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Buttock Enhancement Surgery

Lipomodelage des fesses et liposuccion des hanches
Buttock lipomodelling and hip liposuction

High, firm, curvaceous, muscular, the buttocks are an essential parameter of beauty, both in women and men.

No matter what the culture, origin or ethnicity, flat, empty, sagging buttocks are never appreciated, experienced negatively, and can be a source of unhappiness leading to a real complex. Buttock enhancement surgery increased by 86% last year!

Different techniques exist to reshape the buttock:

  • Prosthetic implants
  • Lipomodelling
  • Lifting
  • Hyaluronic acid injections

Buttock implants or gluteal prostheses or gluteal implants or gluteal augmentation by prosthesis

Requests for buttock enhancement surgery are becoming more and more frequent. The ideal indication is a flat and sagging buttock in a patient who does not have enough fat reserves to perform lipofilling.

The prostheses used are cohesive silicone gel and have been used for more than 40 years. They are CE (European Community) and ANSM (French Agency for the Safety of Health Products) certified, and are very close in consistency to a normal buttock. Over the past decade, dramatic improvements in implant technology have been made. The implant shell is now more solid, preventing perspiration of the silicone gel, and has increased mechanical strength. Silicone gel is very cohesive and much less fluid than in the past, thus preventing any diffusion of silicone into the buttock in the event of the implant rupturing. Implant volumes range from 300 to 570 cc with the average being 430 cc.

Different forms of buttock prostheses exist: a round shape, the most commonly used biconvex shape (a larger volume with equal diameter and no deformation of the buttock in the event of inversion) and oval and anatomical shapes.

The preoperative procedure is simple: two consultations with the surgeon, one with the anesthesiologist, a blood test, the choice of implant size, acceptation of the price quote and, finally, cessation of smoking.

The operation takes place under general anesthesia and lasts between 1h30 and 2h. The incision is placed in the groove between the two buttocks. The scar is almost invisible. The prostheses are most often placed in the same level of thickness of the gluteus maximus, they should never be placed under the skin due to the risk of migration and being seen. A redon drain is placed at the level of each gluteal implant to avoid any risk of hematoma.

Liposuccion culotte de cheval (lipoaspiration des hanches)
Saddle bag thighs liposuction (liposuction of the hips)

The postoperative consequences are quite painful (distension of the skin, large volume prosthesis, proximity and compression of the sciatic nerve, intramuscular prosthesis, very developed gluteus maximus muscle). A hospitalization of 2 to 3 days is therefore necessary. An Intravenous perfusion makes it possible to deliver the pain relief medication most effectively. Lying on the back is prohibited for the first 3 days and should be avoided as much as possible for the following week. Dressings have to be changed by a nurse or another person because the area is difficult to reach for the patient themselves, walking is authorized but will be difficult for the first week. Time off work is 10 to 30 days depending on the profession and no sporting activities can be performed for 2 months.

The result is final after 3 to 6 months when the buttock prostheses become well-positioned and the bruising fades.

Among the potential complications of gluteal implants and buttock augmentation procedures, it is important to mention: buttocks that are too firm, prostheses that are too visible, buttocks that are too round, palpability issues with the prostheses, rupture of the implants (which is inevitable at some point), hematomas, infection (due to the proximity of fecal germs), seromas, sensitivity disorders, shell issues (rare), and inversion of the gluteal implant.

The price of this operation is often high because it requires great expertise, prostheses are expensive, and hospitalization lasts for several days. Prices start from 7000 euros for simple cases (see more information on prices here).

Lipomodelling or lipofilling or liposculpture of the buttocks or BBL or Brazilian Butt Lift or Brazilian Lifting

This is a very interesting alternative to buttock augmentation by prosthesis because it is 100% natural. Provided that you have enough fat. The principle is to extract the fat by liposuction from where it is in excess (saddle bag thighs, hips, love handles, belly, back, arms, thighs, knees …). The fat is then purified by centrifugation (using the Coleman technique) and reinjected into the buttocks in order to level them, redraw them and increase their volume. A real lipomodelling is carried out. The result is often spectacular. It is important to remember that 30% of the injected fat will dissolve in the first 3 months after the procedure. The result is then final.

The operation generally takes place under general anesthesia and lasts for 2 to 3 hours. A compression garment is to be worn for 6 weeks after the operation and 7 to 15 days off work is to be expected. The pain is limited (similar to aches), well controlled by analgesics and hospital stays are short (24 hours on average).

The scars are very short (2 to 3 mm on average), and almost invisible.

The results of buttock augmentation by lipofilling are spectacular and natural because the patient’s own fat is used.

The main risks include asymmetry, infection and phlebitis.

The price depends on the amount of fat to be suctioned and injected.

Prothèses de fesses pour augmentation du volume des fesses (implants fessiers)
Buttock prostheses for increased buttock volume (buttock implants)

Hyaluronic acid or Macrolane or HYAcorp injections

Carried out without anesthesia or hospitalization and with simple postoperative effects, the procedure is attractive but has one major drawback: the price of hyaluronic acid. Significant quantities of the product are necessary to obtain a result and it is absorbable, on average after two years. It is therefore necessary to repeat the procedure and the price can very quickly exceed that of buttock implants or buttock lipofilling. For this reason, this technique of increasing the volume of the buttocks is less used although it gives excellent results, especially with HYAcorp.

Butt lift or posterior body lift

The principle is to remove excess skin at the level of the buttocks. It is of particular interest to patients who have lost a lot of weight (especially following gastric surgery). The scar can be placed in the furrow under the buttocks or above the buttocks. The excess skin is lifted, tightened, and a part reintegrated into the buttock to increase its shape.
The operation lasts approximately 2 hours, takes place under general anesthesia or spinal anesthesia and requires hospitalization for 24 to 48 hours. Smoking must absolutely be stopped at least 3 weeks before the operation. Time off work is 15 days on average and sport has to be stopped for 6 weeks. The dressings are to be done by a nurse or a third party (because they are difficult to access on the back) for 10 days. The pain is easily relieved by conventional analgesics. The result is final after 6 months to 1 year.


Dr Vincent Masson is a plastic surgeon with a post-graduate diploma in plastic, reconstructive and aesthetic surgery and a gold medal in surgery from the Paris Hospitals. He is a former senior registrar and attaché at the Hôpital Saint Louis.

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