WHAT IS GLUTEOPLASTIC?

The gluteoplasty , also called the gluteal contouring surgery, is a plastic surgery which allows to modify the shape and size of the buttocks. Through the intervention of gluteoplasty it  is possible to increase and / or modify the shape of the buttocks in patients who have a relaxation of the tissues caused by an important weight loss or by the natural passage of time, or a flat or too small butt.

WHO IS GLUTEOPLASTIC INTERVENTION FOR?

Gluteoplasty surgery is indicated for patients who want:

Increase the volume of the buttocks to make your body more proportionate. Restoring shape and volume to the buttocks that have become sagging and relaxed following a strong weight loss and / or over time.

WHAT OTHER INTERVENTIONS CAN BE CARRIED OUT TOGETHER WITH GLUTEOPLASTIC?

The buttock remodeling can be performed alone or in combination with other surgical techniques such as mastopexy (with or without prosthesis), tummy tuck, liposuction or other cosmetic surgery.

ARE THERE AGE LIMITS FOR SUBJECTING GLUTEOPLASTIC?

There are no age limits to undergo this type of intervention, but it is preferable to wait for the complete body development that generally takes place around the age of majority. If the patient plans to undergo a diet, it is advisable to undergo a plastic surgery to reshape the buttock only when his body weight has stabilized, so as to maximize the results of the surgery.

WHAT SURGICAL TECHNIQUES EXIST FOR THE INCREASED VOLUME OF THE BUTTOCKS?

The most modern surgical techniques used for plastic surgery of the buttocks are two: lipofilling or lipostructure and the use of latest generation prostheses.

The lipofilling is an innovative technique that, in case the patient has sufficient adipose accumulations, involves the use of its own fat to increase and reshape the buttocks. Through very small cannulas, adipose tissue is taken from areas where this is present in greater quantities (abdomen, hips, thighs, etc.) and, after appropriate treatment, it is re-injected with micro-cannulas in the areas of the buttock to be filled. The amount of fat needed to obtain a good increase in seat volume is between 250 cc and 600 cc.

The great advantage of this technique is that autologous tissue is used to increase the volume and therefore there are no complications related to the use of prostheses (capsular contracture, extrusion of the implant, etc.). In addition, thanks to the removal of fat, a remodeling of the areas where there are fat deposits is done, with great patient satisfaction. The disadvantage of this technique is that a part of fat re-grafted through lipofilling (variable from person to person, on average about 30%) is reabsorbed.

The use of glute prosthesis is indicated in patients who do not have sufficient fatty deposits to increase the volume by lipofilling . The prostheses have a smooth surface and are made of the latest generation of silicone conforming to medical use, specific to be implanted in the gluteal region and therefore more resistant than breast implants.

It has been shown, through scientific studies, that the implantation of silicone implants does not cause or increase the incidence of autoimmune diseases or connective tissue diseases.

The incision for positioning the implant is made in the upper part of the buttocks, in the intergluteus sulcus, so that the scar remains hidden between the two buttocks. The prostheses can be positioned inside the gluteus maximus muscle, according to the Gonzales technique, or more superficially, following the De La Peña technique, below the fascia that covers the muscle.

The largest manufacturers guarantee the buttock prosthesis for about ten years, after which they suggest replacement to avoid any deformation and / or breakage of the same.

GLUTEOPLASTIC WITHOUT PROSTHESIS, WITH HYALURONIC ACID?

As an alternative to surgical methods, it is possible to perform the remodeling of the buttocks without prosthesis, but with the use of Macrolane® hyaluronic acid  and the brand new macromolecular hyaluronic acid Hyacorp , a very slow reabsorption hyaluronic acid.
Among the injectable substances, hyaluronic acid is the safest as it is a substance that is naturally present in our body and because it is reabsorbed over time. Numerous scientific studies have shown the safety of hyaluronic acid as a filler. 
The increase in volume of the buttocks with Macrolane® or with Hyacorp it is performed under local anesthesia, does not leave scars and does not require hospitalization.
The hyaluronic acid filler  is injected into the areas of the buttocks to be remodeled through a needle-cannula. At the end of the treatment a patch is placed and after 24 hours the patient can return to carry out all her daily activities. The rare cases of complications are transient and in any case resolvable by an experienced plastic surgeon.
The results of the remodeling of the buttocks carried out with Macrolane® or Hyacorp are visible immediately after the treatment. One of the advantages of this treatment is that it is possible to make adjustments if the patient wishes to further increase volume or reshape some areas of the buttocks. 
The aesthetic result lasts about a year, after which it is possible to undergo the treatment again.

WHAT ARE THE RISKS AND COMPLICATIONS OF GLUTEOPLASTIC?

The plastic buttock surgery is a relatively complex operation. It is important not to underestimate the risks of the surgical procedure: it is always necessary to have the plastic surgeon explain the results that can be obtained, the possible risks of the intervention and the complications. Particular attention should be paid not to contact non-specialist doctors who offer services at a relatively low cost in unauthorized structures such as surgeries, beauty centers, etc., because although the risk of developing complications is low, they can sometimes happen.

A specialist in plastic surgery, within duly authorized and equipped facilities, can perform surgery in complete safety for the patient.

A possible complication of gluteoplasty is capsular contracture, which is given by the reaction of the organism to the gluteal prosthesis; around the prosthesis a scar is formed which in some people is exuberant going to cause pain over time and compromise the aesthetic result of the intervention. Complications such as infections, seromas, loss of sensitivity, sciatica, are very rare events.

It is essential to follow all the instructions given by the plastic surgeon, both before and after the intervention , to decrease the probability of possible complications of the intervention.

HOW IS THE PRE-OPERATIVE VISIT DONE?

Gluteoplasty is a highly personalized surgery that requires an accurate specialist visit.

During the first visit, the surgeon, after listening to your requests, will evaluate the shape and size of the buttocks, illustrate the most modern surgical techniques that can be used and the improvements that can be obtained. The state of health will also be assessed to exclude pathologies that could affect the final result of the intervention. Before the operation, precise indications are given on the behaviors (nutrition, drugs, alcohol, smoking, etc.) to be followed before and after the plastic surgery of the buttocks.

At the end of the visit, the plastic surgeon, in agreement with you, will choose the most suitable surgical technique to obtain the desired results.

WHERE ARE THE ENGRAVINGS MADE?

The incision for the positioning of the gluteus implants are made in the intergluteal fold, so that the scar remains completely hidden in the fold.

For lipofilling , the incisions made for the removal of adipose tissue, a few millimeters in length, are placed in well-hidden areas. At the level of the buttocks , the recipient site of the adipose tissue, there are no scarring results since lipofilling is carried out by micro-cannulas without any need for incisions.

Hypoplasia of the gluteal region and calves - Gluteoplasty
Fig. 1 Hypoplasia of the gluteal region and calves.
Implant of buttock and calf prosthesis.
Fig.2 Implantation of gluteus and calf prosthesis – Gluteoplasty
Result and scars.
Fig.3 Result and scars.

WHAT TYPE OF ANESTHESIA IS PRACTICED?

Aesthetic surgery of the buttocks can be carried out in loco-regional anesthesia with sedation, in day-hospital regimen, or in general anesthesia with one or two nights of hospitalization in the clinic.

HOW LONG DOES THE GLUTEOPLASTIC INTERVENTION LAST?

The duration of the intervention varies from one to two hours and ends with a compressive dressing.

WHAT IS THE POST-OPERATIVE COURSE OF GLUTEOPLASTIC?

After the operation of gluteoplasty you will have to rest for 48 hours. In this first phase, swelling, bruising and pain in the buttocks may occur.

From the third post-operative day it is possible to resume a normal life, however avoiding strenuous activities, saunas, Turkish baths and sun exposure.

After a week from the cosmetic surgery of the buttocks, it is possible to resume work if it is not excessively tiring.

One month after the surgery, you will gradually resume all normal daily activities.

WHAT TYPE OF RESULT CAN BE OBTAINED WITH PLASTIC GLUTEN SURGERY?

The result that can be obtained with cosmetic surgery of the buttocks is generally very good and long-lasting, but cannot be said to be completely permanent because it is subject to the normal aging processes of the body and the effects of gravity.

GLUTEOPLASTIC: COSTS

The additive gluteoplasty with gluteal implants has a cost that can range from € 8,000 to € 12,000 depending on whether the surgery is performed on an outpatient basis or with one night of hospitalization. The cost includes everything related to the surgery, such as the glute prosthesis, the surgeon, the anesthesiologist, the surgeon, the operating room and all the costs of the clinic. The first visit and preparatory examinations for surgery are not included in these costs.

The gluteoplasty with lipofilling has a cost that can range from 6,000 € to 8,000 € .

The gluteoplasty with hyaluronic acid has a cost that can range from 4,000 € to 6,500 € .

FAQ AESTHETIC GLUTES SURGERY

Q. I read in a newspaper that it is possible to lift the buttocks by inserting prostheses. I wanted to know if this type of cosmetic surgery really exists and if the result is lasting.
A. The increase in volume and the lifting of the buttocks can be obtained by resorting to a cosmetic surgery which consists in inserting silicone gel implants (similar to those used in breast augmentation) or in the transfer of adipose tissue (fat) taken from a part of your body (lipofilling). The prostheses used in surgery to increase the volume of the buttocks are made up of an external silicone casing and an internal silicone gel content. Most of the manufacturers guarantee the prosthesis for about ten years, after which they recommend their replacement to avoid any deformation or deflation of the prosthesis due to prolonged use of the same.

Q. I am 25 years old and have a completely flat bottom. I heard that it is possible to give shape and volume to the buttocks thanks to new prostheses, but that it is a painful operation. It’s true? And how are the prostheses inserted?
A. Cosmetic surgery to increase the volume of the buttocks actually allows to improve the shape and volume of a completely flat butt by implanting silicone gel implants, similar to those used for breast augmentation, which are inserted through an incision made in the intergluteal fold. The scars are invisible as they remain hidden in the folds of the buttocks. The surgery can be performed under loco-regional anesthesia with sedation or under general anesthesia, but the post-operative course is very painful as the prostheses are inserted, through an incision, inside the gluteal muscle and not instead, as it happens in breast augmentation, above or below the pectoral muscle.

Q. Is it true that buttock implants tend to move over time?
A. Prostheses used in surgery to increase the volume of the buttocks, similarly to prostheses used in other cosmetic surgery operations (breast augmentation, increase in volume of the calves), can sometimes face a complication called “dislocation” that occurs when the prosthesis moves from the pocket in which it was placed or rotates on itself changing its position. This complication is very rare in breast augmentation, while it can occur more frequently in surgery to increase the volume of the buttocks due to the different stresses to which this part of our body is subject.

Q. How do you apply for funding for gluteoplasty surgery?

A. It is possible to request the payment in installments of the operation of gluteoplasty , asking your cosmetic surgeon what are the methods of financing cosmetic surgery in cases where there is no immediate financial availability to pay for an intervention.

Q. What are the characteristics of the new Hyacorp hyaluronic acid for the remodeling of the buttocks? Opinions. 

R. Hyacorp is a brand new macromolecular hyaluronic acid made in Germany synthesized in the laboratory and not of animal origin, safe and biocompatible, usable for the remodeling of the body and in particular of the buttocks. The opinions of HYAcorp are absolutely positive. 
The most used techniques for the remodeling of the buttocks they are essentially three: the gluteus prosthesis, the lipofillig and the hyaluronic acid. The implant of the gluteus prosthesis is a real surgical operation very similar to breast augmentation, only in the gluteal region; lipofilling is the transfer of fatty tissue from areas where fat is in excess in the gluteal region for its remodeling; finally hyaluronic acid for buttock remodeling is the simplest and most immediate technique. Hyaluronic acid has been used, as mentioned, for some time for the remodeling of the body and the best known product is the so-called Macrolane, from the Swedish company Galderma. The new hyaluronic acid Hyacorp,produced in Germany, it has the peculiar characteristic, compared to the Swedish one, that even large molecules up to 800 microns can be injected through very thin needles in the gluteal region, but also in the calves. The product is reabsorbable and the shelf life is approximately 18 months. The treatment can be repeated several times over time. Hyacorp is a medical device and can be used only by doctors and after adequate theoretical and practical training; for this reason it is advisable to contact specialists in plastic surgery who are experts in this type of treatment and in this type of surgery, possibly enrolled in one of the main Italian reconstructive and aesthetic plastic surgery companies such as AICPE and SICPRE. 

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