BEFORE AND AFTER PHOTOS
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Implants vs. Fat Injection
Not overlooked in the appreciation of human form is the appearance of one’s butt. A few years ago, an entire book was devoted to the human butt. Several years ago, butt cleavage made its debut among female singers, thankfully this does not appear to be catching on. Jennifer Lopez has a world-famous butt and her name comes up frequently in discussions of buttock aesthetics. Tabloid magazines include a “best butt” category, the same way they include “best abdomen” or “best breasts.” George Carlin for years lamented his lack of buttocks, saying his black friends asked him, “where is your ass at?” Sir Mix-a-Lot immortalized fine (and large) buttocks in the memorable 1992 hip-hop song “Baby Got Back.” Buttocks have some of the same qualities making them look good in men and women—full cheeks, definition and skin tone.
Unfortunately, implants have a higher rate of complications when used in the buttocks than when used in the breasts. These include wound opening (“dehiscence”), infection, seromas, capsular contractures, and malposition. They can produce an unnatural appearance. Most surgeons avoid using buttock implants, and opt for fat injection instead.
Properly-performed liposuction can improve the appearance of the buttocks by reducing excess fat from adjacent areas. Liposuction must be done with the eye of a sculptor to achieve attractive buttocks. The center of the buttock is treated very conservatively, if at all. No one wants a “flat butt.” Most of the liposuction is done around the periphery of the buttocks—the flanks and the back of the thighs. This can give the illusion of tighter, more rounded buttocks. For both women and men, reduction of “love handles” will accentuate the buttocks. This is an illusion that works well to give more of an hourglass figure in women, and improves the appearance of the male butt. The improvement in buttock shape is evident in postoperative photographs of patients treated by liposuction (see Liposuction—Before and After).
The buttocks lend themselves nicely to fat injection. In the past, fat obtained by liposuction was usually discarded. We now recognize that there is a limited amount of fat cells available and it is a shame to discard this limited resource if it can be put to good use. It is becoming much more common now to save this fat and inject it where we want it.