1. Does the augmentation gluteoplasty leave scars?
Every surgery leaves scars, some in more visible places, others in more camouflaged places. Fortunately, buttock surgery allows the scar to be in a well-disguised location, making it virtually imperceptible.
2. Where is this scar located?
The scar is located at the beginning of the intergluteal sulcus, a natural fold existing between the buttocks. The scar is about 5 cm and is located in the superior region of this groove, having a very good and discreet long-term result because it is naturally hidden.
3. How will the size and consistency of my buttocks look like after the gluteal prosthesis gets in place?
Of course, the size of the buttocks will be increased. In addition, we seek to improve the shape and consistency of the buttocks with prosthesis implantation. Following a medical appointment, through a series of measurements taken on your buttocks and maintaining balance with your torso, the surgeon will suggest the prosthesis of the size and shape that best fits your body. Harmony between ideal buttock volume, trunk size and patient height should be preserved at the end of surgery. Therefore, if a friend put on a gluteal prosthesis of a certain size and shape, this prosthesis will not necessarily be right for you. As the gluteal prosthesis has a greater consistency than the buttock tissue, it is expected to increase its consistency after prosthesis placement.
4. Can I choose the shape and size of prosthesis I want?
Each patient has particularities about the consistency, shape and volume of the buttocks, as well as proportions between their height, trunk and hip size. Given this, there are numerous possible combinations of shape, volume and type of gluteal prosthesis and the ideal for each patient will be chosen in the medical consultation after thorough physical examination.
5. Is there a risk that the gluteus prosthesis will burst?
Buttock prostheses are made of an extremely resistant and distensible material. In addition to this factor, the gluteus prosthesis has the protection of a large layer of gluteus adipose tissue and gluteus maximus muscle, located above the prosthesis, which considerably reduces the incidence of trauma rupture in this region. In cases of trauma rupture, the prosthesis would act by absorbing the impact, helping to prevent further damage to the pelvis. Although very rare, in such cases the prostheses could be replaced by the augmentation gluteoplasty scar itself, without any sequel to the patient.
6. If I need injections, can they be done on the buttocks?
No, after augmentation gluteoplasty surgery intramuscular injections can never be performed on the buttocks again. However, this is not harmful, as injections can also be performed equally well on the arms and thighs.
7. Gluteal prosthesis are located above or below the muscle?
The gluteal prosthesis are located in a plane below intramuscular, surrounded by the fibers of the gluteus maximus muscle. Thus, the prosthesis is well protected by the muscle and adipose tissue layer, preventing it from being viewed externally and providing a more natural look to augmentation gluteoplasty.
8. Postoperative augmentation gluteoplasty is painful?
A little painful, especially in the first three days, due to the distension caused by the prosthesis between the gluteus maximus muscle fibers. However, the pain is perfectly controlled with common painkillers and anti-inflammatory drugs, gradually improving during the first week after surgery.
9. When will I reach the definitive result of augmentation gluteoplasty??
Although the immediate result is very good, both in the shape and size of the buttocks, the buttocks will reach their definitive result after about 6 months, when all swelling will have subsided. However, about 90% of gluteal swelling subsides after 3 months, this being the period with the largest changes in shape. Regression of edema will make the glutes look more natural and beautiful, so the result of the surgery progressively improves until the 6th postoperative month.
10.What type of anesthesia is used?
Epidural or general anesthesia, depending on each patient and the indications and contraindications of each type of anesthesia and which will be discussed with the anesthesiologist before surgery.
11. How long does the surgery last?
The average duration of surgery is 90 minutes. Variations in this time may occur depending on each case, however the duration of surgery hardly exceeds the period of 120 minutes.
12. What is the length of stay?
Usually for 24 hours, regardless of the type of anesthesia used.
13. Drains are used in augmentation gluteoplasty?
Almost always a small drain is used that stays inside the buttocks for an average period of 48 hours. The drain is important to prevent the accumulation of blood and secretions inside the buttocks, reducing the incidence of complications in surgery and helping in the regression of postoperative edema.
14. When will surgery stitches be removed?
Absorbable internal stitches that do not require removal associated with the application of a surgical glue on the outside of the scar are generally used, improving the quality of the scar and reducing the risk of infection.
15. When can I take a full bath?
Normally, a full bath is allowed 48 hours after surgery, immediately after removing the drain.
16. When can I perform physical activities?
Usually, the patient is allowed to perform lighter walks 3 weeks after surgery. Running and cycling only 45 days after surgery and bodybuilding, 2 months later. These periods are average, so it is important to ask your surgeon if you are qualified to perform any kind of physical activity before doing it.
17. What is the gluteus capsule retraction?
It is an exaggerated retraction of the fibrous capsule (internal scar) that forms around the prosthesis determining different degrees of hardening to the region, better known as “prosthesis rejection”. Some cases may result in retraction with varying degrees of glute pain and prostheses may need to be removed and replaced. Subsequently, surgeon and patient may consider whether or not to reintroduce other prostheses with a different introduction plan or other approach that best suits the case. The retraction of the capsule does not reflect a surgical problem, but rather an exacerbated reaction behavior of the body due to the presence of silicone prostheses. However, the quality of new silicone prostheses greatly decreases the incidence of these retractions in patients. Currently occurring in gluteal prostheses is very rare, occurring in less than 2% of cases. Lay people often call the capsule contracture "rejection," but augmentation gluteoplasty does not produce true rejection, after all silicone is inert and does not lead to antibody production.
18. Should the glute prosthesis be changed? When?
The gluteal prosthesis suffers a natural wear over time, causing alteration in its shape. However, due to the great technological development of the latest generation of gluteal prostheses, it is believed that today's prostheses should generally be changed after 20 years. However, if after 20 years the prostheses remain pleasing in shape and consistency, replacement is not necessary.
19. How to know if I will develop very visible scars, forming keloids?
The tendency to develop hypertrophic or keloid scars is greatly influenced by genetic factors. In general, fair-skinned people are less prone to this healing complication, whereas dark-skinned or oriental people are more prone to keloid or hypertrophic scarring. This tendency can be predicted to some extent during the initial consultation, when the surgeon asks a series of questions about the patient's previous clinical life, as well as the analysis of family characteristics, which often aid in the prognosis of scars. In general, what decreases the incidence of these scars are care used during their closure during surgery, such as the meticulous closure of the entire scar and the use of surgical glue on the external region of the scar.
20. There is correction for unsightly glute scars?
Today, plastic surgery has several features that not only improve such scars, but also prevent their appearance. Corticoid-based ointments and injections at the scar site and small compressive silicone plaques are the main treatment that will be instituted by the surgeon at the appropriate time. It is important to remember that keloids should not be confused with the normal course of a scar, which maintains a reddish appearance for the first 2 months and gradually improves over time and that questions about the scar should be answered by the surgeon and not by third parties.
21. Buttock surgery may be associated with other plastic surgeries?
Yes. It is extremely common to associate other surgeries with gluteal prosthesis surgery, especially liposuction. However, any association should be discussed with the surgeon, as the possibility of associating more than two surgeries is not usually recommended, since excessive duration can cause harm to patients.
22. What's the best surgery: silicone buttock prosthesis or liposculpture augmentation?
There is no right answer to this question, after all they are different surgeries and with different expectations. The increase of the buttocks through liposculpture has limitations and is not indicated for very small buttocks that require large amounts of fat for their increase. This is because in liposculpture live fat cells taken from other regions of the body (such as flanks and breeches) are implanted in the buttocks, expecting them to remain alive in their new locality. Cells that do not stay alive are removed by the body's defense cells, leading to a variable rate of absorption of this fat (on average, 20-30% of the implanted fat is absorbed). However, if a large amount of fat is implanted in the buttocks, it is more likely to be absorbed, resulting in lower cell survival and results below patient expectations. In addition, grafting fat on the buttocks does not increase their fat consistency, but only their volume. Finally, thin patients without localized fat who want glute augmentation are not eligible for this type of surgery, since the material for the increase (fat) does not exist in sufficient quantity.
But the gluteal silicone prostheses allow larger volume increases without the above mentioned risks of liposculpture, besides improving the gluteus consistency. In addition, when the prostheses are well chosen by the plastic surgeon, more rounded butt shapes are achieved, with a more aesthetically pleasing contour.
Thus, it is clear that for small increases in the buttocks and correction of minor imperfections, liposculpture is well indicated. For larger increases, in patients who also wish to improve gluteal consistency, the most indicated surgery is the implantation of silicone prostheses.
23. There are risks in augmentation gluteoplasty?
Serious complications in augmentation gluteoplasty rarely occur, which is the result of adequate patient preparation, as well as the analysis of whether or not this surgery is associated with others. The risks of gluteal prosthesis surgery are those inherent in any other surgical procedure (such as bleeding, infection, and unsightly scarring) and some specific risks, such as gluteal capsule contracture explained above. However, choosing a good professional, Member of the Brazilian Society of Plastic Surgery, and choosing an appropriate and well-equipped hospital or clinic for the surgical procedure help to minimize such risks.