I need butt implants to counterbalance my wide shoulders!! And I'm a transwoman, I have 22 inch shoulder that is pretty wide
Doctor Answers 3
Wanting to improve your curves
The best way to improve the curves of your torso if you do not have a lot of fat is to consider a comprehensive liposuction of your waistline and buttock implants. The size of implants is determined by the width of your buttock cheeks and this can be determined following a consultation. Please see results below.
Buttock implant sizing
Whether man, woman, or "trans" the process of fitting and selecting the appropriate shape and size buttock implant is basically the same. I have successfully performed buttock implants on over 30 transgender patients in the last 4 years alone. This is definitely one group of patients growing quickly. Please read on for the details:
In short, a combination of sculpting your waistline with liposuction and augmenting your buttock with implants provides the best chance for a long lasting "hour-glass" figure. Please read on for more surgical details:
Regarding buttock augmentation, let me start off by saying that I currently see at least 2 - 3 patients per week, from around the world, that failed "brazilian buttock lift" (i.e. the fat melted away after 10 - 12 months) and are now seeking a more reliable and permanent option (i.e. buttock implants).
One of the most important factors in creating the perfect derriere with implants is indeed selecting the right size AND shape. I have found the best way to assure this is to simply measure the actual dimensions of the patient’s buttock cheeks. With these anatomical measurements, I can select an implant that not only significantly augments the buttock but also supplies the correct 3-dimensional enhancement to look as real as possible...even in the most petite patients. Traditionally, teardrop oval implants have a 30+% risk of rotation and thus unnaturally change the buttock shape/appearance when doing so. However, one year ago I created and patented a new "Stanton Anatomic" shaped implant that avoids this issue - not a single rotation problem in 200+ patients. The benefit of this is the fact that ~80% of women patients have more of an oval shaped buttock cheek than round, thus creating a much more natural and harmonious buttock contour. Thus, the only way for you to know what implant works best is to consult with a board certified plastic surgeon specializing in this procedure and have him/her take your measurements before selecting an implant and proceeding with surgery.
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.
Thank you for your question.
The best thing for you to do at this point is to contact several local/regional plastic surgeons in your area who are experienced with buttock augmentation to discuss your options. They will talk about your goals, take careful measurements, and pick an implant that's right for you.
Dr. Dan Krochmal
MAE Plastic Surgery
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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.