Regardless of the patients anatomy, buttock implants are best placed within the gluteus maximus muscle (ie intramuscular). Indeed a “subfascial” placed buttock implant (aka a fancy term for it placed on top of the muscle) may look good for the first 6 even 12 months tops but highly unlikely thereafter. As swelling resolves and the size/weight of the implant succumbs to gravity over time, it will become visibly and papably obvious. The reason for this is twofold: 1) the investing fascia of the gluteus maximus muscle is extremely adherent and interwoven with the deeper muscle fibers. Because of this, it is impossible to place a buttock implant under this fascia layer without shredding it to pieces, thus rendering it subcutaneous (under and suported by the skin only), and 2) buttock implants are >3+ times as large as other implants which are typically placed subfascial (eg. calf and hip implants). These smaller lighter implants are readily supported long term by the fascia layer, which also happens to be more robust in these other areas. However the much larger buttock implants would eventually thin out and erode through this layer making them obviously visible, artificially palpable, and/or droopy like a "dirty diaper".Implant shape also is extremely important in creating a naturally buttock contour, especially when bending over. Because the gluteus muscle are anatomically much more oval than round, traditional round implants often produce an unatural profile and bulge when bending. However I have patented a new "Stanton Anatomic" shaped implant that avoids this issue. The benefit of this is the fact that ~80% of patients have more of an oval shaped buttock cheek not round, thus a true oval implant (i.e. Stanton Anatomic implant) creates a much more natural and harmonious buttock contour. This is especially true when the patients bends over, does squats, or pokes their butt out while striking a pose or dancing. Glad to be of help.
