Butt implant; Subfascial vs. Intramuscular & shape? (photos)
Doctor Answers 8
Buttock implant details
Buttock/hip implants are a very good, safe, and long term reliable option for most patients seeking buttock/hip augmentation (at least in my practice). I prefer to insert the buttock implants through a 1 1/2 inch long incision along the inner curve of each upper buttock cheek at the level of the tailbone, similar to two opposing parentheses ")(" (concealed within the crevice between the buttock cheeks) and the hip implants through a ~ 1 inch incision just below the beltline above the hip region. The buttock implant should always be placed under or within the gluteus maximus muscle (NOT "subfascial" as this is no different than subcutaneous or "on top of the muscle"). In this position, the implant is less palpable, less visible, and does not sag or shift/migrate over time unlike implants placed on top of the muscle. On the other hand, hip implants are placed under just the fascia because no significant muscle exists in this region. However, because they are much smaller and lighter, their likelihood of migration is relatively low. Because all of this, it is extremely important to seek consultation with a board certified plastic surgeon who specializes in this procedure so that the implant placement is precise for both locations. And in this case too, at least in my surgical practice, the infection rate is minimized to <2% (much lower than and contrary to popular belief by many other surgeons not experienced in buttock implants).
Traditionally, teardrop oval implants have a 20+% risk of rotation and thus change in buttock shape/appearance. However i have recently created and patented a new oval shaped implant that avoids this issue. The benefit of this is the fact that ~80% of women patients have more of an oval shaped buttock cheek than round. Glad to help.
Buttock implant alternatives and risks.
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Subfascial vs. Intramuscular Buttock Implants
Butt Implants, Subfascial vs. Intramuscular & Shape vs Round?
Butt Implants are great for thin patients that do not have enough fat for a Brazilian Butt Lift or for patients that are looking for a lot of projection. The implants can be done alone or in combination with fat transfer.
There are several ways to place the butt implants and the methods vary from surgeon to surgeon. I commonly place the implants in a subfascial position for several reasons. One, the subfacial plane is very clean and avoids damaging the muscle or nerves. However it still holds the implant in the proper position and decreases the chance of scar tissue forming around the implant. The fascia is the strong covering that wraps the muscle, that is why it can hold the implant in place. The submuscular plane can also be used but in my experience, patients tend to have more pain and over time has little benefit over the subfacial system.
In terms of the implant both the round and shape are good implants. I personally use the round implant for several reasons. It gives good projection, which patients that receive the implant are typically looking for from there procedure. Also the butt take abuse in our daily life from falls and so forth, with the round implant you are less likely to have problems if the implant shifts at all. With a shaped implant if it moves at all it will need to be revised, this is not necessarily true with a round implant.
I recommend that you see a board certified plastic surgeon about your butt augmentation that performs a high volume of these procedures.
Butt implant; Subfascial vs. Intramuscular & shape?
Thank you for your question. You are correct that surgeons place the implants either underneath the fibrous tissue (fascia) covering the surface of the gluteus muscle or underneath the muscle itself. These locations are chosen to help secure the implants in place and "hide" the edges. I have performed both depending on the patient and I haven't seen a difference in outcomes - especially not sliding down your leg. Your surgeon has to make a small opening between muscle fibers when placing the implants below the muscle, but this should not injure the muscle in any way. You are correct that there is a slightly higher incidence of sciatic nerve pain after sub muscular implants, but this is still a rare problem. Finally, I believe that the risk of rotation or "flipping" is more dependent upon surgical technique than the implant, and I always choose an implant that fits the patient's body (over a risk of rotation). Good luck!
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