Buttock implants are the alternative option to the most popular buttock augmentation procedure of fat injections. (aka BBL) There are variety of options to consider when undergoing buttock implant augmentation including implant size, style and pocket location. (intramuscular vs subfascial) But one remaining option, seemingly the most insignificant, is that of the type of incision used for insertion.
There are two buttock implant intergluteal incision options, a single midline and paired paramedian incision approach. Both incision lengths are around 7 cms but what differentiates them is more than what is seen on the outside.
The single midline intergluteal incision offers a seemingly simple and straightforward approach to making two implant pockets on each side of it. But such an incision requires the disruption of the sacrocutaneous ligament which must be re-created during closure.
The paired paramedic intergluteal incision allows for separate entrance into each pocket as well as preserves the sacrocutaneous ligament.
Given that both types of incisions remains within well hidden in the intergluteal cleft and heal well, the importance of preserving the sacrocutaneous ligament takes priority. Its preservation is more than just about keeping the integrity of the depth of the intergluteal cleft, its value is that it keeps the two implant pockets completely separate. This is of great relevance when the implants are in the subfascial pocket. Should infection and seroma occur what happens to one implant will it affect the other. The paired incision also is associated with far less wound dehiscence as they are better protected from shearing forces and the pressure of the implants against a single midline incision.
While both types of intergluteal incisions can be successfully used in buttock implant surgery, the paired [paramedian incision has been associated with the least risk of postoperative wound dehiscence given their locations, preserves the sacrocutaneous ligament and keeps each implant anatomically separate from the other.
Dr. Barry Eppley
Indianapolis, Indiana