Sudden weight loss, improper development of the buttocks and ageing may give a flat appearance to the same. 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 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 method” is the transfer of fat from other areas into the buttocks to improve the contours or implants may be used. The Implant maybe placed in two pockets viz. the sub cutaneous / sub fascial pocket or the sub 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 sub muscularly, which is placement under the muscle.
If the patient has enough subcutaneous fat then a subcutaneous implant can be inserted, but if the subcutaneous fat is less, a sub muscular placement is better so that the implant does not show.
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 Op:
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.
Problems: Problems as associated with any other implant can occur here also, but are not as common as in nasal implants. 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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