The female silhouette has been the inspiration for many works of art throughout the centuries. Amongst the many traits that make up a desirable and attractive physique are the buttocks. Sixteenth Century Artists such as Diego Velazquez portray's the female beauty and vanity eloquently in his painting titled "Venus at Her Mirror". Later, in the nineteenth century, French artists such as William Bouguereau who in his realistic style depicted mythological themes flawlessly, also placed heavy emphasis on this part of the female human body. His ideal of perfection portrayed a slender juvenile and beautiful physique as seen in his work "Lost Pleiad" (1884)
What is considered to be desirable in terms of shape and volume varies greatly from one individual to another and is undoubtedly, transcultural.
The universal allure of the "hour glass figure" is more evident in certain cultures. In Latin and Afro american cultures, it is generally well accepted that an attractive back side is a very desirable trait. Among the many theories pertaining to the attractiveness of this physical trait in women, an evolutionary theory stands out. It is hardly sophisticated and assumes the hardwired sentiment equating it to reproductive potential and fertility.
Popular culture, especially during the last decade has made no attempt to minimize it's fashionability. More recently, the media has increased the general demand for gluteal augmentation and reshaping. Statistics collected by the Society for Aesthetic Plastic Surgery reported a 533% increase in gluteal augmentation between 2002 and 2003.
"Venus At her Mirror" By Diego Velazquez Courtesy of Wikimedia Commons
Many of the popular stars today such as Kim Kardashian and Jennifer Lopez amongst many others, have beautiful physiques that tend to have more pronounced and attractive back side silhouette.
The further study of the buttock shape and anatomy in plastic surgery has designated this anatomical unit as the Gluteal Aesthetic Unit.(GAU)
There are a variety of techniques in plastic surgery available to enhance the profile of the (GAU) but can be divided into 2 categories. Autologous (using the patients own tissue) augmentation and Prosthetic Augmentaion (silicone implants similar to breast implants)
The brazilian butt lift is an Autologous tissue augmentation, because it uses excess fat from other portions of the body and then artfully injects them strategically into the areas above and directly into the gluteal muscle to enhance the buttocks. Total fat graft survival is reported to be 50% to 70%. MRI studies have showed favorable results after 1yr in terms of fat graft survival.
Method
The Plastic Surgery Literature is replete with a variety of methods for harvesting fat and then applying it to the gluteal area for augmentation.
In general, the fat donor area is infiltrated (injected) with saline solution in combination with lidocaine and epinephrine(decreases bleeding). This combination is known as tumescent solution. Several versions of this solution are described in the plastic surgery literature. Once infiltrated, approximately 10-20 minutes are allowed to elapse before the fat is harvested into 60cc Syringes with a blunt tip cannula through a small incision. The typical donor sites are the abdomen and the hip areas or abdominal flanks (sides of the abdomen). Other potential donor sites are the upper thighs. Harvesting has also been described with standard liposuction techniques.The fat is allowed to sit and decant(float to the surface). Excess fluid is discarded. Once harvested, a small midline incision at the junction of both gluteus muscles is made. This site is not visible since it is in the crease. A cannula connected to a syringe containing the "purified" fat is inserted and injected strategically in a fan shaped pattern along the gluteal surface to selectively enhance it. Since 30-50% of the fat will resorb (not remain), this is added to the total expected amount of volume.
The typical described amount of the injection varies greatly, but amounts ranging from 300 or 400 to 1500 have been described.
Potential complications reported in the literature from diverse publications.
-Bleeding
-Infection (Cellulitis or Abscess)
-Sacral Numbness
-Small irregularities
-Need for re-augmentation
-Fat embolus (rare)
-Asymmetry
Results
Several studies have demonstrated favorable results using fat grafting. One study including 162 patients of which 123 were available for written followup had the following results:
-Excellent, 112 (91.1 percent);
-Good, seven (5.7 percent)
-Fair, three (2.4 percent)(asymmetry);
-Poor, one (0.8 percent)
Ask your NYC Cosmetic Surgeon what he or she thinks of this procedure prior to undergoing buttock augmentation.
* Always consult with your plastic surgeon prior to undergoing any plastic surgery procedure. Make sure that your plastic surgeon is an actual plastic surgeon by asking if she or he is ABPS board Certified or eligible
Stay Tuned.....
Bibliography:
1 Augmentation of the Buttocks by Micro Fat Grafting: Thomas L. Roberts III, MD,Luiz S. Toledo, MD and
Ana Zulmira Badin, MD Presented in part at the 33rd Annual Meeting of the American Society for Aesthetic Plastic Surgery, Orlando, FL, May 14, 2000. Aesthetic Surgery Journal July 2001vol. 21 no. 4 311-319
2 Gluteoplasty : Anatomic Basis and Technique;Fernando Serra, José Horácio Aboudib, Juan Pedro Visser Cedrola and Claudio Cardoso de Castr ,Aesthetic Surgery Journal 2010 30: 579
3.Buttock Augmentation: Case Studies of Fat Injection Monitored by Magnetic Resonance Imaging,William L. Murillo, M.D.New Orleans, La.; and Cali, Colombia. Plastic & Reconstructive Surgery. 114(6):1615-1616, November 2004.
4.Clinics in Plastic Surgery. 2006, Vol 33 (3): 449-466
1 comment:
Great article Dr. Magana!
Emmanuel De La Cruz MD, PLLC
Houston Plastic Surgeon
www.delacruzplasticsurgery.com
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