BUTTOCK AUGMENTATION

Dr Rajat Gupta, MS, DNB National Board Gold Medalist Cosmetic Plastic Surgeon RG Aesthetics, Delhi 6 years in practice

Dr Rajat Gupta is a board certified plastic surgeon in India. Having completed his training from Maulana Azad Medical College and equipped with a thorough understanding of aesthetic needs of people, he strives to offer the best remedies and cosmetic procedures outfitted with the latest technology to the aspirants in India and across the globe. He attained fellowship at Fellow Instituto de Benito, Barcelona (Cosmetic Surgery) and Fellow Hospital Sant Pau, Spain (Breast Surgery). With his far spanning exposure in countries including Spain, Paris, and Singapore, Dr Gupta is familiar with the international standards of cosmetic surgeries and adheres to them with precision. He has been regarded as a pioneer for high definition liposcultping and buttock augmentation in India.

Know more from Dr Rajat Gupta on buttock augmentation:

How do you identify a good candidate for buttock augmentation? What is the type of patient you typically see for this procedure?

The most common patients who come to us for standalone buttock augmentation procedures are in the age group of 20-35-years-old. These patients are usually not happy with the shape or size of their buttocks. Where the lower back and the buttock lacks definition, they desire a projection of the buttock to create the perfect S-curve. Sometimes they want an hourglass shape, for which the fat has to be removed from their love handles and flanks and it goes into the buttock. The third kind of patient is someone who has hip dips. These are common genetic issues, which are in a way normal, but with the growing popularity of the hourglass models, a lot of women do not prefer these natural hip dips. So these are the three kinds of patients asking for either a projection, a width increase, or a correction of hip dips or their combinations.

A good candidate is anyone with a good amount of excess fat at certain areas of the body – such as abdomen, lower back, thighs, arms – that can be a donor site to augment the buttocks. An ideal candidate is also the one who understands the limitation of the procedure and what they can achieve in a single stage procedure, how much fat they want and how much they can give for donation, how much fat they have in excess in certain areas, and if that much fat is sufficient to give the volume enhancement in the buttock they want. All of this needs to be assessed and discussed with the patient.

How can best results be derived from this treatment? Tell us about the surgical technique adopted by you?

The safest way to achieve best result is by the expansion vibration lipofilling (EVL) technique. This is a technique wherein we achieve the surgical procedure that is now called as safe subcutaneous buttock augmentation (SSBA). This technique ensures that the fat is transferred in the subcutaneous layer of the buttock. It should not go beneath the deep fascia in the muscular layer, and this is where at one point, the procedure went into disrepute. Many surgeons while putting the fat through a syringe and a cannula and pushing the fat in, inadvertently would point their cannula in the deeper layer, and the fat would traverse toward the muscular layer. This is where large vessels would be and the fat cells could go into these vessels causing embolus. Several such cases were identified globally with even causing deaths post buttock augmentation. This is when the procedure went into disrepute with it being banned in certain countries as well.

The most common patients who come to us for standalone buttock augmentation procedures are in the age group of 20-35-years-old.

Eventually, a task force was set up to bring in the safety protocols, which are now well-established, for this procedure. EVL is a safe technique for this procedure and I am proud to say that I was one of the first surgeons who started this procedure in India. We have the largest series of more than 200 safe and effective cases done for buttock augmentation as on date.

What is the recovery time for buttock augmentation and what is the posttreatment care involved?

Whatever fat we transfer in any part of the body, even so with the buttocks, 30 to 40 per cent of fat may get absorbed over the next three to four weeks. But whatever stays has the potential to be permanent. To ensure that the fat absorption is not irregular, there are some typical postoperative recovery protocols that a patient needs to follow.

First, one has to ensure that the buttocks are offloaded. Post the procedure, the patient should not be lying on her buttocks for at least three weeks. I advise them to stay in prone position for three weeks and avoid going supine. At the same time, since we have done liposuction, the patient is advised to wear a compression garment, which is customised to ensure that there is no compression over the buttock area. It typically has holes so that the buttocks do not experience compression, but the donor side for fat – back, abdomen, thighs or arms – have compression. Also, the third important aspect is the BBL special pillow. We cannot ask the patient to not sit for three to four weeks. But when they sit, the pressure will go to the buttock and this can make the fat absorb irregularly. Hence, the BBL pillow can be used as it offloads the buttocks and the body weight is actually transferred to the thighs.

Any contraindications involved that one should be aware off?

In cases where the woman does not have enough fat to give for the buttock augmentation to be done, one has to resort to the silicone buttock implants. The other relative contraindication would be a woman who has high expectations and wants an exaggerated hourglass shape. I usually avoid such cases as the person may require an exceptionally high amount of fat to be transferred to the buttock, which in turn may be dangerous.

Tell us about your most challenging and successful case study for this treatment.

One of my female patients was bit by a dog when she was a child (7-8-year-old) and had developed a deformed buttock on one side. When she came to me at the age of 20, she also had lopsided buttocks. The problem here was that the lopsided buttock was full of scar tissue. In such cases, this technique is not only considered for pure cosmetic reasons, but is also seen as a reconstructive procedure. More than a nice shaped buttock, this patient wanted a normal butt. However, putting fat into a scar tissue is an extremely challenging case. So we had to free the whole scar, create the space and then put the fat.

In present times, I have started using this technique to augment buttocks in most of my body contouring patients and not only restrict it to who ask for buttock augmentation. For example, in a case for liposuction of the abdomen or even abdominoplasty for any women, I add a bit of fat in the lateral hip dips and butt area and it gives the patient a nice hourglass shape. This changes the way how your abdominal liposuction or abdominoplasty result would look like. A small addition of around 100, 200 cc of fat in the lateral butts actually improves the overall body contouring results. This is a small tip that I would like to offer all plastic surgeons: start doing this and you will see your results transform in to a nice hourglass shape, which almost every woman desires.

The safest way to achieve best result is by the expansion vibration lipofilling technique.