Buttock Implant Placement: Under the Muscle Vs. Intramuscular?

Intramuscular implants can improve volume by 400 cc or so, depending
upon the size of the individual. A significant amount above this
volume compromises healing by creating more tension on the healing
incision.  The deeper the placement the greater the risk of sciatic nerve compromise.Kenneth Hughes, MDLos Angeles, CA

The reality is there is no definitive plane between the gluteus maximus and the deeper underlying muscles.  They are all kind of intertwined.  Thus creating a pocket under the first several layers of the gluteus maximus is sufficient to provide good coverage and minimize palpability and visibility and prevent migration of the implant.  Going too deep can lead to impingement &/or injury to the sciatic nerve.  On the other hand, subfascial placement usually tears the fascia and allows more palpability, visibility, and downward migration of the implant over time.  Glad to help... @drryanstanton  

Dear inquirer, You did the right thing, which is due diligence and seeing few doctors. You have to consult with one more doctor who places the implants under the fascia. This is a natural plane and as long as the pocket is well above the crease, the implant is not palpable or visible. In this plane you have less complication, like bleeding and it is much less painful. Most importantly, you can have a much larger implant placed because of a larger pocket and no risk of damaging important anatomocal elements like nerves etc.  Another important issue is the type of implant. The material is mostly solid silicone, but it has to be very soft. The most natural shape is the oval round , which resemble the anatomical shape of the butt. Consult with an experienced board certified plastic surgeon who performed hundreds of surgeries with that technique.