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Women and men with an absence of the projection and volume of the gluteal region. With the trend towards fitness and muscle development, women are looking for a pert more voluminous buttock either surgically or through exercise. Deformities can be congenital or acquired, occurring from childhood or appearing in adult life. Alterations in volume or projection are generally due to muscle hypotrophy and lack of fat in the upper gluteal region. With time, the excess fat in the hip area, tummy and thighs together with the force of gravity and the limitations of flaccid skin provoke a concentration of fat in the lower part of the buttocks, giving the appearance of heavy, flattened buttocks.
Incisions and technique:
Usually three to six small incisions in the hip area and gluteal folds. The great advantage of the liposculpture techniques in these cases is the combination of aspiration the excess fat with the injection of this aspirated fat in the depressed areas. In most cases, there is an accumulation of fat in the hip area, culottes and inner thighs and the removal alone of this excess fat with liposuction will bring improvement to the contour. This excess fat can be used as a graft to increase the volume of the gluteal region. Fat injected subcutaneously depending on the specific problem, can correct the problem.
Postoperatively we prescribe the use of an elastic girdle which helps maintain the new form and keep down the swelling. Lymphatic drainage, the light massage, is also encouraged, helping with the swelling in the liposuction areas avoiding the fat injection site. It can be started 24 hours postoperatively. Walking is essential from day two, increasing the distance covered each day. From the third week low frequency ultrasound and endermology will help in the correction of any hardened areas that might develop. These postoperative procedures are done by a trained esthetician or physiotherapist and always under the supervision of the surgeon. Strenuous exercise, running and weight lifting only after 30 days. Walking a mile: two days. Temporary mild pain, especially in the first 48 hours can be treated with analgesics. Swelling, soreness, numbness, bruising usually last a few weeks. Dressings are applied on the small incisions. There will be a leak of the aesthetic fluid through the incisions in the first 24 hours. Dressings will be changed daily. Shower is allowed after 24 hours. You may have to wear a girdle for a few weeks. Stitches will be removed between the 5th and 7th day. Back to work: 2 to 3 weeks. Exercise and sunbathing: 4 to 6 weeks or more. Fading and flattening of the little scars: 3 months to 2 years.
Duration of Results
After the sixth month there should be no more reabsorption and the result remains stable. If the weight remains the same results should be permanent, especially when combined with diet and exercise.
Liposuction improves body contour and increases self-confidence. The results may take a few months to show because there is the possibility of fluid retention following surgery with prolonged swelling. Sometimes the fat injection procedure has to be repeated because there is a limit to the amount of fat that can be injected in one stage. Occasionally, a secondary procedure, or “touchup” may be indicated to improve certain areas, most times under local anesthesia. A special massage, called manual lymphatic drainage helps with the swelling and bruising in the postoperative period, increasing comfort. Gluteoplasty includes several different procedures, from silicone implants to increase the volume, to resection of the skin at the waistline to lift the gluteal region and improve the gluteal fold. These are invasive techniques and as such involve scars with the associated higher risk and complications.
To increase the projection of the gluteal region through the association of liposuction and fat grafting. There are two main body types the gynoid, with a concentration of fat below the waistline and android, which concentrates fat above of the waistline. Both types can benefit from this type of surgery. The gynoid type in general needs liposuction of the hips, thighs, legs, tummy and fat injection in the buttocks. The android type needing liposuction of the arms, axylla, back, hips, tummy and breasts with fat injection of the buttocks and often the inner thighs as well.
Local with sedation or general. Tumescent anesthesia made the procedure safer.
1 to 3 hours.
Usually outpatient. Extensive procedures may require 24 hour inpatient stay.
There may be temporary pain and tenderness, swelling, a change in nipple sensation and possibly bruising for two to three weeks.
Significant complications from liposculpture are infrequent. Potential complications are asymmetry, rippling, and pigmentation of the skin, bleeding, infection and problems with anesthesia. Temporary numbness of the skin and hematomas (blood accumulations) are possible mild complications. Irregularities of the skin can happen in some patients, but can be treated if necessary. More serious complications involve loss of fluid or blood that can provoke shock, although this is now very rare with the tumescent anesthesia. Infection is very rare. Few patients have found the fat injection technique a disappointment, either because their re-absorption rate was high (estimated at 50-60%) or because they didn’t have enough fat for the increase in size they were looking for. We can inject up to 500ml of fat in each buttock, depending on the case, injecting subcutaneously, and into the existing fat as necessary.