Background: Buttock implants offer a method of buttock augmentation when one has inadequate fat to harvest. It has become more popular over the past decade than ever before as the patient demand for buttock augmentation has risen dramatically. But unlike fat transfer there are multiple considerations when buttock implants are considered. These include size, shape and implant location.
The biggest consideration in using buttock implants is whether they should be placed above (subfascial) or into the muscle. (intramuscular) Each implant location has its own advantages or disadvantages. The intramuscular location offers the lowest risk of long-term implant complications but the longest after surgery recovery. Its other ‘disadvantage’ is that the implant size will be more limited. The intramuscular pocket does not allow for much bigger implants than about 350ccs of volume. This us unlike the subfascial location where much larger buttock implants can be placed.
Case Study: This 26 year-old female wanted a larger buttocks but knew she did not have enough fat to get a good result. She was aware of the concept of subfascial vs intramuscular pockets and wanted the implants placed inside the muscle. She had a flat but moderate-sized buttock shape and preoperative measurements indicated that a 300cc to 350cc implant could be placed.
Under general anesthesia and in the prone position, a 7 cm. intergluteal incision was made. The intramuscular pockets were created by a muscle splitting approach. Soft solid silicone 330cc anatomic buttock implants were placed on both sides. No drains were used.
Her two month results show a fuller and more rounded buttock shape. Her buttocks were bigger in the upper pole with increased fullness. She had a rather long recovery as it took her about a month to get back to most physical activities. She developed a partial incisional dehiscence about 3 weeks after surgery of the lower half of her incision. It was treated by topical silvadene and went out to fully heal three weeks later.
For those patients considering intramuscular buttock implants it is important to realize that the recovery period will be significant. It is a muscular injury in an area that will need to be sat on as well as important for many other bodily movements as well.
1) Buttock implants offer a reliable and permanent method of buttock augmentation
2) The intramuscular placement of buttock implants offers the least complications long-term but has a significant surgical recovery.
3) Intramuscular buttock implants have size restrictions and are only indicated in patients that are not eligible for a fat transfer buttock augmentation.
Dr. Barry Eppley