With the concern of the higher than realized rate of death from the Brazilian buttlift procedure, other mechanisms of augmentation should be reexamined as well.

Butt augementation can be achieved with semisolid silicone implants which can be placed within the muscle or below the fascia. The implants cannot be placed under the muscle as this results in sciatic nerve compression. There must be a protective gluteal muscle cuff below the implants to relieve pressure on the sciatic nerve.

The butt implant surgery can be performed through multiple incision locations, though many perform the incision or incisions at the level of the intergluteal crease or cleft (above the level of the buttock crack).

Buttock augmentation can be conservatively done with implants as small as 200 cc or so up to the largest implant of 712 cc. Dr. Hughes has performed many of the 712 cc buttock implant surgeries though smaller implants admittedly result in easier recovery and fewer complications, in general. Once again, there is a balance between patient expectations for improvement and what is reasonable or safe for a person’s anatomy. Due to the large number of butt implant revisions Dr. Hughes performs, he realizes the need to satisfy the patient demands with the first surgery in regard to size and shape.

Buttock implants come in largely two shapes, round and oval. Dr. Hughes uses almost exclusively round implants as many patients are trying to achieve not only projection but roundess of the buttocks and hips as well. This simply cannot be achieved with oval implants. In addition, oval implants have the added risk of rotational deformity should they move within the pocket.

Butt implants can have complications including bleeding, infection, fluid collection, tissue thinning, capsular contracture, wound separation, need for replacement, implant migration, among others.

The Brazilian buttlift and buttock or gluteal implant surgery are the only two approved methods of buttock augmentation.

Foreign Body Injections for Buttock Augmentation

Dr. Hughes does not inject foreign materials into the buttocks. We do not have FDA approved fillers for this purpose. Dr. Hughes does however spend at least several hours a week removing foreign material that has been injected by someone else. These injections can lead to skin damage and skin death, infections that can become fulminant and lead to death, hard areas that generate pain on sitting or walking, along with various other complaints not the least of which is cosmetic.

In many of these cases of injection that Dr. Hughes treats the substance may be silicone, PMMA, hydrogel, and many other liquid variants. The patients often present with pain, skin changes, and inflammation, redness, and swelling around the sites of injection. Dr. Hughes makes every effort to remove as much material as possible while minimizing the cosmetic deformity to the extent possible. In addition, Dr. Hughes makes the incisions small, frequently only placing one small incision on each side to facilitate removal. Dr. Hughes has this process choreographed on several of hius you tube videos. A small incision is made and through visual inspection and palpation, Dr. Hughes is able to identify the offending agents. He then removes these areas without removing the surrounding viable tissue so that he minimizes deformity to the patient.

A large number of Dr. Hughes’s patients have had previous removal through a large scar that extends from hip to hip at the level of the buttocks. In these patients, Dr. Hughes frequently has to revise the scar and reposition tissue or add fat or gluteal implants to restore the contours.

The main risks of the procedure include fluid collection, incomplete removal, infection, and need for cosmetic adjustment with fat transfer or buttock (gluteal) implants in the future.

Recovery is typically rapid with patients expresses improvement in comfort and feel of the buttocks shortly after surgery. Patients should realize that recovery may take 3 months or longer for the surgical sites to heal internally. At that time, additional cosmetic surgery can be performed if necessary to improve the cosmetic appearance.

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