Q: Dr. Eppley, I am a very very thin Asian male that is looking for buttocks enhancement to get more of a Hispanic or Afro looking buttocks that is more perky and with a lot of volume. Because I am thin I know that fat grafting is obviously not an option so from what I know, implants are my best bet. I am looking for more of a shelf with augmentation in the upper buttocks area but as well as more outward projection to the entire thing…protrusion up and out. I would like to go for bigger implants if possible (that are within reason). I do a lot of physical activity such as dancing, running, biking, you name it. From my understanding placement can be from most superficial to deepest, subcutaneous, subfascia, intragluteus maximus or under the gluteus maximus. I have heard that intramuscular is best for augmentation towards the top but for more actual outwards projection, subfascia is better because the space is larger and because intramuscular would make it close to the sacral nerve which is dangerous. My questions therefore are as follows:
What would you agree is the best placement for somebody of my build with my goals?
I understand that this is based on softness of the implant, but why would anybody want to have a harder implant over a softer one?
Because I’m trying to aim for more of as a shelf as well as projection additionally, is it possible I might need different implants placed in different spots?
What would be the max size you would put in somebody of my thin male Asian build?
What kind of buttock implant shape is best?
A: Thank you for your thoughtful inquiry and insightfiul questions. A male getting buttock implants is uncommon but certainly not unheard of. There is no question that the best long-term results for buttock implants is in the intramuscular position. (never completely submuscular as this is where the sciatic nerve lives) This follows a general rule that the deeper an implant is placed and the more well vascularized soft tissue cover is over it, the better it is for the implant and the fewer complications that can ensue. But when looking at your aesthetic goals, an intramuscular implant can not achieve the buttock size and projection that you seek. Thus, only a subfascial implant placement will work. This will allow for a larger buttock implant size and it will have more lateral and posterior projection. A round shaped buttock implant is what you want to use. (oval implant can rotate in the subfascial plane which can create an obvious problem)
It is hard to know without seeing you and taking measurements as to the maximum implant size that you should get. But certainly I would not think bigger than 450cc to 500cc
Buttock implants are made of a very soft gel elastomer which feels very much like muscle. There is no reason to use a harder implant durometer.
You never want to place more than one implant for any body area, the buttock region notwithstanding.
A primary concern in any buttock implant patient is that they take teh required time to allow the tissues to properly encapsulate the implant befire beginning any strenuous activities. It would be well advised to wait at least four to six weeks before doing so. Seroma formation is the number one complication in buttock implants and a primary cause is too early physical activity.
Dr. Barry Eppley