BOOTY CALL

If the popularity of J. Lo and Kim Kardashian have taught us one thing, it’s that women are not afraid of showing off their derrieres. They just want to make sure they’re show-worthy, particularly in this the season of sculpted bodies.

With the popularity of the Brazilian Butt Lift and expansion of our knowledge and use of  fat manipulation, contouring the buttocks has become increasingly common in modern cosmetic surgery – once you’ve maximized the appearance of the old gluteus maximus through exercise. There’s no butts about it. (I couldn’t resist.)

Patients tend to have three different concerns regarding this area, which guide the choice of treatment.   For those patients possessing full, wide buttocks, liposuction is often the procedure of choice.  The most common approach combines tumescent anesthesia with suctioning of specific areas of fatty deposits using small cannulas to remove the fat.  Incisions are very small so scarring is usually not an issue for these patients.  More recently, using laser-assisted liposuction such as SmartLipo has helped achieve better contouring through tightening of the undersurface of the skin with the laser.  In carefully selected patients, this approach can yield dramatic results.

For men and woman who have lost volume over time, augmentation combined with judicious use of liposuction in the surrounding hips and thighs becomes the procedure of choice.  With more attention to this area, augmentation with specially designed implants have become increasing popular.  Paired gluteal implants can be placed through one central incision either under the gluteus musculature or more recently, within the substance of the muscle itself to help avoid underlying nerves. This is the most effective method of enhancing the buttocks in a man or woman who has little excess fat in other areas for transfer.

It can take from four to six weeks until the person can resume all previous activities.  To avoid the longer recovery associated with this procedure, patients who have fat deposits in the abdomen or hips can have their own fat harvested, separated out and re-injected into the buttocks to raise and lift.  After the fat has been removed from another body area with small syringes, the fluid is spun down in a centrifuge, and the fat separated out for injection. Recovery is easier with this approach, but further augmentation with fat and touch-ups in the future are often necessary.  Often a combination of both approaches will yield the best results.

For those patients who have lost significant volume of fat and have excess skin following  large weight loss (including following bariatric surgery), then a body lift becomes the procedure of choice, often as part of a comprehensive approach to extra skin in other areas of the body, including the thighs. In this approach, more extensive scars are part of the process as the tissue is lifted and the excess skin removed, often in a “belt-like” pattern around the lower back.  The scars fade with time and the significant change in contour makes them very tolerable to patients who have had large aprons of extra skin removed.

Sculpting the buttocks is not to be undertaken lightly, as there are potential complications to this surgery, including nerve damage and fat embolism.  In addition, expectations can differ from results. As in all cosmetic surgeries, careful and open communication between the surgeon and the patient is critical to insure a good outcome.  The initial result should become evident three to four weeks following the surgery, as the postoperative swelling begins to subside and the underlying contours appear. Postoperative massage and often ultrasound treatments can help the skin to take on the planned shape.  The final, corrected contour will usually become evident about six months after the surgery.

Those patients entering the process with realistic expectations should be tickled with their new tushies.

Please send questions or comments to mrosenberg@plasticsurgeryweb.com.

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