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Background:  Buttock augmentation is generally a procedure than is done much more frequently in women. Between synthetic fillers, BBL fat injections and implants the female patient probably comprises 95% to 98% of the buttock augmentation population. It is not that men don’t undergo buttock augmentation but the buttocks is less of a signifier ant nconcern for the shape of the male body than it is for women. While men may be aware of their small buttocks they very rarely are so motivated to undergo surgery for it.

Men typically undergo buttock augmentation to not only increase the size of their buttocks but often to improve its shape as well. Shape wise men often have a lateral indentation or contour defect between the greater trochanter on the hip area and the central buttock region. That combined with a small buttocks may be enough of an aesthetic concern to consider surgical improvement.

There are not any significant differences between men and women when undergoing buttock implant augmentation. The location of the incision, intramuscular pocket placement, implant size selection and the recovery are nearly identical. The only slight difference may be in implant size selection where men may not desire as much implant size as some women. Often they seek more of a shape improvement compared to a major size increase.

Case Study: This male was bothered by his flat and small buttocks. His upper buttocks had an indentation making it smaller than the lower half of the buttocks. An intramuscular implant placement was desired with the maximum implant size possible.

Under general anesthesia and in the prone position a midline 7cm intergliuteal incision was made. The muscle was exposed on both sides and the intramuscular pockets developed on both sides by blunt dissection. Both sides had 400cc round silicone buttock implants placed.

His immediate intraoperative result showed the change in buttock shape and size.

The placement of buttock implants in the intramuscular position offers the best anatomic location with the lowest risk of complications. It is not an easy surgery to either perform or from which to recover. The challenge in the intramuscular pocket is that it is a more restricted implant space which comes with some size limitations. Fortunately that is a good buttock implant size for most men.

Case Highlights:

1) Buttock implants in men pose similar pre- and intraoperative considerations as women.

2) Intramuscular buttock implant placement in a males probably can not go more than 400ccs in volume as an initial placement implant.

3) The funnel insertion device an be a useful aid in getting the implant past the limited opening of the intergluteal incision.

Dr. Barry Eppley

Indianapolis, Indiana

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