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Better Contouring with Body Implants

Implants are an exciting addition to body contour surgery. They have especially been embraced by males, explains Sydney cosmetic plastic surgeon DR DARRYL HODGKINSON.

With the popularity of Naomi Campbell on the catwalk and Jennifer Lopez as a film superstar, fans and admirers have noted and envied their well-shaped backsides. Genetically disposed to have a full round buttock, these women are encouraging others without such proportions, to seek out buttock augmentation.

BEFORE and AFTER buttock
implants by Dr Hodgkinson

The marketing of padded underwear for enhancement of the buttocks and hips, in men and women, is a large selling item at lingerie and underwear stores indicating that many people are displeased about their buttock projection and proportion. In the history of male and female sexuality, body building, wearing hoops under dresses to enhance the derriere represent ways in which the back end has been enhanced for sexual appeal. Many apes and monkeys display their derrieres as primary sexual devices which is not totally lost on us humans.

Buttock enhancement by plastic surgeons has undergone an international review and reassessment recently. Fat injections have been used by many surgeons; however, the champions of buttock augmentation are the South Americans who use a variety of different, silicone implants both gel and firm. Previously, our South American colleagues responded to the demand in their countries by developing different sized and shaped buttock implants which were inserted under the skin. But more recently, implants have been inserted under the gluteus maximus muscle and the muscle fascia. The aesthetics need to be carefully reviewed by the surgeon and discussed in detail with the patient. The solid or cohesive gel implants need to be inserted so as to give maximum projection in line with the pubis – not too high or too low. In males who seek buttock implantation, the implant can be inserted about 20% higher than in females,which gives an elevated buttock and looks much better in hip hugging jeans. Males often present after an accident or purely because they have a flat ‘butt’ and some males are on Protease inhibitor medications which have a tendency to flatten the buttock because of loss of fat around the gluteus maximus muscle.

Technically, the procedure after careful design, requires general anaesthesia, the patient in the prone position and a midline intra-gluteal incision down to the sacrum and exposure of the gluteus maximus muscle. This muscle is split and the implant is placed under the split muscle. The muscle is then repaired. If the patient has enough soft tissue, the deep fascia] approach can be entertained and this does not interfere with the gluteus maximus muscle itself. The unpredictability of fat injections and the need to repeat the procedure of fat injections, often deters both the surgeon and patient from the employment of this technique and many patients who do request buttock enhancement are in fact, devoid of excess fat for such a procedure.

My tips for success for buttock augmentation, are careful pre-operative assessment and planning with the patient; a quiet post-operative period, preventing sitting on the implants for 10 days and then ‘pillow’ sitting for a further 14 days. See photographs of before and after buttock augmentation, padded underwear and Michaelangelo’s masterpiece.

Reference: Jean-Luc Hennig -“The Rear View” Souvenir Press 1995