Am I A Good Candidate For Buttock Implants?

Q: Dr. Eppley, I am 5’3” and 115lbs, 48 years old, healthy, and work out regularly. I have tried the Brazilian Butt Lift surgery (BBL) but not only didn’t it work but it also made my buttock shape more square than round. It also gave me some indentations. I am now very interested in buttock implants. I consulted with a plastic surgeon in South America and one in Los Angeles. They are both saying intramuscular for the buttock implant location. One is using highly cohesive gel implant called from Silimed and the one in Los Angeles uses semi solid silicone. They are recommending 400cc round or 480cc oval. As I was researching I came across your site. I noticed that you don’t recommend anything bigger than 350cc. I appreciate if you could share your opinion with me. I like the softness of cohesive but safety of solid ones. I love round looking butt, not too big or too small. Thank you for your time and feedback.

A: Let me provide you with some basic information about buttock implants. All buttock implants used today, regardless of the manufacturer, are made of soft flexible solid silicone elastomer. In essence they are all highly cohesive semisolid silicone gel. There is really no difference in their material composition. There are some minor differences in the durometer of the semisolid gel used (slight differences in stiffness) between the manufacturers but tis is really of no consequence to the patient.

Buttock implants can be placed either inside the gluteus maximus muscle (intramuscular) or on top of it. (subfascial) There are arguments for and against each implant location. If there was one perfect location for buttock implants, that would be what everyone would use. Intramuscular buttock implants are technically harder to perform, have a significant recovery but have the lowest incidence of long-term complications. There is also a limit, no matter what a surgeon says, as to the size of buttock implant that can fit into the intramuscular space. In someone of your size, that is going to be about 350cc or less. I can not see how any buttock implant of 400cc or greater can truly fit into the tight intramuscular pocket…at least with someone of your small size. It is not a recommendation that I make, it is simple function of what the anatomy will accomodate.

Subfascial buttock implants are technically easier to perform, have a shorter recovery and permit implants of larger sizes to be placed. It would be no problem to placed implants of 400cc or greater in the subfascial space. You have one important issue that may make this buttock implant location more favorable than it might be for others…you have had a prior fat injection procedure. While it may not have accomplished your overall buttock augmentation goal, it has provided some increased tissue and vascularity to the buttock tissues. I think given your desire for a very round looking buttock of intermediate size, you are likely better off with subfascial buttock implants.

Dr. Barry Eppley

Indianapolis, Indiana