Buttock Contouring Specialist
Barry L. Eppley, MD, DMD, has extensive experience in buttock augmentation and contouring and has helped many plastic surgery patients who are dissatisfied with their gluteal (buttock) area. To learn more about this procedure, please read the respective information and visit the buttocks contouring results page.
ACHIEVING A MORE PLEASING BUTTOCK SIZE (Buttock Augmentation)
Lack of fullness of the buttocks, which often appears as a ‘flat butt’ without a rounder shape, is the most common reason today for unhappiness with the shape of the buttock area. Some patients who undergo buttock augmentation have a congenitally small buttock, have lost a significant amount of weight after bariatric surgery, or simply desire a much rounder and fuller buttock than what they have. This concern can be treated with either fat injections or a buttock (gluteal) implant, depending upon the size and area of the buttock deficiency.
Fat Injection Buttock Augmentation (Brazilian Butt Lift)
The most popular method of buttock augmentation today is through fat injections. Known more commonly as the Brazilian Butt Lift, fat is obtained by liposuction harvest, processed and then injected into the buttocks. Its appeal is two-fold. It is a natural non-implant technique that uses one’s own fat tissue and a concomitant body contouring effect is achieved by the liposuction harvest. In essence, a Brazilian Butt Lift is a two-in-one procedure.
Not every patient is a candidate for a Brazilian Butt Lift as one has to have enough fat to harvest to make the procedure worthwhile. Depending upon the change in buttock size that one desires and how much fat one has to give is an important assessment before surgery. Some patients have plenty of fat to get a good buttock size change while others will have to settle for a more modest or subtle buttock shape change.
There is also the unknown variable of how well the fat survives after injection. All 100% of the injected fat into the buttock never survives and, on average, 50% to 70% of what is injected may take. The patient must accept this fat survival risk.
Candidates for Butt Implants
Ideal candidates for butt implants are patients that:
- Are physically healthy.
- Are unhappy with the current size and shape of their butt.
- Have realistic expectations for the procedure.
Dr. Barry Eppley provides treatment for a wide range of patients. While some people believe that butt augmentation procedures are only performed on females, Dr. Eppley has extensive experience providing male butt implants as well.
For those patients who have inadequate fat for harvest, the only option is the placement of buttock implants. Unlike breast implants, buttock implants are solid, soft silicone so there is no risk of implant rupture or a silicone leak. Buttock implants are available in different sizes and shapes to optimize how much and what part of the buttock is lifted and made larger. The volume obtained from buttock implants is stable lifelong as the implants will never degrade or rupture.
They are placed through a small intergluteal crease incision. (top of the butt crack) Buttock implants can be placed either into the muscle (intramuscular) and on top of the muscle. (subfascial) There are advantages and disadvantages to either implant location. The intramuscular location is better long-term and has less risk of implant-related complications but the recovery is signiicant and the size of implant that can be placed is more limited. (350cc or less) Buttocks implants placed on top of the muscle can be of much larger sizes, have less recovery but have a higher incidence of complications (seroma, infection, implant displacement).
LIFTING THE SAGGY BUTT (Buttock Lift)
Sagging or hanging down of the gluteal (buttock) area over the lower buttock crease is what many patients refer to as a ‘saggy butt’. This occurs when skin or fullness in the buttocks hangs over the gluteal crease (junction between the leg and buttock) as a result of weight loss or aging This deformity is untreatable by any type of non-surgical means such as exercise, topical creams or skin tightening devices. Liposuction of the buttock overhang will only make it worse.
This problem can be very effectively treated by a buttock lift, the removal of the excessively overhanging tissue. This results in a better lower buttock shape with a more pleasing transition between the buttock and the posterior upper thigh. The resultant scar lies along the buttock crease in a naturally-occurring fold. While this operation is not for everyone, it is effective in the properly selected patient who prefers the trade-off of a near hidden scar as opposed to a tissue overhang.
Often, buttock contouring requires a combination of procedures to get the best result which may include adding buttock volume (implants vs. fat), reducing fat around the buttocks (liposuction) or performing a tuck from below (buttock lift).
Buttocks Lift – Before Surgery
An examination is needed to determine the size and shape of the buttocks and which procedure, (Buttock lift, buttock implants or fat injections, would be most effective in improving its shape of the buttocks. It is important that the patient have a clear understanding of the location and size of the resultant scar if a buttock lift is chosen. In buttock implants, measurements are taken to determine the size and style of buttock implant to be used. When choosing an implant, the risk of infection and shifting of the implant position after surgery must be addressed. With fat injections to the buttocks, how much fat will survive is unpredictable and one must accept that overcorrection is initially needed or multiple fat injections sessions may be required. In some cases, combination(s) of implants, lifts, or fat injections may be used to achieve the best buttock shape and size.
Buttocks Lift – Operation
A buttock lift is almost always performed on both sides simultaneously under general anesthesia as an outpatient Procedure. The area is marked before surgery in the standing position. The overhang is elliptically cut out and closed with dissolvable sutures placed under the skin. The incisional area is usually taped after surgery for support.
Buttock augmentation through implants or fat injections is also performed under general anesthesia as an outpatient procedure. Buttock implants are placed through a single vertical incision in the intergluteal fold between the upper buttocks, and the small incision is closed with dissolvable sutures. A compression girdle is placed after the operation is completed.
Buttock augmentation with fat injections is an outpatient procedure done under general anesthesia also. Fat is harvested, usually from the abdomen and flanks, processed for concentration, and then injected into the desired buttock areas. Usually 250cc – 500cc is injected per each surgery session. Usually as much fat is injected as possible based on how much the patient has to give.
Cosmetic Procedures – Buttocks Lift – After Surgery
In buttock lifts, the most important postoperative care concern is to limit the amount of extending sitting, bending over, or flexion of the hips that places strain (stretching) on the incisions. Standing or laying down keeps the junction between the legs and buttocks un-stretched and this should be done as much as possible in the first several weeks after surgery. One may return to completely normal physical activities within two to three weeks. There is very little discomfort associated with this procedure other than the feeling of tightness in the area after surgery.
In buttock enlargement with implants or fat injections, sitting will be uncomfortable after surgery. While there is no harm from sitting, it will not be completely comfortable for several weeks after surgery. One may resume physical activity as soon after surgery as one desires.