The fashion for attractive buttocks of certain shapes has grown tremendously in the last decade due to the influence of social media and some famous stars in the world. However, even before surgical operations became popular, over the past half-century, various procedures for the formation of gluteal muscles were performed to correct deformities and improve proportions, eliminate laxity or adjust the size. Many procedures can be used to improve the appearance of the buttocks, including non-surgical injections, implants, fat grafting, excisional surgery, liposuction, or a combination of these. Understanding the patient’s physiological characteristics, problems and goals help the plastic surgeon formulate an ideal plan and choose the best technique to give the patient a pleasant result.
In other words, this is liposuction with a transplant of own fat or a Brazilian buttock lift. First, the plastic surgeon determines the areas from which adipose tissue can be taken from the patient: stomach, chest, side of the chest, waist, hips, back, and arms. For the best aesthetic results, the lower back, sacrum, waist, and thighs are almost always liposuctioned to narrow the waist, accentuate curves, and lower the hip/waist ratio. After liposuction, the fat is cleaned, excess fluid is removed, treated with an antibiotic solution, and combined with the patient’s plasma immediately before the injection. The prepared material is injected into the patient’s buttocks using a 4 mm infiltration cannula.
This method of correcting the buttocks is also called gluteoplasty and is effective when the patient’s fat tissue is not enough to increase the buttocks, and the thigh area is poorly defined.
First, the surgeon marks the areas where incisions will be made and implants will be inserted. The medial extent of the implant is approximately 2 cm lateral to the outer edge of the sacrum. The patient is under general anesthesia, foot pumps are used to prevent venous thrombosis and a special drug is administered. One vertical incision, 6 cm long, is made along the midline of the sacral region in the buttock fold. The incision is made through the skin, and subcutaneous tissue continues to the lateral borders of the sacrum and the medial border of the ischium. Then a 4-6 cm incision is made intramuscularly and an implant pocket is created. This is done on both sides. The implants are inserted into the pocket through small incisions using a plastic funnel and placed under the gluteus maximus muscles. We do not perform this procedure.
This method of buttock correction is often performed on patients with massive weight loss. It is used to repair damage to collagen and elastic fibers that have been severely stretched. The typical V-shaped figure of a patient who has lost a lot of weight is due to excess skin and its insufficient elasticity. A postoperative buttock lift is also often performed to eliminate laxity and ptosis of the skin. But the procedure can also be combined with autogenous fat transplantation and/or buttock implants.
The first step in this technique is to make a superior incision along the iliac crest with the patient in an upright position. A pinch test is then performed to determine where the lower incision will be marked. Excision of excess skin and fat is performed by the “seagull wing” method. Liposuction of the sides and thighs is performed only when necessary. Another common procedural addition to a formal lift is a posterior thigh lift.