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Background: Buttock augmentation is most commonly done by fat injections. But when not enough fat is available for transfer, buttock implants must be used. While buttock implants have an historic mixed reputation when done by surgeons experienced in doing them and with intramuscular placement, they have a good success rate with a low incidence of complications.

While improved buttock implant results are obtained by skilled intramuscular placement, this anatomic location poses some implant limitations. The intramuscular pocket is smaller and more restrictive than that of the more superior subfascial pocket. This means that smaller buttock implant volumes must be used. In addition the height of the implant needs to be lower to get a competent muscle closure over it.

Natural Contour Buttock Implant Dr Barry Eppley IndianapolisTraditional buttock implants have really been made for the subfascial plane with a very round shape and many larger size options available. The intramuscular pocket requires smaller implant sizes that has a lower implant profile. These type of solid silicone implants are known as natural contour buttock implants. They are available in sizes of 230, 285 and 330cc with implant projections of 3.2 to 3.6 cms.

Case Study: This 25 year female wanted augmentation of her upper buttocks which has become flat after an ill-conceived upper buttock lift.  The excision of upper buttock tissue may have provided a slight buttock lift but it also created a flattening effect. She did not have enough fat to harvest to do an adequate fat transfer.

Intraoperative Intramuscular Buttock Implant results 230ccUnder general anesthesia, she had intramuscular placement of 230cc natural contour buttock implants through bilateral intergluteal incisions. The intramuscular pockets were made through a muscle splitting technique. This added a nice upper pole fullness that was not too round or overly projected.

Natural Contour Buttock Implants results left side viewNatural Contour Buttock Implants results right side viewThe intramuscular placement of buttock implants fundamentally changes their long-term success rate. Like any implant in the face or body, the deeper it is placed and the more well vascularized tissue that covers it, postoperative complications are substantially decreased. But getting the implant into an intramuscular pocket and getting the muscle closed over it requires smaller volume implants with a lower projection.


  1. Buttocks implants are the only option for buttock augmentation in thinner patients that do not have enough fat to transfer.
  2. Natural contour silicone buttock implants provide an augmentation effect that is not abnormally round or looks like a ‘bubble.

3) Smaller buttock implants can compensate for upper buttock volume loss after a superior buttock lift.

Dr. Barry Eppley

Indianapolis, Indiana

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