Your Questions
Your Questions
Q: I’m 29, very healthy and I weigh 128 lbs. I have always wanted a more rounder shapely butt for years but never could get enough money for the procedure and was afraid of the risks associated with the procedure. My self-esteem is very low because of my small buttocks. I just want to feel good and feel secure about myself and my looks.
A: While buttock augmentation can be done with either an implant or fat injections, your small frame and low weight leave you with only the implant option. The good thing about buttock implants is that they produce a very nice result in a single operation and the augmentation is stable over one’s lifetime. Because it is an implant, however, there is a longer recovery and there are potential implant risks of infection or seroma formation.
The key, in my opinion, to your buttock augmentation is to place the implant into the gluteal muscle and not to place too big of an implant. Going above the muscle in the subfascial plane is not advised with low buttock soft tissue coverage. Getting good closure of the muscle over the implant during the surgery is important as it helps reduce the risk of any problems.
Recovery is the biggest short-term concern for buttock implants and one should really allow about three weeks before returning to work and most more normal activities. More physical activities like working out, running, and cycling will take up to 6 weeks until one is more confortable to do them.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I don’t have a butt and my tail bone sticks out further then my butt. I have an pronounced tail bone and don’t have a butt. It hurts to sit long periods of time because of my tail bone and having no butt. My butt is really small and has no outside fat or butt to it. I can never find pants to fit because of having no butt to hold them up. I don’t wear bathing suits because of what little butt I have. I am 26 years old and would like to have a butt and not be embarrassed to wear tight jeans and/or a nice bathing suit in the summer time. I would like to see if you can help me with this. I had Ricket’s as a child and that is why I didn’t grow a butt. That is what the doctor’s told me and I would like to finally have a nice butt. Please help me if you can.
A: Buttock augmentation can be done by either injecting your own fat or using synthetic implants. While I usually prefer fat injections for buttock enlargement in my Indianapolis plastic surgery practice, there are certain limitations to its use. You have to have enough fat to harvest for transfer and there has to be some subcutaneous fat in your buttocks to put fat into. Fat grafts need an adequate fat bed to be implanted and grow. With absolutely no buttock substance at all (completely flat), fat injections are not a viable option. With such lack of buttock volume, the body habitus of such patients is that they would not have adequate fat to harvest anyway.
Buttock implants are the only option with such severe buttock hypoplasia. While the recovery and risks of buttock implants are important to consider, their submuscular placement is necessary if any significant buttock enlargement is to be obtained in a very thin patient.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I have been infected with HIV for 31 years, and have seen every one of my former friends and acquaintances succumb to AIDS. For some reason meds have always become available just in time to save my life. For that I am thankful But my life feels hardly worth living with the disfigurement of facial lipoatrophy and pain of buttock lipoatrophy. My face is so gaunt it is horrible and I have not butt at all!
A: One of the very unique effects of anti-viral medications in the management of HIV/AIDS is their effects on fat wasting or lipoatrophy. While much of the body (but not all) is affected by this fat loss, the face and the buttocks are frequent areas of aesthetic concern.
Facial lipoatrophy can be treated by two potential methods. The non-surgical approach is with the use of Sculptra injections. This is an FDA-approved injectable material that is essentially the placement of crystals or ‘seeds’ of a resorbable polymer that promotes collagen formation. It requires a series of injections over time to get a sustained response. The injections are placed in the cheek and submalar areas where the hollowing is the worst. While there is the possibility of a foreign-body reaction or granulomas with its use, good technique can minimize that risk. This injection material is not permanent and must be repeated every year or so once the desired result is obtained. From a surgical standpoint, cheek or submalar implants can be used which is actually my preferred approach. The procedure is simple, is done from incisions inside the mouth, and the volume obtained is permanent. Once can then use Sculptra to further highlight and feather the result out further into the face if desired.
Unlike the face, there is no good solution for the buttocks. Fat injections are not a good idea as there is no fat to harvest in most HIV patients and it will likely be absorbed anyway even if there was. Buttock implants are a possibility but the pain of recovery and the risk of infection may this procedure unappealing.
Dr. Barry Eppley
Just when you think you have heard it all, a new and bizarre tale of cosmetic surgery rears its head. If I didn’t know any better, this story may well have happened in China or the back streets of a remote Siberian city.
From the Garden state of New Jersey in Essex County, a group of female patients (six to be exact) ended up in hospitals after undergoing buttock enhancement. Apparently, they received buttocks enhancement injections containing caulking material. The same material that is used to caulk windows and bathtubs was injected to make their glutes larger. Different from medical-grade silicone, the substance used in these Mengele-like botched procedures was believed to be a diluted version of a nonmedical-grade silicone. Traditional buttock enlargement procedures are done with either a medical-grade solid silicone implant or with fat injections.
Apparently administered by unlicensed providers, the women were admitted to hospitals following the injections after developing raging infections. They were treated with surgery and antibiotics and appear to be recovering (although, you can be certain their buttocks will never be the same).
While many may wonder why anyone would want their buttocks enlarged (since many women would actually want them reduced), this is a popular request amongst certain ethic groups where a fuller and rounder buttocks is more appealing. Some have called this the Jennifer Lopez effect.
While these cases are certainly a tragedy, the looming question is how could this happen? In a country with the finest and most advanced medical technology in the world, how does someone come to the fate of having their butt caulked?
While injectable aesthetic treatments, such as Botox, collagen and fat, have been a real advance in plastic surgery, there is a rare, dark side to the concept. Because injection therapy is not surgery, it is not regulated like traditional plastic surgery procedures. There is no oversight and many of these treatments take place in a wide variety of settings by ‘providers’ of all backgrounds.
Because of their apparent simplicity to administer, injectable treatments are often viewed as a commodity. As in, ‘what treatment can I get for the lowest price’? While searching for bargains is commendable in many retail situations, a faux watch or look-alike handbag does not carry the same risk as do faux injection materials.
While not common in this part of the U.S., black-market injectors do exist and their practitioners prey on the weakest and least educated consumer- those that often can least afford it. As crazy as the butt caulking incident sounds, there has been a recent history of dubious practitioners providing cosmetic implants of nonmedical-grade materials. They function in a makeshift office for a short time, then get put out of business…only long enough for other shady providers to take their place.
Most of these incidents happen in large metropolitan cities with a high percentage of immigrant populations. In such an environment it is easy to hide, to be invisible to the authorities, and find plenty of victims before moving on. Smaller cities like Indianapolis are more difficult for unlicensed providers to remain anonymous as they are more quickly exposed, and appeal to a much smaller population.
The conclusion is …Caveat emptor: Buyer beware. If the costs of the procedure look too good to be true, there is probably a reason.
Dr. Barry Eppley