Buttock augmentation has become an extremely popular body contouring procedure. But unlike another body part, the breasts which are much more frequently augmented, the buttocks can not just be made to any desired size. I frequently get requests for patients who want a really ‘big butt.’ While what constitutes a large buttocks is open to interpretation and is at least partially based on the body frame of the patient, such requests indicate an understandable misconception of what is possible with the various buttock augmentation procedures.
From that perspective, an overview of the various options available for buttock enlargement will help put into perspective the various advantages/disadvantages of these procedures. Always remember that every plastic surgery procedure is about aesthetic tradeoffs.
Synthetic Injections Almost more than any other buttock procedure, the use of injectable materials get a lot of press…and for all the wrong reasons. These are essentially illegal buttock procedures performed by persons of dubious backgrounds and medical education. (or lack thereof) These back street injections may consist of silicone liquid or even caulking compounds and, not surprisingly, have an incredibly high rate of complications. This is the cheapest and fastest way to get larger buttocks but at the price of such problems as infection, chronic pain, and even death. Enough said. This is not a valid buttock enlargement method.
Fat Injections Known as the Brazilian Butt Lift, this is the most common method of buttock augmentation today. It is popular because it provides a simultaneous body contouring benefit from the fat harvest for the injections. Usually the abdomen and flanks are aspirated by liposuction and get smaller as the buttocks get bigger. But it is not the most effective method of buttock augmentation despite its popularity. The survival of fat after injection is a challenge and far less usually survives than is injected. At best, a 50% survival rate can be expected and final buttock size increases are usually modest rather than dramatic. Because many patients want and need liposuction for fat reduction, this is a good time to recycle the ‘waste’. In addition, fat injections are done to the buttocks because other procedures are being performed and this is a good opportunity to take a chance on the procedure. (coincidental buttock augmentation) While fat injections may not offer the most ideal buttock size, it does have the lowest risk of any complications because of its natural material.
Implants. FDA-approved buttock implants made from silicone gels have been around for over a decade. While never achieving the popularity of breast implants, they do offer an assured and long-term augmentation result. Despite its guarantee of permanent volume addition, it is the least popular method of buttock enlargement. This is because it is the most invasive buttock procedure with a significant recovery and costs.
When it comes to placing buttock implants, there are two methods based on their location to the gluteus maximus muscle The best place to put implants is inside the muscle, known as an intramuscular pocket. This has the lowest risk for potential implant-related complications and takes an experienced surgeon to do it. But good muscular coverage of the implant limits its size to around a 300cc implant with a moderate buttock size increase result. The recovery is the hardest due to the splitting of the muscle fibers. The other location for buttock implants is above the muscle. (subfascial) Much larger implants can be placed, up to 600cc, and the recovery is less than when placed inside the muscle. But there are higher risks of infection, fluid collections and implant shifting than when the implant is placed inside the gluteal muscle. Subfascial buttock implants can result in large augmentation results.
Different methods of buttock augmentation have different outcomes, risks and recovery associated with them. Therefore, those seeking a really big buttock augmentation that is permanent should have buttock implants placed above the muscle. Fear of implants and their recovery is why fat injections are preferred…not because they produce the biggest result.
Dr. Barry Eppley
Indianapolis, Indiana