Explore Plastic Surgery - Dr. Barry Eppley

Plastic surgery is one of the marvels of modern medicine, with a wide range of options for face and body improvements. And today’s media outlets make it easier than ever before to gather information on the latest plastic surgery procedures. But how does this information apply to you and your concerns?

Every person is unique and has his or her own desires. What procedure or combination of treatments is right for you? And what can you really expect? EXPLORE PLASTIC SURGERY with Dr. Barry Eppley, Indianapolis plastic surgeon, who can provide you with a wealth of practical and up-to-date insights into the world of plastic surgery through his regular blog posts. In his writings, Dr. Eppley covers diverse topics on facial and body contouring procedures. You will be sure to find useful information that will help broaden and enrich your plastic surgery education.

Background:  Buttock enhancement has become a popular body contouring procedure in the past decade. Influenced by a growing multicultural population mix and the influence of pop culture and social media, the desire for rounder and fuller buttocks is growing. The typical patient is either African-American or Hispanic where the shape of the buttocks is one of the most significant body features.

While buttock implants have been around for some time, they are not behind the increase in buttock augmentation procedures. Rather than a synthetic material which involves a longer recovery and more pain, fat injections today account for the majority of buttock enlargement procedures. It offers the simultaneous benefits of concurrent body contouring of undesired fat areas, a faster recovery than a buttock implant, and a natural augmentation material.

Fat injection buttock augmentation has been given the procedure name known as Brazilian Butt Lift. That name is a bit deceiving in that there is no conventional buttock lift per se. Use of the term ‘lift’ in the procedure implies that the buttock is reshaped by actually lifting it through some type of skin removal and/or tightening. In reality, the lift of the procedure comes from making the buttock fuller through volume augmentation. To some degree the buttock is ‘lifted’ by making it bigger. That distinction is important as some patients may want their sagging buttocks lifted and not necessarily bigger. That would require a different procedure. (lower buttock lift or tuck)

Case Study: This 32 Hispanic female wanted her buttocks bigger and reshaped. Besides being too small or flat, she had a lot of irregularities/indentations in the overlying skin. She wanted fat injections and not an implant as she had other body areas that she wanted reduced as well. She was not a big person or had a large amount of abdominal fat. This limited her to the result that fat injections could achieve and that this would be a one-time procedure. (all available fat taken the first time) The choice she had to make was to have a buttock result with fat injections that was not as much as she wanted (but was natural with a quicker recovery) or use an implant to get a bigger result. (and have a longer recovery with more potential complications)

Under general anesthesia, he underwent liposuction of her full abdomen, waistline, lower back and upper back. A total of 1,900cc of aspirate was obtained. This was centrifuged to create a volume of concentrated fat of 700ccs. Each buttock was then injected with 350cc down into the muscle as well as in the subcutaneous space.

At three months after surgery, her result appeared stable and had not changed in any visible way from that seen at one month after surgery. It is presumed that this result will be volumetrically stable long-term. There may be the potential for growth (unlikely) but probably no further resorption or volume loss will be seen.

This patient represents a very typical Brazilian Butt Lift patient and result in my experience. Due to the volume of available fat to be harvested and surgical economics, this will be a one-time procedure. Visible buttock enlargement and reshaping is seen and maintained but the result is rarely as full as most patients would like. Some method fat concentration/purification should be used to get stable volume results.

Case Highlights:

1)      The Brazilian Butt Lift is not a skin excision or tuck procedure, rather it is buttock enhancement with fat injections. There is no real lift but volume expansion.

2)      There are secondary body contouring benefits from the liposuction harvest of fat in a Brazilian Butt Lift including abdominal, waistline, hip and lower back/upper buttock reduction.

3)      The amount of volume or size that the buttocks can be increased in this procedure is a function of three factors; amount of fat that can be harvested, amount of fat that can be injected, and how much inject fat will survive. As a general rule, most volume increases are less than what most patients desire but the result is natural and soft and will never cause any long-term problems.

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

Indianapolis, Indiana

The Brazilian Butt Lift is a confusing term for those interested in buttock reshaping. The misleading part of its name is that of the lift. It is absolutely logical to assume that the buttocks are actually moved upward by some type of tissue lifting or relocation. This would usually mean that skin and fat is removed and tightened like that of a tummy tuck or a breast lift. But that is not the case.

The qualifying term is the Brazilian word that precedes butt lift. Understanding the significance of this country descriptor goes a long way towards appreciating the ethnic importance of larger buttocks and what is actually done during this cosmetic procedure.

The buttocks has long been associated as an important sexual feature of a woman. The buttocks are anatomically formed by the gluteal muscles of the hips and upper leg. The overlying skin and fat help make its overall shape but the size of the muscle plays the key role. This muscular feature has been given many cultural interpretations but it is largely aligned with the organs of reproduction. Thus when cosmetic surgery is performed on them, it is to increase their sexual attractiveness.

The buttock lift as we know it today comes out of Brazilian plastic surgery. The Brazilians downplay breast size but emphasize buttock size and shape…the exact opposite of American or  Northern hemisphere emphasis. This is the Brazilian view of the body. Given the large number of cosmetic surgeons in that country, Brazil has become an international center for cosmetic surgery and their techniques have subsequently been promoted all over the world.

Firming and tightening the buttocks has been around for over fifty years. But the historic approach of cutting out skin and fat, which leaves noticeable scars, never caught widespread popularity. Increasing the size of the buttocks, by volumetric addition, creates both increased fullness and a bit of a ‘lift’. The Brazilians have promoted the use of silicone implants for buttock enlargement for years and have refined that technique to an art form.

But the use of buttock implants is not complication-free and it has its set of problems…like any implant-related procedure does. The use of fat from liposuction has been developed as an alternative to an implant for buttock enhancement. As a natural alternative to a synthetic implant, fat injections into the buttocks offer a dual benefit. The donor fat removed makes for contour improvement in the harvest site, which is usually around the waistline and stomach. It is essentially a redistribution of  a problem into a benefit.

The Brazilian butt lift is, therefore, buttock enlargement by fat injections. The lift part comes as the buttocks is filled out and it gets a lift by skin expansion. The downside to using fat is that it is not always predictable and all of the fat injected will not survive. For some patients it may be necessary to do a second fat injection session.

Excisional buttocks lifts still do exist but they are reserved for two specific buttock problems. When the lower buttock skin hangs over the lower crease, known as the banana peel deformity, the overhanging skin can be removed and a new tighter lower crease made. (lower or inferior buttock lift) An upper buttock lift is done as part of a circumferential body lift for those patients who have under gone extreme weight loss, usually from bariatric surgery.          

Dr. Barry Eppley

http://www.eppleyplasticsurgery.com

http://www.ologyspa.com

Clarian North Medical Center, Carmel, Indiana

Clarian West Medical Center, Avon, Indiana

Indianapolis