Combination of implant and fat transfer
You would best benefit from a buttocks implant and fat transfer. The implant is used for central projection and the fat for lateral fullness. Please see example of patients with buttocks enhancement below.
What Butt Implant is Best for Me?
This is a great question as selecting the proper implant is very important. There are several ways to go about selecting the proper implant for your butt augmentation.
First of all while there is a limited number of butt implant sizes, there is still a range to choose from for the surgery. It is important that the implant fits the size of your buttock. Having an implant that is an appropriate size will help limit any problems post-operatively and will give you the best results possible.
Secondly I like for patients to send me wish pictures so that I can help guide them to the implant that will help them achieve those goals. It also allows us to have a talk about what are realistic goals from the surgery.
Thirdly, I typically use round implants as I feel that they help add volume to the hips and buttock. It gives patients a great shape even if they do not have sufficient fat to augment their hips. A round implant also avoid the issues with implant rotation that can happen with shaped implants.
In my practice the most common implant I use is a 548cc silicone round implant. There are larger and smaller implants depending on the individual needs of each patient.
Make sure that you talk to a board certified plastic surgeon that performs a high volume of implants about your butt implant surgery.
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 i have recently created and patented a new "Stanton Anatomic" shaped implant that avoids this issue. 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. 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. 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 under the skin 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.
Dear Mommyof4, Thanks for submitting your pictures. It would have been helpful to have your height. From observing your pictures, due to the underwear it is difficult to assess if your butt is more full at the upper part and flatter in the lower part. That helps to determine the selection of style one - oval round or style two - oval bubble butt. You have a noticeable indentation laterally under the hips. When choosing the right size implants, they will fill that indentation and give you a nice and round hips. I have done butt implants surgery on well over 500 patients and based on that experience and your pictures, you can have implants size of 565 cc or 660 cc according to your desire of projection. I use almost exclusively oval round implants (style one), because they are more anatomical than the round implants , they give you a very nice 'S' curve (shelf) and they fill up , rounding the hips. My technique is sub fascial (on top of the muscle) which is superior to the intra muscular technique, because it allows for bigger implants, more natural shape, less pain and quicker recovery. You have to realize that not all result are the same, because there are different techniques and different implants. Additionally, experience , skills and aesthetic eye are critical for good outcome. So, do your due diligence and choose wisely. Always, consult with experienced board certified plastic surgeons who do 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 nice projection, nice 'S' curve, round hips and single intergluteal incision. Also, check the reviews on 'RearSelf' for ratings and positive experience reports. Best of luck, Dr Widder
You would have to be seen in person to determine what implant would be best for you. I prefer the round ones.
Size and form is a critical question for many women who choose, an buttock implant . The key is to work with a Board Certified plastic surgeon with expertise and experience in buttock augmentation. There is an ideal shoe size for your foot. Too small and your foot will be crammed and too large and your foot will not fill the shoe. The same thing is true with buttock: too large and it will look round and fake; too small and it will be loose and empty. The common denominator to the most beautiful buttock is that they were sized objectively on the basis of measurements. We combine a proven formula based on measurements of the back and hips along with through discussions of patient's desires. Photos of ideal buttocks and results from patients with similar buttocks are often very helpful in the discussion. A rice test in the office or at home can also be very helpful.