Posted on June 3, 2019
By: Dr. Asaf Yalif
Butt lifts come in many varieties. There are patients who want a bigger rounder profile to accentuate their curves and there are those that just want a bit more oomph and can’t seem to get there with squats alone. As more and more of our diverse Atlanta patients come in requesting enhancement of their buttocks we thought it would be good to discuss the latest trends and “state of the art” procedure that we are performing.
The classic way to make a round projecting buttock profile was to place a solid silicone implant. Initially we placed it over the gluteal muscles but it was plainly visible so over time we refined the technique to place the implant within the gluteal muscle itself. There were several problems with this operation though many still offer it today. The first issue was motion of the implant – over time because the implant is in the muscle and you use the muscle to walk, the implant pocket can gradually increase in size. This makes the “fit” between the pocket and the implant loose and I am sure you’ve all seen videos of women flipping the implant in their backside. Needless to say that is not what we hope for. Second the access incision for this operation is significant because the implants are usually large. As such this operation has become less common and has been replaced by the Brazilian Butt Lift (BBL).
BBL has been the go-to operation for the last several years when you are building a butt. It requires liposuction and then cleansing of the harvested fat with re-injection into the buttock area. That means it is entirely dependent on how much fat the patient has. Meaning little fat means little buttocks. Also the technique has been refined over time to be less risky – as in the past there was a significant risk of injury to deep structures and inadvertent placement of the fat in places we did not want it to be.
These risks and the desire to offer a change for patients that did not have enough fat to transfer to their butts led us to find options for a non-surgical butt augmentation. You have also assuredly heard horror stories of random people injecting cement or free silicone in a basement somewhere in an attempt to make a bigger buttock. These were early unsafe and unskilled attempts at non-surgical augmentation. Over time we have found that the same fillers we use in the face can be used elsewhere in the body. The difference is that for the buttock we require a larger volume than we do in the face. This led us to re-examine Sculptra Aesthetic, a long used filler that can last for over 2 years and can help with irregularities in the skin and cellulite as the preferred option for a liquid BBL.
Sculptra Aesthetic is made with biocompatible, biodegradable, synthetic material called poly-L-lactic acid, which is gradually and naturally absorbed by the body and helps to encourage production of collagen in the area treated. The product is injected in the deep dermis, which is why it may improve the skin texture with less dimpling or less cellulite.
As with any injection we start by having a consultation and making sure that we take good pre-procedure photos. Then we draw where we want the product placed and place some local anesthetic at the injection areas. We also offer adjunct anesthetic options like Pronox©, or various topical anesthetics. Once comfortable we proceed with injecting the product in the outlined areas, similar to having filler elsewhere. It will take a bit longer as there is more product being used. Once completed your buttocks may be sore for a few days and have some swelling and bruising. Mild lumpiness is also normal. We instruct you on massaging the area to make sure the product is spread evenly and works as expected.
The initial swelling and bruising will disappear over a couple of weeks. Massaging the area is expected and will help the product integrate properly and distribute as expected. Over 6-12 weeks you will begin to notice the skin looking better and the contours improving. If at this time you want more volume we can consider re-treating the area to add more. Most patients receive 1-3 treatments to get to their desired result.
We now have an option for patients that don’t want surgery, or who are too thin for a traditional BBL. These are exciting times and allow us the ability to really help with buttock contouring in a way we haven’t been able to in the past. It is safe and effective and allows an incremental increase in the buttock allowing for high variability based on each patients desired result.
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