Thigh - Buttock lift

What procedures can we perform today to correct hanging buttocks?

In the recent years, women tend towards well-shaped but more feminine silhouettes. The increase of procedures that involve improvement of buttocks’ appearance is high and has led to the development of new surgical techniques.

The American Society of Aesthetic Plastic Surgery announced a five-time increase in the number of buttock lift procedures compared to the previous year. With existing techniques, we can achieve lifting, reshaping as well as resizing the buttocks. In particular, we use the classic buttock lift procedure and more recent techniques in Liposculpture, silicon implant or fat placement - Liporecycling (using fat from the same patient to enhance the size of the buttocks). The above procedures are performed under general anaesthesia and require one day of hospitalisation. They can be performed alone or in combination with each other depending on the problems that need to be fixed and the desired aesthetic result. However, as is the case in all aesthetic procedures, the evaluation and treatment of each patient is fully individualised.

How do we select which procedure(s) to perform?

Our main criteria are the shape and dimensions of the buttocks and, of course, the body. Another very important criterion is the quality and quantity of the skin and fat in the area (e.g. elasticity, excess fat, cellulite, stretch marks etc). Excess fat and skin laxity allows us to proceed only with a buttock lift (a much more extended procedure with larger incisions and scars which cannot be avoided and are made at the upper limit of the buttocks, along their length).

However, when skin quality is good, liposculpture, performed in key points (e.g. upper and outer buttocks, outer and upper thighs), may give the illusion of a buttock lift with concealed scars and very good results. If we also want to increase the size of the buttocks we may combine the buttock lift with implants placement or even use fat from areas in which fat is not needed.

How painful are these procedures?

Cosmetic surgery procedures are quite tolerable in general and for this they are more popular. The recovery time and post-surgery pain is of course relevant to the extend of the procedure and in our case, as mentioned before, the buttock lift is considered to be a procedure of greater severity that involves incisions usually made above and/ or under the buttocks and drain placement. Of course, we systematically administrate analgesics for at least 5-10 days and pain is limited to a minor feeling of discomfort and tension that improves by the day. Other procedures: liposculpture and implant/ fat placement are much better tolerated.

In how many days can a patient resume his/her activities?

After the Buttock Lift a patient needs approximately 10-15 days before returning to work but it will take a month before everything is back to normal again. During this period, bruising and intense swelling reduces but the patient must wear a special compression garment. Swelling will fully subside 3-4 months post-op, but the difference is impressive and is already apparent from the first month.

As mentioned above, recovery is faster compared to other procedures. Thus, after liposculpture performed with or without liporecycling, the patient needs approximately 7-10 days before resuming daily activities but the compression garment, which is also needed in this case, remains on for 4-6 weeks. The patient will be able to sit down after 48 hours but not for too many hours and may return to the gym after 4-6 weeks. The same applies following implant placement, the only difference being that the swelling remains for a longer period (up to 3 months). This is why implants first appear to be placed higher on the buttocks until the swelling retreats and implants return to their normal position.

How visible are the scars?

Buttock lift with incisions leaves extended and permanent scars that improve with time, but their appearance is relevant to the patient's recovery rate. We aim of course at making the incisions in areas that are usually covered by underwear, but this is not always possible. Liposculpture leaves almost no scars and implant placement is usually made through a vertical 4-6cm incision in the intergluteal cleft that is not apparent after healing.

How long do results last?

Results have prolonged to permanent duration on the condition that the patient's weight will not increase or decrease significantly.

What are the risks from such a procedure and what should one expect?

The risks are the same as in every aesthetic procedure and are surely relevant to the extent of the procedure. To name but a few, procedure risks include haematoma, inflammation, temporary alteration of appearance, imperfect healing of trauma, scars, asymmetry and possibility of recurrence. All above are rare problems that can be handled if there is good co-operation between the doctor and the patient. In general, however, a good selection of candidate patient (healthy, well-informed and without absurd expectations), and with correct implementation of the appropriate technique, risks are reduced, and results are satisfactory.

Can silicone implants or fat be used to fill the buttocks?

Silicon implants in compact resistant form are used for breast augmentation and enhancement of the upper-middle part of the buttocks (silicon is different in texture compared to that used in breast implants). They are placed through a relevantly small incision “concealed” in the upper end of the intergluteal cleft in a pocket created between the layers of the gluteus maximus.

The patient should know that this procedure has an increased risk of inflammation and incision opening which however can be treated if it occurs. Moreover, very rarely the implant can move or turn in which case a second procedure is required. In case of previous liposuction in the same or in another area fat may be placed wherever need in the buttocks area.

A relevant problem is the rate of infused fat to “survive” and to be incorporated in the surrounding tissues. This is why we prefer over-correction so that we may retain a satisfactory long-term quantity following the first quarter absorption. As to the feeling at the specific area, this is quite natural. On the other hand, implants provide the feeling of a very tough muscle after many years of exercise.

Which are the advantages and disadvantages of these procedures?

The advantage of the Buttock Lift is that it is actually the only procedure that can correct marked laxity and excess skin. The disadvantages include the severity of the procedure and recovery time as well as the extent of scars following the procedure. Liposculpture is a good way of getting a buttock lift result with small incisions with the advantage of the possibility to use fat for enhancing the buttocks. The disadvantage of the procedure is that we cannot use it on slim women, and we cannot predict exactly the volume of fat that will be absorbed during the first quarter since the result is permanent after that period. For thinner women may benefit from the implants’ technique. However, this also involves an increased risk of inflammation and longer recovery period.

There is a lot of talk lately about threads. What is it exactly and how is it applied?

There is a lot of talk recently on the use of threads, first of all on the face (Threadlift) and then on breasts or buttocks for lifting with a procedure of limited extend. The idea is very interesting, but we are not yet convinced, nor is the scientific community around the world, about the safety, quality and longevity of the achieved results.

Which buttock lift procedure would you recommend to a young woman?

We advise young women with a Mediterranean figure and good skin quality given their age, to undergo a Liposculpture with or without Liporecycling. A thinner woman with irregular figure and smaller fat concentration (e.g. thighs fat) could benefit only from a liposculpture while silicon implants placement might also be advised.


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