Ideal buttocks aestheticsButtock types
Consultation
Buttock enhancement procedures
Where will your procedure be performed?
Details of your procedure
Your recovery
Your results
Relative contraindications
Surgical risks and potential complications
With the increasing public awareness and knowledge of buttock reshaping procedures, an increasing number of patients are requesting buttock enhancement surgeries to achieve rounder, more projected, curvaceous buttocks.
Buttock shape is influenced by a number of factors that include genetics, gender, race, age, and weight. Some people have small or large buttocks that are genetically coded. For others, the buttock shape and size may reflect their racial background. Weight can also influence and affect the volume and shape of the buttocks and surrounding anatomy. Other factors such as ageing, pregnancy and weight loss play important roles in the buttock form. Ageing results in mild degree of fat loss from the buttocks with skin and connective tissue laxity. The buttocks are thus loose and saggy. Similarly, after pregnancy, many women experience some fat loss from their buttocks. At the extreme form, massive weight loss or post-bariatric patients experience significant deflation of the buttock region as well as the rest of their body. The deflated buttocks are typically loose and sag. There is significant excess of lower back and buttock skin and soft tissue.
Patients present for buttock enhancement with different concerns and requests. Each patient has different needs and requests. Some will need buttock reduction while others request buttock augmentation and reshaping. For others, a combination of buttock reduction with lift or buttock augmentation with lift will be more appropriate. In recent years, Dr. Agha has developed signature buttock reshaping procedures as a result of his extensive experience in body contouring surgery.
Buttock Enhancement or Gluteoplasty is the lifting, sculpting, or augmenting of the buttocks to achieve a more aesthetic body proportion. The buttocks can be reshaped using a number of distinctly different methods:
Buttock Lift- This procedure involves removal of excess skin of the upper buttocks and lower back to correct for buttock looseness and sagging.
Buttock Augmentation- This procedure can be performed by using silicone buttock implants or your own fat. The latter procedure is known as buttock lipoaugmentation or Brazilian Butt Lift. Because of the risk of complications and problems with use of buttock implants, most of our Orange County patients elect to have buttock lipoaugmentation.
Buttock Reduction and Lift- This procedure involves removal of excess tissue of the buttocks and lower back and, tightening of the buttocks.
Buttock Augmentation and Lift- This procedure involves use of the lower back tissue to augment the buttock projection and, tightening of the buttocks.
The ideal buttock contour follows certain features that define an aesthetically beautiful figure. These include:
- Buttocks that are round or A-type shape (see below).
- Buttocks that are projected appropriately according to your body type
- A smooth inward sweep of the lower back (lumbosacral area)
- A "V-shaped depression" that demarcates the lower back and buttock regions
- Concave waist line
- No or minimal sagging of the buttock tissue over the crease that separates the buttock from the thigh (infragluteal crease)
A number of buttock types have been described according to the buttock shape. These are highlighted below.
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This patient presented to Dr. Agha for a mommy makeover that included a breast lift, abdominoplasty, liposuction, and buttock augmentation. She has a Boxy-type buttock shape with inadequate projection. |
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This patient presented to Dr. Agha for a Mommy Makeover that included a breast lift and a lower body lift (circumferential abdominoplasty, buttock augmentation and lift, thigh lift and liposuction). She has a Boxy-type buttock shape. |
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This patient presented to Dr. Agha for a total body lift that includes an upper body lift and a lower body lift (circumferential abdominoplasty, buttock augmentation and lift, thigh lift and liposuction). She had significant weight loss after gastric bypass surgery. She has a V-type buttock shape. |
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This patient presented to Dr. Agha for a total body lift that includes an upper body lift and a lower body lift (circumferential abdominoplasty, buttock reshaping, thigh lift and liposuction). She had significant weight loss after gastric bypass surgery. She has a V-type buttock shape. |
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This patient presented to Dr. Agha for a total body lift that includes an upper body lift and a lower body lift (circumferential abdominoplasty, buttock reduction and lift, thigh lift and liposuction). She had significant weight loss after gastric bypass surgery. She has a Round-type buttock shape. |
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This patient presented to Dr Agha for a total body lift that includes an upper body lift and a lower body lift (circumferential abdominoplasty, buttock augmentation and lift, thigh lift and liposuction). She had significant weight loss after gastric bypass surgery. She has a Round-type buttock shape with severe buttock deflation, laxity and sagging. |
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This patient presented to Dr, Agha for a total body lift that includes an upper body lift and a lower body lift (circumferential abdominoplasty, buttock augmentation and lift, thigh lift and liposuction). She had significant weight loss after gastric bypass surgery. She has an A-type buttock shape with saddle-bags. |
CONSULTATION
During your initial consultation, Dr. Agha will inquire about your general health status, pre-existing health conditions, prior surgeries, medications that you are taking, allergies, and smoking habits. Relevant questions in the history include:
- Pregnancies and their effects on the body.
- History of weight gain and loss.
- A detailed history of current psychological issues and medical problems, e.g. heart disease, diabetes, and a history of thromboembolic disease, connective tissue disorders and wound healing problems.
It is important that you be thorough when providing the requested information as this will enable proactive and preventative care that will prevent complications during your surgery. When asked about medications, be sure to include any diet pills, vitamins or herbal supplements, since some vitamins and herbal medications can affect your blood pressure and clotting ability. Honesty regarding your smoking and alcohol use is also very important, as these may have a profound impact on your recovery period and your ability to heal following your procedure.
After reviewing your medical history, Dr. Agha will discuss your concerns, priorities and motivations for pursuing plastic surgery. Dr. Agha will then proceed with examining you and assesses your lower body contour. With regards to your buttocks, Dr. Agha will assess multiple factors including, the buttock form (see buttock types), the volume (surplus versus deficient), the contour (distribution of tissue within the buttock), the laxity and sagging, and finally the skin quality and any dimples. Also, he will evaluate the structures that surround and present your buttocks. These include the back, the flanks (love-handles), the thighs and saddle-bags. These areas can immensely alter the aesthetic features of your buttocks. For example, excessively heavy back and flank regions camouflage the V-shaped demarcation between your back and buttocks, and mask the degree of projection of the buttocks. Each of these components will determine which procedure is best for you.
He will subsequently provide you with information on different options and will explain the advantages and disadvantages of the each procedure. Considering your input, Dr. Agha will plan an appropriate procedure to best suit your anatomy, and meet your desires and expectations. Finally, you will then be provided with information regarding the potential risk and complications of each surgery.
At the completion of your consultation, you will be given a written estimate of the cost of your procedure. At this time, you will also have the option to schedule your procedure if you so choose. You are encouraged to bring your spouse, significant other, family member, or a friend to your consultation.
If you think you might be a good candidate for a buttock reshaping, this page will give you a basic understanding of the procedure and the results you can expect. The cornerstone of Dr. Agha's approach is to customize treatment to your specific needs and circumstances, and to ensure that you have an adequate understanding of the procedure so that you are able to make a fully informed decision. This will help you achieve the appearance you desire with the least invasive procedure available.
Prior to surgery, you may be asked to obtain specific lab tests and a medical evaluation.
Buttock enhancement procedures
Whether your goal is to correct the lack of your buttock projection, reshape your buttocks following weight loss or pregnancy, or simply resculpt your buttocks, you have several choices.
Buttock Contouring by Liposculture
If you have nicely shaped buttocks, liposculpture of the excess lower back, flank and saddle-bags can help to accentuate your aesthetic features. In this procedure, the buttock regions are not liposuctioned per se, but the surrounding structures that influence the silhouette of the buttocks are sculpted based on aesthetic principles. Dr. Agha will perform liposcupture of the lower back to accentuate the V-shaped demarcation of the back and buttocks. Lower back dimples can be formed if desired. Excess prominence of the flanks and saddle-bags are then liposcutioned to obtain a smooth hour-glass contour.
Patient of Dr. Agha 9 months after liposculpture
Buttock Augmentation
For those who have hypoplastic or deficient buttock tissue, a buttock augmentation can significantly enhance the shape, form, and projection of your buttocks. The size and fullness of the buttocks can be augmented with your own fat cells (autologous) in a procedure known as the Brazilian Butt Lift or Buttock Lipoaugmentation, or with Buttock Implants.
1) Buttock Lipoaugmentation or Brazilian Butt Lift
This procedure is designed to fill the buttocks so that the final overall shape is a lifted and rounded contour. It involves harvesting your own body's fat from the flanks, hips, lower back, thighs, or abdomen, and transferring it into the buttock tissue. Because the areas receiving liposuction are now leaner and sculpted, your round full buttocks will become the beautiful highlight of your sensuous new shape.
You must however have enough fat in different areas of your body to serve as the source for the graft. You must also have some fat and muscle already present in your buttock to serve as a foundation for the grafted fat to be placed into and to grow into.
Buttock lipoaugmentation is the method chosen most often by Dr. Agha's patients. Dr. Agha removes fat from selected areas of your body (commonly lower back, flanks, and saddle bags) with very gentle, low-vacuum liposuction to protect the living fat cells. The liposuctioned fat is then washed with a solution that contains antibitotics, processed, and carefully injected into the buttocks as small droplets or micrograft. During this fat micrografting process the buttocks can be contoured to the desired shape and size. The fullness and projection of the buttocks can be greatly increased by layering many fine layers of fat micrografts throughout the thickness of the buttock (gluteal) muscles and the overlying fatty tissue. Microinjection uses specialized instruments and techniques in placing the processed fat droplets to maximize their blood supply. This optimizes their survival in their new location in the buttocks tissue. After the fat is transferred, a certain percentage of it will re-vascularize and survive in the new location. Because approximately about 20 % of the injected fat resorbs, grafting is usually exaggerated and at times may be repeated after about 6 months. Once the micrografted fat is re-vasularized and takes at about 6-8 weeks, further loss of volume is minimal. Compression garments are worn for several weeks after surgery in order to help form the buttocks as well as to reduce swelling.
By applying meticulous processing and micrografting principles, Dr. Agha obtains predictable results after buttock lipoaugmentation. Most of the injected fat survives (about 80% in his practice) and so far none of his patients have required or requested a second lipoaugmenation revision. However, buttock augmentation through fat grafting is not for everyone, especially for women with minimal body fat. For these patients or those individuals who desire a significant augmentation, buttock implants will be more appropriate.
Patient of Dr. Agha after one session of Buttock lipoaugmentation at 6 months.
2) Buttock Implant Placement
The FDA has approved the use of solid and semi-solid silicone implants for buttock augmentation surgery. Buttocks implants are soft, but much stronger than breast implants, and they are solid, so they can't leak. Depending on your figure and your desire, Dr. Agha will work with you to select an appropriate implant size for you. The incision is 2-3 inches, and is hidden in the crease between the buttocks. There are two options for buttock implant placement. Implants can be placed either within the buttock muscle (intra-muscular) or over the muscle but under the muscle connective tissue cover (sub-fascial). The intra-muscular approach is most suitable for those who need more fullness in the upper half of the buttocks. For those who need more fullness in the lower half of their buttocks, Dr. Agha usually recommends sub-fascial placement. In this approach, the implant is placed between the main buttock muscle and its overlying strong covering tissue (fascia). This space is larger than the space inside the muscle, so a larger implant can be used with this technique.
Because, the buttock implant incision is located in the buttock crease, it needs to be meticulously cleaned in the shower on daily basis and every time after bowel movements for the first two weeks. Having a support system of family, friends or a professional caregiver is of the utmost importance in days after surgery, since you will need assistance with everyday tasks, such as going to the bathroom. After surgery, you are not allowed to sit on your buttock implants for more than a few minutes at a time during the first two weeks. This means no driving during this period. From the third to six weeks onwards, you can sit on soft pillows and cushions.
In comparison to buttock implants, Brazilian Butt Lift Surgery is considered the best way to achieve the most natural result for buttock augmentation. Although, the fat grafting technique takes significantly longer to perform, it produces superior results that are permanent, safer and customized according to the buttock shape. Buttock implants, on the other hand, can be fraught with complications years later because an artificial silicone implant doesn't incorporate into your normal tissues the way a fat graft can. In addition to a longer recovery time and more discomfort, there is a possibility of shifting of the implant or asymmetry because the gluteus muscle is located in this high-stress area.
Buttocks Reduction and Lift
Some people wish to have smaller buttocks. Again, liposuction of the surrounding structures, as well as deeper buttock tissue can be beneficial to some degree. However, most often, for larger reductions, a buttock lift together with buttock reshaping will be needed. This requires a plastic surgeon who has an excellent knowledge of female proportions, an artistic eye, and a keen 3-dimensional sense. Like all buttock enhancement surgeries, buttock reduction and lift truly requires a very customized strategy. During this procedure, Dr. Agha removes excess skin and tissue of the upper buttock region and lower back. He will then lift the buttock tissue to a predetermined position on your lower back and will reconstruct the V-shaped depression that is a recognized aesthetic feature. Dr. Agha will also reshape the buttock form into a rounder shape. In certain cases, a buttock reduction and lift can flatten the buttock mound. Dr. Agha will restore buttock projection in these cases by use of fat micrografts or buttock reshaping strategies.
Patient of Dr. Agha after buttock reduction, reshaping and lift at 8 months.
Buttock Augmentation and Lift
For some patients, especially those who have lost significant weight or have had gastric bypass surgery, the buttock are loose and deflated. A combination of buttock lift, buttock augmentation and reshaping will serve these patients the best. This procedure involves creation of pockets under the buttock regions to accommodate for the lower back tissue that is turned under (as flaps) to augment the buttocks with your own tissue. In this manner, moderate degrees of buttock augmentation can be performed. The buttocks are then lifted to a predetermined position on your lower back to reconstruct the V-shaped demarcation. This is a rather complex surgery that truly requires enhanced training in body contouring surgery. Dr. Agha performs his own signature body reshaping procedure that combines many of the procedures described here. This procedure is most often done in conjunction with a lower body lift.
Patient of Dr. Agha after lower body lift, buttock augmentation and lift at 7 months.
WHERE WILL YOUR PROCEDURE BE PERFORMED?
Dr. Agha has been granted staff privileges at several local hospitals and outpatient surgery centers. In the interest of the safety of his patients, he only performs surgery in fully accredited facilities with the proper services and staff.
DETAILS OF YOUR PROCEDURE
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Brazilian Butt lift or buttock reshaping usually takes two to three hours when performed by Dr. Agha. The latter combined with a lower body lift may, however, take five to six hours. After you have changed into a gown and had your intravenous line started, Dr. Agha will mark certain landmarks on your back, buttocks, flanks, and thigh in the preoperative holding area. This ensures proper planning for the surgery and liposuction. He will also review the entire operative plan with you including potential complications again. You will then be given a dose of intravenous antibiotics as a precautionary measure. |
What happens during thigh lift surgery?
Step 1 - Anesthesia
Buttock enhancement is usually performed under general anesthesia. After initiation of anesthesia in the operating room, Dr. Agha will inject a solution of local anesthetics known as "tumescent solution" at the intended incision site, the surgical site, as well as sites that are marked for liposuction. The injection solution consists of a low concentration of lidocaine and epinephrine. The lidocaine will numb the surgical site and the epinephrine causes constriction of the blood vessels at the surgical site, reducing your potential for bleeding and bruising. Liposuction is performed to as indicated.
Step 2 - The incision
Brazilian Butt Lift- This procedure involves liposuction of fat usually from the back, flanks, and thighs through several small stab incisions that are discretely placed. The fat is then processed and injected into the buttock through minute incisions.
Buttock implants- For this procedure, incisions are made where the butt cheek meets the back of the thigh, or down the buttock crease. The latter is the more common place for an incision, since scars are less noticeable, however it carries a higher infection rate than the other locations. Working through the incision, Dr. Agha creates a pocket large enough to place the implant. The implants are placed above the sitting area of your buttocks, to reduce the possibility of the implants shifting. The same is done for the other cheek. Dr. Agha carefully examines both sides to make sure they are symmetrical and natural.
Buttock Augmentation Reduction and Lift- Parallel incisions are placed over the lower back and the upper buttock. The tissue in between is then developed as a flap on each side. A large pocket is then created over the buttock muscle. The lower back flaps are then rotated into the buttock pockets and secured in position via sutures. The buttock is then elevated over the flaps to meet the lower back incision. When this is performed correctly, the incision lies appropriately at the junction of the new lower back and the buttock.
Buttock Reduction and Lift- Parallel incisions are placed over the lower back and the upper buttock. The tissue in between is excised and the buttock is elevated to its new position. When this is performed correctly, the incision lies appropriately at the junction of the new lower back and the buttock.
Step 3 - Closing the incisions
The incisions are carefully closed to minimize your scar. Dr. Agha places all his sutures beneath the skin where they are gradually absorbed by your body. Not having to undergo suture removal has improved patient comfort and satisfaction.
Step 4 - Dressings
A sterile dressing is applied to the incisions, and a compression garment is placed on you. This compression garment helps support your lower body during healing, decreases postoperative swelling, and helps decrease any bruising that may occur.
YOUR RECOVERY
- Stay- You will need to stay nearby for 14 days after buttock enhancement surgeries. By the time you leave, you should be able to sit down (gently!) on your new bottom.
- Day of Surgery- Many buttock enhancement surgeries may be performed as an outpatient procedure, but you may choose to stay in the hospital overnight when buttock reshaping together with lower body lift are performed. If you choose to go home, you will recover in the recovery room for approximately one hour or two prior to being released in the company of a friend or family member. We also have a private duty nurse available to care for you in the comfort and privacy of your own home if you so choose.
- Do not be alarmed when blood-tinged tumescent fluid oozes from the sites of fat harvest or liposuction. This is a normal result of liposuction and usually stops within the first day. The surgeon leaves these tiny incisions exposed so that the liquid spills out, thereby minimizing bruising. You should cover your bed to avoid staining from this fluid. On the other hand there should not be any drainage from the incision where the implant has been placed. If this happens, please inform our office.
- Garment- Following liposuction, fat injection, or implant placement, you are placed in a support garment. You should plan to wear the compression garment 24 hours a day for three to four weeks following surgery. This will help to reduce bruising and swelling, skin retraction and helps with the shape of the buttocks. We usually have the patient remove their garment and to take a shower after 2 days. The first time that you remove your garment you will feel faint, which is normal. Have someone with you at that time. After your first shower you need to apply Vaseline or heavy lotion all over liposuctioned areas and the buttock skin to alleviate the itchiness that is caused by the skin-drying effects of liposuction. This is a good time for you to start massaging the fat injection areas. You should massage these areas softly about three-times a days for about six weeks. If you have implants don't get the incision wet until instructed by your surgeon.
- Resting and Sleep- For the first two weeks you should sleep on your stomach and or side. This ensures that the tension on your incision line is minimized, and the pressure on the implant or the fat micrografts is reduced. During this time you should avoid putting direct pressure on your buttock for more than a few minutes at a time. If you have to sit, use a very soft cushion. From week three until six you should also sit on cushions when sitting for prolonged periods.
- Mild discomfort and tightness in the buttocks is common for the first 72 to 96 hours with most buttock enhancement procedures. After the fourth to fifth day, the tightness will begin to subside and the pain improves significantly.
- Painkillers- Usually, fat injection is much less painful that buttock augmentation with implants. Fat injection feels mostly like a bad bruise while implant placement feels like a bad muscle cramp. These pains are manageable with the prescribed medications.
- Bruising- There will be bruising in many areas that are liposuctioned or grafted, as well as in adjacent or dependent areas. For example, you will also note bruising and swelling in the back of your thighs and your genitalia. This is not because these areas are actually liposuctioned. However, bruises usually move downward due to gravity, and can thus temporarily accumulate in the genitalia. Occasionally, bruising can last a long time or even lead to permanent skin pigmentation. Sun tanning immediately after surgery can cause these bruises to become permanent skin stains.
- Early Ambulation-You're likely to feel sore for a few days, but you should attempt to get out of the bed in 24 hours. This is the best way to reduce the chance of getting a blood clot in the legs. Most of your discomfort can be controlled by the prescribed painkillers.
- Showering- The inner buttock incisions need daily care to keep them clean and dry until healed. You may take a shower after 72 hours after the surgery. Also, with buttock implants, you need to meticulously clean your incision in the shower or with alcohol preps after each bowl movement for the first two weeks after surgery. After showering, simply pat your incisions dry and replace your dry dressings and garment.
- First Post-OP Visit- Dr. Agha prefers to see you on day 5 for your first post-operative visit.
- Swelling- Any swelling in your lower body may take three to five weeks to subside.
- Driving- You may drive when driving does not cause pain. This usually occurs in 2-3 weeks. It is not safe to drive a car within twenty-four hours of taking pain medication, as your reflexes and alertness may be altered.
- It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing.
- Light Exercise- Dr. Agha recommends a program of light exercise following surgery. The motion afforded by this activity will reduce swelling, decrease the possibility of developing blood clots and enhance skin tone.
- Activities- During the first week after surgery, you want to avoid activities that raise your blood pressure. This could cause bleeding at the operative site, which could result in a hematoma (collection of blood). You should able to resume your normal daily activities within a week after a Brazilian Butt Lift, two weeks after a buttock implant placement, and about 3 weeks after a formal buttock lift. During this time you can start gentle walking. You can do upper body exercising after two weeks. Most patients return to work within a week after fat grafting, two weeks after buttock implant placement, and about 3 weeks after a buttock lift. Avoid exercises which directly stress the area of your surgery for a full four to six weeks. After this period, cardiovascular activities, such as riding a stationary bicycle or brisk walking, can be initiated. Avoid heavy lift, contact sports and jugging for up to 6 weeks. By the time you are six weeks post-operative, you will be nearing your pre-operative level. The reason to avoid stressing the surgical area has to do with healing and scarring. During the early phase of healing, one must avoid irritation around the operative site, as this can worsen swelling and fluid accumulation. This could cause development of a seroma (fluid collection) or cause problems with the wound (dehiscence or opening of the suture line, or widening of the scar). Even though the skin is closed, there are many activities taking place beneath the skin.
- Sexual Activity- Fat injection does not hinder your ability to have sexual relations. However, you should resume sexual activity only when you feel comfortable in doing so. On the other hand, with buttock implant placement you should avoid having strenuous sex for about six weeks after surgery.
- Healing- You will need a few weeks to recover and heal from buttock enhancement procedure. The typical healing time is at least one to three weeks before returning to work.
- Scarring- Every person's body is different, and many factors contribute to scar healing. Your scars will be firm and pink for about six weeks. Nonsmokers and those who follow the Enhanced Recovery Nutritional Supplements have a better chance of having rapid healing and thinner scar. Expect to wait at least nine months before your scars lighten in color and become as flat as the rest of your skin. Although they will never disappear completely, scars will not show under most clothing, even bathing suits.
- Numbness- All surgical areas stay numb for four to eight weeks. Massage will help to desensitize your skin in order to avoid hypersensitivity or skin irritation.
- Follow-ups- Regular checkups protect against complications.
- Emergencies- Some discomfort is expected following your surgery; however, be sure to tell us if:
- There is an increase in swelling, pain, redness, drainage or bleeding in the surgical area.
- You develop fever, dizziness, nausea or vomiting, or a general ill feeling.
- If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
YOUR RESULTS
You will notice a more balanced look to your buttocks and a more sensuous backside. Following buttock enhancement procedures, many patients experience an immediate improvement in their self-esteem and discover a greater self-confidence. In addition, many also find greater access to different clothing styles and fashions and are less self-conscious at the gym, around the pool, or at the beach.
However, the final results may be initially obscured by swelling after surgery. When the swelling subsides, the true results will be more evident. You will notice an improvement in your buttock shape and contour. Your buttock enhancement procedure will result in a tighter and firmer buttock contour that is more proportionate with your body type and weight.
A buttock enhancement procedure should not be viewed as a magical cure however; while the procedure improves your shape and contour, you will have to make lifestyle changes in order to maintain the appearance of your new shape. A good, healthy diet and exercise regimen can be incorporated into one's daily routine to maintain your look.
RELATIVE CONTRAINDICATIONS
Severe comorbid conditions (eg, heart disease, diabetes, morbid obesity, cigarette smoking)
Thromboembolic disease (blood clotting disorders)
Morbid obesity (BMI >40)
Unrealistic patient expectations
Patients who tend to form keloids or hypertrophic scars
SURGICAL RISKS AND POTENTIAL COMPLICATIONS
All forms of cosmetic surgery carry some degree of risks and complications. Therefore, you should consider it as seriously as you would any major surgery. Also note that augmentation with implants carries a much higher rate of complications as compared to fat injection. The risks for having implants placed in your buttocks include infection and bleeding, common risks for any surgical procedure. Risks of infection are even higher when incisions are made in the gluteal crease. Another complication that could occur is the implants shifting and causing the results to appear asymmetrical. The implants may also rupture, or break, a rare, but possible occurrence.
Surgical anesthesia: Both local and general anesthesia involves risks, which will be discussed by your anesthesiologist on the day of surgery.
Unfavorable scarring: If the sutured area doesn't heal properly or if the area takes too long to heal, the scars may be thicker than normal. If the patient heals relatively quickly, minimal scarring results. Scars will take years to fade, but they are permanent. Despite the best effort by Dr. Agha, scar appearance and healing are not fully predictable. The scars may be uneven, excessively wide, and/or asymmetrical. Scars may be unattractive and of different color than surrounding skin. Excessive, hypertrophic and keloid scarring are uncommon. Additional treatments including surgery may be necessary to treat abnormal scarring.
Bleeding/Hematoma: Bleeding may result if the sutured areas do not heal correctly or if there is improper coagulation after the procedure. If a patient notices any unusual bleeding after their surgery, they need to contact Dr. Agha immediately. Do not take any aspirin or anti-inflammatory medications for ten days before surgery, as this will increase the risk of bleeding. Non-prescription "herbs" and dietary supplements can also increase the risk of surgical bleeding. Hematoma is a blood collection that can form under the skin and enlarges as a tender bulge.
Fluid Accumulation (Seroma): After fat grafting or implant placement, body fluids (serum) occasionally accumulate underneath the skin as a seroma. If the fluid collection is significant, Dr. Agha may elect to aspirate the fluid with a small needle in an office procedure. For Buttock Lift, drains may be placed at the surgical site at the end of the operation to collect seepage of the fluid. After their removal in about 5 to 7 days, seroma may occasionally accumulate underneath the skin, requiring aspirations. If that fails to cure the seroma then the patient will need to be seen either in the office or operating room for insertion of new drainage tubes and removal of seroma cavities. This is very rarely necessarily.
Poor Wound Healing: Individuals that have a slower than average healing rate or those who are smokers may find that they do not heal properly; or that the sutured areas reopen easily; or that they are more prone to infection. Smokers should avoid smoking three weeks prior and after the procedure so that their body's natural healing process is not hindered.
Wound Dehiscence: In general, your skin closure is in multiple layers. Separation of the superficial, deep and/or both layers may occur any time during your first post operative month. Suture breakage, knots untying, sutures tearing through an excessively tight closure, too much movement or bending by the patient, skin necrosis (death) are some of the recognized causes of dehiscence. Breakage of suture in the superficial layer of skin may be sutured closed or allowed to heal secondarily, at the judgment of Dr. Agha.
Deep dehiscence may require return to the operating room for closure under anesthesia. These healing problems may require frequent dressing changes, extra office visits and further surgery to remove the non-healed tissue. Open wounds may take weeks to heal or secondary closure may be appropriate. Wounds allowed to heal on their own usually benefit from secondary scar revision.
Smokers have a high risk of skin loss and wound healing complications. Do not smoke for 3 weeks before and after your surgery.
Suture Granuloma: Some surgical techniques use deep sutures. These items may be noticed by the patient following surgery. Sutures may spontaneously poke through the skin, be visible, or produce irritation that requires removal.
Numbness in Skin Sensation: This is a normal consequence that occurs at the site of surgery in everyone to a different extent. You may experience "paresthesia," which is an altered sensation at the site of the liposuction. This may either be in the form of an increased sensitivity (pain) in the area, or loss of any feeling (numbness) in the area. In most patients, numbness goes away within the first four to sixth months after surgery. Massaging the surgical area helps increase circulation, and facilitates return of normal skin sensation. Numbness is permanent in very rare cases.
Fat Absorption and Sclerosis: Approximately 20 to 30% of the injected fat does not survive and gets absorbed. If this happens unevenly, there could be areas were you feel or see asymmetry due to fat resorption. Gentle massage over the buttock area helps even out and smoothen these areas during the recovery phase.
Skin Irregularities or Dimples: Contour irregularities and depressions in the skin may occur after liposuction. Also, the areas of injected fat can occasionally develop contour irregularities, including bumps and dimples depending on your skin elasticity. Usually, post-operative massage can be helpful in smoothening these areas. On occasion, asymmetrical fullness, bulges, and depression may be present.
Skin discoloration/swelling - Some skin discoloration and swelling can occur following liposuction. In rare situations, swelling and skin discoloration may persist for long periods of time. Permanent skin discoloration is rare.
Depression, emotional, or sexual changes: There have been reports of depression in the literature after liposuction, similar to postpartum depression.
Asymmetry in Scar Placement or Contour: No two halves of the body are identical. Therefore, following buttock augmentation, these asymmetries may persist and appear as differences between the contour and size of the two sides. Scoliosis or other spine derangements can magnify body asymmetry. On occasion, asymmetry may occur after buttock lift. Although this is not typical, it is a risk associated with the procedure.
Skin Necrosis (skin death): The skin above the site of surgery or at the incision site may become necrotic or "die." When this happens, skin may change color and slough (fall) off. Necrotic skin may become infected with bacteria or microorganisms. This may require further surgical management.
Pain that may persist: Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue after surgery.
Allergic Reactions: In rare cases, local allergies to tape, suture material, or topical preparations have been reported. Systemic reactions which are more serious may occur to drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.
Residual deformity- Despite best efforts to obtain tight buttock contour after a buttock lift, a small degree of residual deformity may persist or develop months after the surgery.
Need for revisional surgery: The practice of medicine and surgery is not an exact science. Should complications occur, or some aesthetic expectations remain unmet, additional procedures or other treatments may be necessary. Other complications and risks can occur but are even more uncommon.
Suboptimal Aesthetic Result: You may be disappointed with the results of surgery. Under treatment with residual laxity and looseness or over treatment with excessive tightness of skin can occur with flattening of regional contours and widening or thickening of scars. Considerable judgment is used to achieve the optimum shape but for a variety of reasons the ultimate aesthetics may be suboptimal. At times, it is desirable to perform additional procedures to improve your results.
Infection: Infection may happen after any surgery and may rarely occur after liposculpture. The rate of infection increases with the increasing amounts of injected fat; but the overall rate still remains very low due to routine use of peri-operative antibiotics. On the other hand, there is significantly higher risk of infection with the use of buttock implants; about 25-30%. This is likely due to the proximaty of the incision to the rectum. Milder infections can be treated with antibiotics. More significant infections require implant removal, and the wound has to be left open for it to close gradually, which can take several weeks. Extremely rarely, infections may be serious or life threatening. In cases of buttock lift, minor wound infections, accompanied by exposed and "spitting" sutures can occur and are usually easily dealt with by limited debridement, antibiotics, and dressing care. Major Infection with fever and large areas of red skin (cellulitis) is unusual. Should a serious infection occur, treatment including intravenous antibiotics or additional surgery to remove dead tissue and drain abscesses may be necessary. There is a greater risk of infection in smoker, in those with diabetes and with multiple procedures.
Deep Vein Thrombosis (DVT) and Pulmonary Complications: Deep vein thrombosis is rare but worrisome complication of plastic surgery. It represents formation of blood clot in the deep veins of the legs during anesthesia and surgery. Although a sequential compression device will be used to reduce the risks, few patients may still develop DVTs. Its frequency is reduced by early postoperative mobility so that blood does not have time to become stagnant in calf muscles. Fat embolism during liposuction is an extremely rare condition where loosened fat enters the blood through injured blood vessels during liposuction. Fat fragments can then get trapped in the blood vessels, gather in the lungs, or travel to the brain.
Pulmonary complications may occur secondarily to migration of blood clots or fat clots into the lungs (pulmonary emboli) or partial collapse of the lungs after general anesthesia. The signs of pulmonary emboli may be shortness of breath or difficulty breathing. If you have the signs or symptoms of pulmonary emboli, it is important for you to seek emergency medical care at once. Should this complication occur, you may require hospitalization and additional treatment. Pulmonary emboli can be life-threatening or fatal in some circumstances.
Nerve Injury: Buttock implants can either press upon or migrate onto the sciatic nerve which travels in the buttock region. This can potentially cause impingement or injury to the nerve. Treatment may include removal of the implants.
Implant Protrusion: It is possible for the buttock implants to migrate and gradually extrude through the incision or other areas of the buttock skin. The incidence of this complication increases if there is seroma, hematoma, or infection. Also, excessive pressure over the implants during the early period of healing can increases the risk of implant protrusion.
Visceral Perforations (puncture wounds in the organs): There have been reports of visceral perforations in the literature during liposuction by damaging internal organs with liposuction cannula. When organs are damaged, surgery may be required to repair them. Visceral perforations may also be fatal.
Toxicity from Anesthesia: Lidocaine, a drug that numbs the skin, is frequently used as a local anesthetic in the tumescent fluid. Large volumes of tumescent fluid may be injected during liposuction. This may result in high doses of lidocaine which can be toxic. The symptoms of this toxicity are lightheadedness, restlessness, drowsiness, tinnitis (a ringing in the ears), slurred speech, metallic taste in the mouth, numbness of the lips and tongue, shivering, muscle twitching and convulsions. Severe lidocaine toxicity may cause the heart to stop, resulting in death. In general, any type of anesthesia may cause complications and is always considered a risk during any surgery. To minimize the potential for lidocaine toxicity, Dr. Agha limits the dose of lidocaine used during general anesthesia.
Fluid Imbalance: Liposuction procedure involves injection of large amounts of tumescent fluid into the tissues. Although much of the fluid will be suctioned, the remainder will be gradually absorbed and may result in a fluid imbalance. While you are in the surgical center or hospital, the staff will be monitoring you for signs of fluid imbalance. However, this may happen after you go home and can result in serious conditions such as heart problems, excess fluid collecting in the lungs, or kidney problems as your kidneys try to maintain fluid balance.
Fatalities Related to Liposuction: There are reports of deaths related to the liposuction procedure. Studies conducted to date have not been definitive, so it is difficult to be sure how often death from liposuction occurs. In order to understand the extent of the risk, one study compares the deaths from liposuction to that for deaths from car accidents (16 per 100,000). It is important to remember that liposuction is a surgical procedure and that there may be serious complications.
