Butt Implants. Above or under the muscle?

Question

So I’ve been told that I don’t have enough fat to get a BBL so I’m trying to get some information about getting implants. Is the implant placed above or under the muscle? If under the muscle does the butt ever feel natural? How often do you have to change/replace the implants? What is the recovery process like? I can’t wait to hear your answers.

Shlomo Widder, MD · Answer

Dear Keziah,    Butt augmentation with implants is very gratifying when performed in expert board certified plastic  surgeon's hands. You have to realize that not all results are the same because there are different implants and different techniques.Also, experience, technical skills and aesthetic eye are critical for good outcome.      I have done butt implants surgery on over 600 patients and I use exclusively oval round ultra soft silicone implants, placed in a sub fascial pocket. This technique gives you a very natural look with nice 'S curve, nice projection and round hips. I also use a low single incision between the cheeks which is invisible. Recover is 6 weeks for strenuous activity like gym, sex or heavy lifting. For one month you have to sleep on your stomach  and lean forward when sitting while driving or doing desk work etc. You can return to light duty work after one week.   As far as feel, it depends on the butt's fat layer   thickness. When it is thick, you can't feel the implants, however, when it is thin. the butt feels like when you tighten the muscles- a little firm.   Check the photo gallery of surgeons who use different techniques and compare the results. Go with the surgeon whose results are the most attractive and natural in your eyes. Also, check the reviews on RealSelf , to evaluate good patients' experience.                                    Best of luck                                                         Dr Widder

Kenneth Hughes, MD · Answer

Butt implants placed within the muscle will look more natural though the feel leaves something to be desired.

Ryan A. Stanton, MD · Answer

Buttock implants should always be placed within the gluteus maximus muscle, never on top or “subfascial”. In the intramuscular position, the implant is much less palpable & visible (ie. it kind of looks and feels like an Olympic sprinter's butt), and does not sag or shift/migrate over time unlike implants placed on top of the muscle or "subfascial".For recovery, the first 2 weeks is the most challenging with swelling, tightness, and discomfort. Also sitting is prohibited for these 2 weeks. Patients may return to work after 2 - 3 weeks as sitting and basic daily activities become easier.  For those whom work from home, return to work resumes much sooner if they can work standing, kneeling, and/or lying down reclined in the "dentist chair" position. After 2 weeks patients may sit for up to 30 minutes at a time then stand up or take a short walk for 15 - 30 seconds before sitting back down, 3 weeks for up to an hour, and at 4 weeks unlimited.  At 3 weeks patients can resume upper body exercises while standing only, at 4 weeks upper body exercises while seated may be added.  By 6 weeks, all restrictions are lifted as life nears normal again, all exercise (including squats and lunges) and sports may be resumed again but at low intensity.

Steven Wallach, MD · Answer

Implants can be placed three ways. Above the muscle and fascia, above the muscle but under the fascia, or within the muscle like a sandwich.  I perform them for woman that do not have enough fat to create the shape that they want.

Enriquillo Clime Rivera, MD - Account Suspended · Answer

Thank you again and have a great day
Hi, and thank you for the question
  
Well most surgeons will prefer to put the implant inside the muscle. if you send us pictures we can evaluated your case and give you our suggetions. As you can understand studies and test are needed to see if you are clear for surgery but in general, if you seek the attention of a certified plastic surgeon, you should have a great result and a normal life. So feel free to contact us for further evaluation.   
  
Thank you again and have a great day

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