What is missing in my buttocks to look good? (photos)
Doctor Answers 2
Since its so soon after surgery its difficult to tell for sure. Choosing a size can be challenging since there are so many shapes and sizes. It may be that the surgeon chose an implant that wasn't long enough for your buttock. This could also be swelling that distorts the result. Give it some time for the swelling to go down and then reassess.
"Whats missing in my buttock...?"
The largest stock buttock implant currently available in the USA is a 690cc round implant. For the implant brand i prefer and my Stanton Anatomic Oval implants, the largest is 600cc. Indeed custom implants can be ordered larger, not only at a premium price but at a premium risk for most patients'. Unlike breast implants which are placed under the very expandable tissue of the breast and half of the pectoral major muscle, buttock implants should only be placed under or at least within the largest strongest muscle of the body, the gluteus maximus muscle, which is not nearly as expandable or forgiving. Thus most patients simply do not have a large enough native buttock muscle to fit an implant much over 500 ccs', without leading to significant complication such as wound breakdown/opening &/or implant exposure...necessitating removal. If a patient wants larger implants, 9-12 months after the initial implants have settled in to place and the muscle relaxed/stretched, then a second operation can be performed to replace them (similar to the process of going bigger with breast implants). Be aware, the "subfascial" space that is sometimes talked about is not a real potential space to place a buttock implant. It is essentially the same as a subcutaneous pocket (ie on top of the muscle/under the skin and fat layer only) and therefore should be avoided at all costs. Some of those sought after video-vixen and celeb-types (without mentioning names) with cartoonish bottoms could have either gotten extremely lucky with a huge oversized implant (very unlikely if properly placed under the muscle), had a very large volume of filler injected such as silicone, PMMA, Sculptra, or hydrogel - all NOT recommended because of high risk of severe infections, migration and/or hardening over time, and even deadly consequences in rare but significant instances (if mistakenly injected into the blood stream); and/or have been genetically "blessed" - although quite unlikely.
I generally do not recommend fat grafting at the same time as placing buttock implants because of a significantly increased risk of infection. For fat to survive it must be grafted into muscle, however that is also where the implant sits. Thus, if fat it injected into the implant or implant pocket then it will die and almost assuredly get infected - necessitating removal of the implant as well. Fat transfer later on must be done very carefully and cautiously, preferably by the original surgeon, for the very same reasons as above. In both instances, the risk/reward ratio is very high (meaning high risk to very low potential reward) because over 80% of the fat is likely to melt away yielding very small gains in augmentation.
Nonetheless, buttock implants are a proven safe and effective method of buttock augmentation as long as the recommendations of a board certified plastic surgeon specialist are adhered to.
Glad to help.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.