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Dr. Barry Eppley

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Surgeon Dr. Barry Eppley

Posts Tagged ‘buttock liposuction’

Dispelling Common Myths of Buttock Enhancement

Monday, January 14th, 2013


The desire for fuller and more uplifted buttocks is one of the most popular body contouring requests in the past few years. When it comes to the buttocks, the issues mainly consist of its size and shape as well as the texture of the overlying skin. Implants, fat injections, liposuction and cellulite treatments are available for the cosmetic improvement of the buttocks. But because of their relative newness of buttock enhancement procedures, there are many misconceptions and myths about them. Here are some of the most common butt myths.

Liposuction can help get rid of cellulite on the buttocks. The search for an effective cellulite treatment has been ongoing for years and to say that it is elusive is an understatement. The buttocks is a prime location for the cottage cheese look of the skin. Over the years such treatments as Endermologie and VelaShape have been promoted but their effects are short-term and any improvement requires regular maintenance treatments. Liposuction surgery, however, is exactly what you don’t want to do. Liposuction removes the superficial layer of fat and removes the support from the overlying skin…this has the high likelihood to make the appearance of cellulite even worse. The newest cellulite treatment, Cellulaze, may offer improvement of buttock cellulite on a more sustained basis but long-term results (years) remain to be reported.

Fat injections are a better option for buttock enlargement than implants. The most popular method today for increasing the size of the buttocks is fat injections. Known as the Brazilian Butt Lift, its popularity is because it requires simultaneous liposuction for the fat harvest and a a result one also gets some body contouring through  abdominal and flank reduction. (the largest sources of excess fat in most people) Fat injections also make the recovery from the surgery much easier as the real recovery is from the liposuction harvest sites not the buttocks. All of this makes fat injections so much more appealing than the intramuscular placement of implants which have a much longer recovery. With the exception of one thing…the survival of fat injections is unpredictable while implant produce a reliable and permanent means of buttock augmentation.

Sitting on buttocks that have been injected with fat will cause it to resorb. The take of fat injections into the buttocks depends on some of the fat getting an adequate blood supply (nutrition) and perhaps some of its stem cells that accompany it becoming fat cells themselves. This is a process that takes several weeks after surgery. But once the fat cells take, the y should be permanent provided one takes does lose a lot of weight later. But sitting on the buttocks over time is not going to cause the fat to resorb anymore than one’s natural fat there would. But it is important in the first few weeks after surgery to avoid prolonged sitting so as to not induce pressure on the newly implanted fat which may have a negative effect on its survival.

The buttocks can be enlarged and lifted by exercise. The gluteus muscles (maximus and minimus) are large-sized and occupy a significant part of the buttocks depending upon their natural size. Like any muscle, it can be toned and enlarged. So to say that exercise can make your buttocks bigger is true…but only by a minimal amount. Strengthening and toning of the gluteal muscles can definitely be done and this may provide a degree of a ‘buttock lift’ but not actual enlargement of the buttocks.

Dr. Barry Eppley

Indianapolis, Indiana

Buttock Enhancement Through Combination Liposuction And Fat Injections

Tuesday, October 18th, 2011

Enhancement of the buttocks has become enormously popular over the past decade. Most methods of cosmetic buttock surgery are perceived as that of increasing its size through either implants or, more commonlytoday, fat injections. But buttock enhancement is as much about contouring and reshaping as it is about size increase alone. Large poorly-shaped buttocks are far less appealing than slightly smaller ones that have a more desireable shape.

When evaluating the buttocks, it is best to see it as an anatomic structure with different areas as zones that can be modified. There are essentially six aesthetic zones to the buttocks which can be described as follows: zone 1 is the midline lower back/sacral area, zone 2 is the upper lateral region or low flanks often also called the muffin tops, zone 3 is the middle lateral region where the muscle inserts, zone 4 is the low lateral or greater trochanter area, zone 5 is the upper inner thighs, and zone 6 is the amount of buttock projection seen in the side view.

The relevance of these buttock zones is that they all represent areas of either reduction (liposuction) or augmentation. (fat injections) Zones 1 and 2 are the areas of greatest liposuction fat removal while zones 3, 4 and 6 are the primary areas of fat injection augmentation.

Improving buttock shape is more than just injecting a lot of fat all over the entire buttocks. Skillful reshaping by fat removal combined with fat augmentation is a more successful approach. In many patients, it just isn’t possible to place enough fat or have enough of it consistently survive to create a better shape by simple volume addition alone.

In improving the shape of the buttocks the contour of the hips is a key area. Buttock projection can look diminished when the hip and back area has a good thickness of fat. This obscures any appearance of an upper gluteal shelf. When liposuction is done to reduce the hip and back fat, an inward skin retraction occurs. This creates an inward indentation or concavity which can match the curve of the lower of the lower buttocks as it dips inward towards the posterior thigh. By so doing, the illusion of a greatee central buttock projection is created. This can be further enhanced by concurrent fat injections into this central mound. This is a good example of the ‘ying and tang’ approach to increasing any body contour. The combination is always better than either approach alone.

The survival of fat injections in the buttocks is always an issue of concern. While there are numerous methods of processing fat prior to injection, none have been shown to be better than another. Some method of concentration is important to eliminate excess oils and fluids. In the buttocks, unlike many other face and body areas where fat is injected, there is a choice of injecting into the subcutaneous fat layer, the muscle, or both. The buttocks have a large gluteus maximus muscle and most of the fat injected should be into it. This will ensure the most amount of injected fat survival due to the better intramuscular blood supply.

Buttock augmentation is best done through a combination of zonal liposuction reduction and intramuscular fat injections. This is best for those patients that have an excess of fat around the buttocks in the hips, back and waistline.

Dr. Barry Eppley

Indianapolis, Indiana

Liposuction of the Buttocks

Saturday, December 29th, 2007

Contouring of the Buttocks with Liposuction
Reshaping of the buttocks can be done through a variety of plastic surgery techniques including, implants, fat injections, lifts, and liposuction. By far, liposuction is still the most common buttock contouring technique used. Liposuction of the buttocks, however, must be done with caution to avoid unsightly cosmetic complications.

Typically, buttock liposuction is part of a body contouring surgery where multiple body areas are being treated as part of the same surgery. It would be common to do thigh, hip, flank, or knee liposuction, with the buttocks to create an overall more contoured mid-trunk region. When doing buttock liposuction, the cannula is introduced through the posterior buttock crease or at the top of the middle buttock crease, dependent upon the positioning of the patient on the operating room table. The key to a successful outcome from buttock liposuction is…..not to overdo it…..or be too aggressive in removing fat! The buttocks is a unique area to liposuction as too aggressive liposuction may disrupt the fibers that connect the skin to the underlying muscle, allowing the skin to hang down over the buttock crease. This is what we call the ‘banana roll’ deformity. In addition, the skin of the buttocks can only contract so much, so over aggressive liposuction can result in unsightly dimpling, irregularities, and loss of any of its rounded shape.

The key to contouring the buttocks is a patient’s understanding that you can not really make a large buttocks small….and don’t try to do so by aggressive liposuction. The buttocks is an area where the risk of cosmetic irregularities and unhappiness with the results is not rare. Buttock liposuction must be done with care, paying great attention to the areas of buttock fat that are being removed and the amount that is being removed. When it comes to buttock liposuction, less is really more!

Dr. Barry Eppley

Indianapolis,, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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