Saline butt implants - Are they an option? (photo)

Question

I'm a 54-yr-old female in great health; I've had breast implants since I was 20 years old (not same implants the entire time), and have done remarkably well with saline. Is this an option? If not, what are my options? What percentage of improvement do you think I could reach? Am I a good candidate? Thank you.

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

There are currently only two FDA approved surgical options for augmenting the buttock/hip area:  1) Buttock and cosmetic Hip Implants (which are soft semi-solid silicone rubber implants that cannot rupture &/or leak) and 2)Brazilian Butt Lift (aka BBL) - which utilizes the patients own fat from liposuction then transfers this fat into the buttock. On the other hand, BBL using fillers such as hyaluronic acids, Sculptra, etc… is a dangerous, guaranteed waste of money, and is NOT FDA approved. So what it comes down to, like any surgery, is proper patient selection and long-term results. Implants provide the only guarantee for a sustained permanent result and tend to be ideal for perking up not only lean or deflated buttocks but also providing substantial projection to any butt, which is what every single patient wants. Typically a combination of sculpting the waistline with liposuction and augmenting the buttock with implants +/- the hips with implants provides the best chance for a long lasting and desirable "hour-glass" figure.  Based upon your photos, a Stanton Anatomic®️ shape buttock implant may serve you best.

Unfortunately, fat typically melts away leaving disappointing results after 12 months, often sooner.  Unless your BBL surgeon is injecting only 200 to 300 ccs of fat into each buttock cheek, a large percentage of that fat is going to die.  Dead fat leads to dents and dimpling like cellulite, unevenness, loss of projection, and fatty necrotic oil cysts which are hard marbles and can be very tender 
Unfortunately, because ~70+ % of the fat transferred will melt away within a year or two, most patients are not good candidates for BBL because they lack an adequate amount of fat to harvest. Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation. Even those patients that had adequate amounts of fat pre-operatively, still end up seeking buttock implants after a year or so because most of the fat transferred melted away leaving them with minimal result.  Fillers such as Sculptra are cost prohibitive, provided enough volume is injected (i.e. at least 400 cc of active ingredient costing over $300,000) and last only 12 - 18 months.  Additionally, any physician promoting “biostimulators” for buttock enhancement is just a joke, and any board certified plastic surgeon promoting such, should not be trusted with your butt.  So, if you're looking for a reliable, predictable, and long-term permanent option that also provides projection in the central buttock and hips, buttock and hip implants are your solution. Please note that an extremely few number of board certified plastic surgeons specialize in buttock or hip implants, so you may need to travel far and away from home to find this particular surgeon.  Getting it done right the first time around is not only the best chance for success, but also will save you from a lot of headaches and money in the future. Glad to help.

John L. Burns Jr., MD · Answer

Butt implants are only available in silicone.  Butt implants have an extremely high complication rate which is why most plastic surgeons do not do them.  Based on your photos I'd suggest doing a butt lift with fat transfer.  This will both improve the loose skin and add projection and volume.

Shlomo Widder, MD · Answer

Dear Julie,
   Thanks for posting your picture. If you call my office my  staff will be able to send you before and after pictures of a patient with almost identical anatomy to your and I trust that you will like the outcome. As far as type of implant, I use on my patients semi solid round or oval silicone implants. Saline implants are not recommended because they can easily rapture and they do not look natural or attractive. I have performed butt augmentation on over 800 patients with exclusively semi solid or ultra soft silicone implants. On my breasts augmentation patients I use exclusively saline implants, but obviously it is totally different anatomy with different level of stress on it.
   Always, consult with experienced board certified plastic surgeon who performed lots of butt implants surgery in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure that they are numerous, consistent and  attractive with single incision between the cheeks, have nice projection and round hips, and most of all look natural.
               Best of luck,
                                 Dr Widder
                         widderplasticsurgery.com

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