A relatively misunderstood operation is that of buttock augmentation with silicone implants. The reason is that in the past there was a relatively increased rate of complications, both due to the materials and techniques used, resulting in it being rejected as a method by many plastic surgeons, myself included and seeking alternative ways, such as fat transfer and injectable treatments. However, thanks to the evolution of materials, new techniques and the experience of recent years, we are now talking about a very safe operation with excellent results, comparable to breast prosthetics.
For whom buttock augmentation surgery with implants is suitable
The operation concerns both women and men, without any strict age restriction. The ideal candidates for augmentation with silicone implants on the buttocks are people who anatomically do not have as developed the gluteal muscle, or due to low body weight have a loss of volume in the buttocks or have a general imbalance of the buttocks compared to the rest of the body.
Comparing buttock implants with fat transfer to the buttocks, the advantages are that this method can be applied practically to any person who needs to increase the buttocks regardless of weight, the result is much more reliable and does not change over the years and weight fluctuations, the change in size is much more remarkable and the shape given much more impressive.
This operation does not have to be identified with exaggerations and excessive buttocks. The aim is to give an ideal shape, without exaggerating in volume and ideally we want the changes to be natural. In some cases, buttock augmentation can also be combined with silicone implants and buttock liposculpture to achieve the ideal result. This hybrid method gives excellent results, because we ensure the size and shape with silicone implants, while at the same time we correct any imperfections with liposuction and fat transfer around the buttocks.
Selection of suitable materials
As in breast surgery, choosing the right implants is vital for the success of the operation. Buttock implants are quite similar to breast implants, but they contain much harder and more durable silicone and the shell is much stronger to withstand mechanical stress. In terms of shape, we distinguish round and anatomical implants, While in some companies there is also the possibility of an oval shape. The safest option is round silicone implants, because we eliminate the possibility of rotation compared to oval or anatomical ones.
In terms of size, the choice is based on measurements of the pelvis and buttocks, and from there the diameter of the implants is determined. In addition, the total size is also determined by the projection of intentions, i.e. their height. Precisely because we do not usually seek exaggerations, both for a more natural result and for safety reasons, we prefer to choose low or moderate implants.
It should be emphasized that under no circumstances should breast implants be used in the buttocks, no matter how tempting they may be in terms of cost. Mechanical stresses are much greater, and breast implants are much more likely to lead to premature rupture. On the contrary, buttock implants are designed for exactly this purpose and are much more durable.
Buttock augmentation technique with silicone implants
The operation is usually performed under general anaesthesia, with the patient in a prone position and lasts 1-1 and a half hours. The incision is placed in the intergluteal fold, that is, between the buttocks, and the length is 6-7 centimeters. This placement of the scar ensures minimal visibility and is always hidden between the buttocks.
The placement of implants can be done above the muscle, under the muscle or inside the gluteal muscle. Of these techniques that have been tried, the one that has the most natural results and the fewest complications is intramuscular, i.e. inside the gluteal muscle. It has the advantage of better coverage at the upper pole, so that the outline of the implants is not very prominent, while at the same time does not have the risks of placement under the muscle. Once the cavities are created and complete hemostasis is ensured, the complete aseptic placement of the buttock implants and the fixation of the gluteal muscles in the intergluteal fold are performed. No drains are inserted, unless there is a serious risk of bleeding or fluid collection. The suturing is done with biodegradable sutures that do not need removal.
In some cases we can apply the hybrid technique, which combines buttock plastic surgery with Brazilian buttock lift (BBL). After the implants are placed and the cavities are closed, liposuction is performed on the sides of the torso and possibly on the thighs and a part of the fat is placed with the EVL technique on the outer and upper pole of the buttocks. In this way we achieve perhaps the maximum correction in the size and shape of the buttocks.
Recovery after buttock augmentation surgery
Recovery is unfortunately a bit misunderstood and many patients come terrified before surgery, which is not really the case. After surgery, a special buttock elastic garment is placed and it is recommended to avoid buttock pressure for 3 weeks. This practically means that sleep should be done on your stomach, you need to pay attention to the way you sit in a chair and you also need to abstain from exercising for 6 weeks. In my experience, no patient complains of pain after surgery and does not need to be covered with strong painkillers. Usually there are no bruises and the swelling is very mild.
Regarding the result after buttock augmentation, the implants need 3-6 months in order to take their final position and be fully integrated. After this time there is no foreign body sensation at all, and also they do not interfere with sport activities. The result is extremely natural and it does not appear that any intervention has been made.
