lot many variations that can happen and realistic expectations are a must and will be guided by your bodily proportions and bony structure.
Displacement and rotation are important factors to consider in buttock implants. When done by untrained surgeons and more so when anatomical or tear drop shaped implants are used, chances of rotation and displacement are there.
The major problem that can occur is implant rejection. So the initial healing period is very important.
In the later stages, care should be taken not to get any Intramuscular injections in the buttocks.
A pressure garment is a must for the next few weeks.
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