BUTTOCK
AUGMENTATION

Buttock augmentation surgery involves using implants, fat grafting or sometimes a combination of both to increase the size of your buttocks. This procedure can:

• Increase fullness, roundness and projection of your buttocks
• Improve the balance of your figure
• Enhance your self-image and self-confidence

Buttock augmentation surgery is right for someone who does not like the shape of their buttocks or is looking to balance their body. It is performed in one of two ways, with implants or fat transfer. The fat transfer procedure is commonly known as a Brazilian butt lift.

Is it right for me?
Buttock augmentation is a very personal procedure and you should do it for yourself, not for someone else. It is a good option if:

• You are physically healthy
• You have realistic expectations
• You are bothered by the feeling that your buttocks are too small
• You are unhappy with the roundness or general shape of your buttocks
• Your buttocks are asymmetrical

During your consultation, be prepared to discuss:

• Why you want the surgery, your expectations and the desired outcome
• Medical conditions, drug allergies, and previous medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use

Your plastic surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Take photographs
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of buttock augmentation and any risks or potential complications

Prior to surgery, you may be asked to:

• Get a blood test
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin and certain anti-inflammatory drugs as they can increase bleeding

Buttock augmentation surgery may be performed in an accredited outpatient ambulatory surgical center or hospital. Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Your buttock augmentation surgery can be achieved through the use of implants, transferring your existing fat or, sometimes, a combination of both. Your surgeon may choose between a variety of incision patterns and techniques.

The appropriate technique for you will be determined based on:

• Buttocks size and shape
• The amount of fat you have on your body that is available for use through liposuction
• Your goals and activity level
• Skin quality and elasticity as well as the amount of extra skin

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you. No matter which type of buttock augmentation procedure you have, anesthesia will be used to ensure your comfort during the procedure.

Buttock Implant Procedure
Step 1 – Buttock implant procedure
Incisions will be made. Your surgeon may place incisions toward the top on both sides of the upper buttocks, toward the bottom in both of the gluteal creases (the areas where your “cheeks” meet the top of the thighs), between both cheeks (hidden in the crease) or down the center of the sacrum (the crease between the buttocks). The length of the incision and scar is directly related to the affected areas.

Step 2 – Implant placement
A silicone implant specially made for the buttocks is inserted either in the muscle or above the gluteal muscle on each side. The method for inserting and positioning implants depends on the type of implant, degree of enlargement desired, your body type and your surgeon’s recommendations.

Step 3 – Closing the incisions
Incisions are closed with layered sutures in the buttock tissue and skin adhesive or surgical tape.

Step 4 – See the results
The results of buttock augmentation are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to increase as you recover. Results of this surgery are permanent.

Fat Grafting/Brazilian Butt Lift Procedure
Step 1 – Liposuction
Liposuction is performed through small, inconspicuous incisions. First, diluted local anesthesia is infused to reduce bleeding and trauma. The cannula, a thin, hollow tube, is inserted through the incisions to loosen excess fat using a controlled back and forth motion. The dislodged fat is then suctioned out of the body using a surgical vacuum or syringe attached to the cannula. In general, your surgeon may use liposuction to remove up to three times the amount of fat than what will be injected into the buttocks.

Step 2 – Fat Injection
The fat, tissue and blood that were removed through liposuction are processed. Syringes are then connected to a special cannula and your surgeon will use this cannula to add the fat to the buttocks through small injections all over your buttocks.

Step 3 – See the results
The results of buttock augmentation are immediately visible; however you will not see your final results for up to a year after surgery, as time is needed for the fat to “take.” This procedure offers natural looking and feeling results, but the projection of the buttocks may decrease over time.

Some of the initial volume you experience after your fat grafting procedure will fade as the fat is absorbed by your body (on average, patients will retain 60-80% of the transferred fat). Satisfaction with your new image should continue to increase as you recover.

The decision to have buttock augmentation surgery is extremely personal. You will have to decide if the procedure will achieve your goals and if the risks and potential complications are acceptable. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

Risks of buttock augmentation with implants include:

• Infection
• Bleeding
• Opening of the incisions with implant exposed, requiring removal
• Scarring
• Nerve damage
• Firmness
• Implant rupture
• Implant migration
• Fluid accumulation (seroma)
• Pressure on your sciatic nerve
• Anesthesia risks

Risks of buttock augmentation by fat transfer include:

• Excessive loss of blood
• Blood clots
• Bruising
• Deep vein thrombosis, cardiac and pulmonary complications

• Possibility of revisional surgery
• Numbness and pain
• Fat embolism, injection of fat into the bloodstream that causes inflammation in the lungs
• Infection
• Fluid shifts and lidocaine toxicity
• Complications of liposuction
• Complications of anesthesia
• Swelling and bruising
• Asymmetry
• Possible need for a revisional surgery at a later date
• Fatty tissue found deep in the skin might die (fat necrosis)
• Anesthesia risks
• Oil cyst
• Hematoma
• Stretch marks
• Cellulite

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

After surgery, you will be taken into a recovery area to be closely monitored. Your buttocks will be wrapped in gauze dressings and an elastic bandage or support garment will minimize swelling as you heal. You may be permitted to go home after a few hours.

Before leaving, you will be given specific instructions that may include how to care for your buttocks following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with your plastic surgeon. You may be instructed to wear a support garment around the clock for the first week or two. It will be important to cleanse the incision sites and apply ointment as directed. Be sure to follow all instructions carefully.

After a post-surgical recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you will likely experience soreness and swelling for a few weeks. Exercise and normal activity can resume at the direction of your plastic surgeon.

Fat grafting recovery:
You will be asked to avoid prolonged sitting for about two weeks (some surgeons prefer longer). This is very important because prolonged sitting will damage the fat. You will also be encouraged to sleep face down or on your side. When you do have to sit, you will have to use a pillow or cushion placed behind the legs (hamstring muscles) to help raise the buttocks and avoid pressure on the fat grafts.

You will also be provided with a support garment that will apply even compression to the areas that were treated with liposuction. In addition, small temporary drains may be placed in existing incisions beneath the skin to remove any excess blood or fluid.

You will be given specific instructions that may include how to care for the surgical site and drains, specific concerns to look for in your general health and when to follow up with your plastic surgeon.

Your surgeon may encourage you to seek a lymphatic massage from a licensed massage therapist. You can generally resume exercise after six to eight weeks.

With either procedure, it is important to be informed about the steps you can take to aid your recovery. Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• How long will I wear the compression garment?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

It may take several months for the swelling to fully dissipate. As it does, your new contours and enhanced self-image should continue to develop.

The results of your buttock augmentation surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to increase as you recover from surgery. Incision lines are permanent, but will continue to fade over time. The final results of your buttock augmentation with implants will appear over the next few months as your buttock shape and position continue to settle.

If your procedure was performed with fat transfer, it can take up to a year to see your final results. Some of the fat that leads to the initial shape after surgery will be reabsorbed by your body.

It is also important to keep in mind that this fat can behave like any other fat in your body. As you gain or lose weight, your results may change as the transferred fat can grow or shrink just as any other fat in your body.

The results of your buttock augmentation surgery will be long lasting. Over time, your buttock size and shape can continue to change due to aging and gravity. You’ll be able to retain your new look longer if you:

• Maintain your weight
• Keep a healthy lifestyle

Cost is always a consideration in elective surgery. A surgeon’s cost for buttock augmentation may vary based on his or her experience, the type of procedure used and geographic location. Many plastic surgeons offer patient financing plans, so be sure to ask.

Cost may include:

• Surgeon’s fee
• Hospital or surgical facility costs
• Anesthesia fees
• Prescriptions for medication
• Post-surgery garments
• Any special pillows that may be required for your recovery
• Implant fees
• Medical tests

Most health insurance does not cover cosmetic surgery or its complications.

Your satisfaction involves more than a fee:
When choosing a plastic surgeon for buttock augmentation, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.

Plastic surgery involves many choices. The first and most important is selecting member of the American Society of Plastic Surgeons (ASPS) you can trust. ASPS member surgeons meet rigorous standards:

• Board certification by the American Board of Plastic Surgery® (ABPS) or in Canada by The Royal College of Physicians and Surgeons of Canada®

• Complete at least six years of surgical training following medical school with a minimum of three years of plastic surgery residency training
• Pass comprehensive oral and written exams
• Graduate from an accredited medical school
• Complete continuing medical education, including patient safety each year
• Perform surgery in accredited, state-licensed, or Medicare-certified surgical facilities

Do not be confused by other official sounding boards and certifications.
The ABPS is recognized by the American Board of Medical Specialties (ABMS), which has approved medical specialty boards since 1934. There is no ABMS-recognized certifying board with “cosmetic surgery” in its name. By choosing a member of The American Society of Plastic Surgeons, you can be assured that you are choosing a qualified, highly trained plastic surgeon who is board-certified by the ABPS or The Royal College of Physicians and Surgeons of Canada.