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.
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 fascial
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.
Reference:
Jean-Luc Hennig -"The Rear View" Souvenir Press 1995
Darryl J.
Hodgkinson, MD
20 Manning
road
Double Bay,
NSW 2028, Australia
Tel. ++61 2
9328 7044
e-mail:
dr_hodgkinson@bigpond.com.au
