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Buttock implants are ultrasoft solid silicone hemispherical devices. They have a role in buttock augmentation when the patient has insufficient fat for a BBL procedure or an inadequate BBL result to meet their aesthetic needs. They can be placed either inside the gluteus maximus muscle or on top of it. They are advantages with either pocket location but lower complication rates are associated with the intramuscular pocket.

The intramuscular pocket is uniquely different from the subfascial pocket in many ways. But when it comes to implant insertion the passageway through the split muscle fiber is more narrow and tighter. This is why in South America, where the intramuscular pocket technique was developed, they use silicone gel implant which are exactly similar to breast implants. Their malleable and easily compressible form allows their passage through this tight muscular entrance easier.

Solid silicone buttock implants, while very soft, are not easily compressible by hand into a form that fits smoothly through a narrow aperture. A good technique to do so is borrowed from that of its close geometric cousin, the breast implant. The funnel device has revolutionized how to insert silicone breast implants. It works because it temporarily converts a rounder implant form into more linear one that fits through a smaller hole than its original base diameter.

funnel buttock implant insertion 2 Dr Barry Eppley IndianapolisWhile a buttock implant is not completely spherical the funnel device still works fairly well with its firmer hemispherical form. The key is to cut the aperture a little bigger than one would with a breast implant to compensate for its firmer form. But it definitely makes it easier and involves less implant manipulation than trying to push it in by hand.

Of all the body implants, buttock implants are the hardest to place particularly in the intramuscular pocket. But the short and long term advantages of this pocket location are well worth the effort particularly in regards to lowering the risk of complications. Any technical strategy that wins this process is worthwhile and, like with breast implants, the funnel insertion process is an invaluable adjunctive technique.

Dr. Barry Eppley

Indianapolis, Indiana

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