When your goal is buttock augmentation, I believe the first option that we should discus is liposuction of the torso with fat grafting to the frame and butt. However, there is a small subset of individuals that simply do not have enough fat to sufficiently augment their buttocks and change their overall frame shape. In these individuals, there are essentially two other options for buttock augmentation:
What is the difference between Butt Implants vs Butt Fillers? Why should you go with one over the other? Overall, this is best answered in a consultation. In general, Butt Implants are form stable implants that can provide significant buttock projection. Butt implants are especially useful in patients that have minimal to no volume or projection. The butt implants are also very useful in individuals that have “firm” or “tight” skin and tissue that requires an implantable device to help force the skin and tissue to expand, create shape, and projection. The main negative to buttock implants are the recovery and sitting restrictions immediately after surgery.
Medical grade fillers, typically I utilize Sculptra®, are another great option to provide volume to the butt or the frame. Fillers behave in the same way as fat. The fillers can provide more volume and fullness to the butt and/or frame. Butt fillers also have the positive of being performed in the office, do not require anesthesia, and do not require any sitting restrictions. The main negative to butt filler are the cost of the fillers. Butt fillers, like fat, have limitations: (1) if you have tight or firm skin (think a very flat butt), then the filler has a limitation of how much it can push out the butt, (2) if you are wanting a significant volume increase from fillers, there is a physical limit, again like fat, to how much filler can be placed at one time; however, more filler can be placed at a later date. Overall, medical fillers are a great option and are very popular in people that cannot afford downtime and/or sitting restrictions.
So why would you choose a Butt Implant over Butt Fillers? If you have a tight, firm, or a very flat butt, then a butt implant is likely a better choice for you. If you are wanting a significant volume or projection difference where we really are needing the implant to “push the butt out”, then a butt implant is likely a better choice for you. If you like the round shape of an implant, then I would suggest utilizing the butt implant for augmentation. If you do not want to have to deal with having fillers replaced every couple of years, then a butt implant is a better choice. Overall, I think both options have their merits. The specific goals of the individual help to determine the correct treatment.
Butt implants are sized in a similar way to the breasts, to ensure we get a volume that fits or matches your buttocks. We take measurements of the width of your butt to so that we choose implant widths that are the right size and not too wide or too narrow for your butt. This is extremely important because if we choose an implant that is too narrow, it will make your buttocks look “boxy” or “square”. If we choose an implant that is too big, then we risk the implant coming out of the incision. This is why, I place so much importance on properly measuring and sizing you when we discuss choosing the implants.
Differences between Breast and Butt Implants
Unlike breast implants, Butt Implants are form solid (think of one of those stress-balls). This means that the Butt Implant is not designed to be replaced after a set amount of time. In addition, due to the solid nature of the implant, the butt implant can be carved or sculpted, if needed, to better fit the buttocks shape. The final major difference is the difference in volume change after augmentation. The form stable and solid design of the butt implant allows the implant to create significantly more projection and shape change to the butt. A 379cc Butt Implant gives significantly more butt projection and shape change than a 379cc Breast Implant gives to the Breast. A way I like to think of it is a Butt Implant gives about 1.5x times more projection and shape change than a Breast Implant. For example: a 400cc Butt Implant behaves or gives the shape change and projection to the Butt as 600cc Breast Implant (400cc x 1.5= 600cc).
Implant Styles & Shapes
Butt Implants have two main shapes: 1) Round and 2) Anatomic also known as Butt Shaped (which is essentially oval). For the most part, I prefer a round shaped implant. Why? Because overall we are typically trying to create a “full” and “round” shape to the butt. This then creates the base of the hour glass. In addition, we don’t have to worry about the implant “spinning” as you do with an anatomic shaped implant.
Unlike breast implants, butt implants come in a more limited amount of volume (i.e. cc’s). Just like the width of the implant is important, how far the implant sticks out (projection) is also important. Based on your specific goals we will help you choose the specific type (measurements) for your implant.
Also, unlike breast implants butt implants are not designed to be changed out after a certain time period (for example most breast implants have warranties that last ten years). The specific volume that we use depends on your specific goals, frame shape, butt width, and type of skin. As a general guideline I categorize the following sizes:
I do not recommend going larger than 540cc for the initial butt augmentation. I feel the negatives of larger implants are too significant and are not recommended. There are a few specific instances where we may be able to perform a larger volume implant. However, this is not the norm.
Butt Implant Augmentation Surgery is a Same-Day surgery (You get to go home after surgery). The surgery can be performed under IV sedation; however, it is significantly better tolerated with general anesthesia. The implants are placed by making an incision that hides in butt cleft. The implants can be placed above the muscle (but below the muscular fascia) or within the muscle itself. Unlike breast implants, we do not place the implant completely below the muscle because there are important nerves and blood vessels that could potentially become damaged. The idea is the scar will hide in the butt cleft shadow and/or be covered by underwear or a bathing suit. The surgery takes about 1-2 hours. I will always place a sizer first to make sure I am happy with the implant pocket prior to placing the implant. I always worry about the risk of infection with any implant surgery and therefore I always clean all the areas with antibiotic solution before placing the implant. The incisions are closed with dissolvable sutures. After closing the incisions you are placed in compressive shorts.
The first thing we should discuss with a butt implant augmentation is the sitting restrictions. You have to be able to follow the sitting restrictions. If you do not follow it, you will cause irreparable damages to the implant that may ruin you result. I am not trying to be negative; I just want you to have realistic expectations and requirements of the surgery.
How long are the sitting restrictions? No sitting or laying on the butt or side for 2 weeks. Rarely, this is longer if the incisions take longer to heal (an additional 2-4 weeks). Then, you are able to sit utilizing a butt pillow (i.e. booty pillow, happy booty pillow etc).
As a quick reference for the sitting protocol:
Return to Work
The return to work largely depends on whether you are required to sit. If so, then you will need to wait until at least after 2 weeks when you are typically transitioned to the sitting pillow.
Return to Gym & Activity
You are immediately released to walk (not strenuous) after surgery. We want you walking as much as possible after surgery. This helps to quicken your recovery and decrease the risks of some post-operative complications. You are able to go back to the gym at 6 weeks. You are able to perform gluteal exercises and weights at 8 weeks.
In some individuals, there is fat present but not enough to do a complete butt augmentation with fat; in these individuals, I like to get the majority of the shape and size with the implant and then perform liposuction with fat grafting at the same time. I believe this helps to “soften” the implant and it also gets rid of any pesky fat pockets!
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