When one wants assured buttock enhancement, the use of a synthetic implant is needed. Whether the implant is placed above the muscle (subfascial) or inside it (intramuscular), an incision is needed to get to the desired recipient site. The standard incision for buttock implants is placed at the apex of the gluteal crease and extends upward to the very low back region for a total length of about 7 cms. Closure of this incision and the use of postoperative drains is critical in preventing postoperative problems with it.
The few inches of the intragluteal incision is surprisingly all that is needed to insert the soft and flexible buttock implants. Because it is a single incision that provides dual access for both implants, how it is closed is absolutely critical. All layers must be carefully reapproximated from fascia up to skin to provide tissue separation of the two implants and to be able to resist the shearing forces from sitting and sliding across this area in the early postoperative period. While some minor incisional separations can occur, major wound breakdown is to be avoided. The concomitant use of drains, one under each implant, is important with the placement of buttock implants to prevent the most common complication from their use, that of fluid accumulation or seroma formation. They will exit from the sides of the incision, about one to 2 cms to the side, until they are removed 7 to 10 days after surgery.
Understandably, most patients are concerned about how these scars will look after surgery. This scar is mostly well hidden in the crease with only a small part just above the ‘crack’ area. The drain tube exit scars appear as small circles just to the side of the vertical scar. While these scars will be red for up to six months after surgery, eventual fading of them will make their appearance as a fine white vertical line and small white dots. Most patients consider these scars as negligible and a very small trade-off to make for the benefits of a larger and more shapely buttocks appearance.
Dr. Barry Eppley
Indianapolis, Indiana