J. Lo, Kim Kardashian, Serena Williams and Nicole Austin have been making the pages of celebrity magazines for several years now. In addition to sports, reality television or singing talents, these women are best known for their exaggerated figures and prominent backsides. In fact, the London Mirror just published an article naming three of the Kardashian sisters (Kim, Khourtney and Khloe) as having the best celebrity behinds in Hollywood.
While many writers have praised the ‘big booty’ trend as a return to ‘real women’ and obtainable beauty standards, this trend towards a more exaggerated silhouette has also heralded an international explosion in the popularity of certain plastic surgery procedures to enhance the buttocks.
Buttock enhancement: On trend or passe?
While numerous plastic surgeons have reported a decrease in the amount of patients requesting extreme enhancements, procedures to augment or enhance the backside remain popular. While buttock enhancement procedures are more common internationally, particularly in Latin America, with over 75,000 procedures performed annually according to the International Society of Aesthetic Plastic Surgery, the national numbers appear to confirm surgeons reports. However, it’s too early to tell whether this is just a temporary blip in the numbers or a steady trend. It's also impossible to know how these numbers are affected by the growing phenomenon of medical tourism which is increasingly popular among young and middle aged Americans seeking plastic surgery procedures*.
The 2012 report by the American Society of Plastic Surgeons, shows that the number of gluteal procedures actually decreased by 1/3 from 2011 but grew by 114% overall since 2000.
More importantly, here's what you need to know about these procedures if you want a more pronounced posterior.
Types of gluteal augmentation
There are two different procedures used for gluteal augmentation; fat grafting and gluteal implantation. Each procedure has different recommendations and potential complications. Deciding what procedure is best for each individual should be determined during a consultation with the plastic surgeon. During this consultation, the surgeon will take a through medical history, evaluate the patient’s skin and muscle tone during a physical examination and provide a complete explanation of the procedure and expected outcomes. The patient should bring photographs, and be prepared to ask questions during this session. Together, the surgeon and the patient should decide upon the procedure to best incorporate the patient’s existing physique, overall appearance and desired enhancement for the optimal post-operative appearance.
Fat grafting is the use of the patient’s own fat for buttock enlargement. This procedure is usually recommended for patients who want more subtle results, are having concurrent liposuction or patients who do not want artificial implants.
With fat grafting, also known as fat transfer, the plastic surgeon uses liposuction to obtain fat from another area of the patient’s body for transfer to the buttocks. This procedure is often done in combination with liposuction procedures for that reason. For example, a patient undergoing fat grafting may elect to have liposuction of the lower abdomen at the same time to enhance the body contours by slimming the waist and enlarging the buttocks. This procedure is best used for candidates that are interested in more subtle results. If very large amounts of fat are injected into the buttocks, the risk of dimpling and unattractive jiggling may increase.
Over time, a small amount of the transferred fat will be reabsorbed. However, there is little risk of infections, or allergic reaction since the injected material is native to the patient. Patients may have bruising and discomfort at the liposuction site for up to a month after the procedure. However, the most serious complication of this procedure is fat embolism, which is a risk with both fat grafting and liposuction. While this complication is rare, it can be fatal.
Gluteal implants are silicone implants that are similar in appearance to breast implants. These implants are placed into the gluteal muscle to enhance the buttocks through a 3 cm incision in the valley between buttocks. This procedure is recommended for patients who desire more dramatic results as well as very slim patients who may not have sufficient adipose tissue for fat transfer. This procedure is also preferred by individuals who want a more firm, or muscular post-operative appearance.
The most frequent complication from gluteal implantation is infection due to the proximity of the incision to the anus. While superficial infections of the surgical incision can be treated with antibiotics, more serious infections may require removal of the implant. Other complications of this procedure may include implant migration, or visible implant contours, particularly if the implant is placed too close to the skin surface. With proper placement, implants should be invisible to the eye and imperceptible to the touch.
Both of these procedures should be considered major plastic surgery; requiring a full pre-operative evaluation prior to proceeding. While many surgeons perform fat grafting under conscious sedation or epidural analgesia, some surgeons may use general anesthesia for either of these procedures which may increase the risk of cardiovascular complications particularly in patients with a history of hypertension, high cholesterol, smoking or cardiovascular disease such as a previous heart attack, stroke or peripheral vascular disease.
Safe surgery for optimal results
These procedures should always be performed by a board-certified, licensed plastic surgeon in an approved medical facility like a same day surgery center or hospital. Surgeries of this magnitude should never be performed in a doctor’s office, a motel room or the patient’s home.
Make sure the surgeon is actually a plastic surgeon. As reported in multiple news stories and websites, many of the doctors advertising cosmetic surgery procedures are not board-certified plastic surgeons. Sometimes, they aren’t even physicians. Prospective patients should verify the surgeon’s credentials with the American Board of Plastic Surgery or the state board of medicine.
These procedures should never be performed by unlicensed personnel. Additionally, the injection of other substances such as silicone, vegetable oils or other compounds directly into the tissue, is not an approved surgical procedure, and may cause serious complications such as infection, disfigurement or even death.
*Few reliable statistics exist for determining the number of medical tourists from the United States each year.