Top 5 Post-bariatric Body Procedures
Each year, close to 200,000 people choose bariatric procedures to drop excess weight. Here are the 5 most common plastic surgery procedures that follow weight loss surgery...
Buttock Lift and Butt Augmentation Surgery
Reviewed by Siamak Agha-Mohammadi, MD, PhD
Body contouring surgery, including a butt lift, is often needed after massive weight loss such as that which occurs following bariatric surgery. A butt lift removes sagging skin and excess fat while reshaping your waist, hips and the lower back.
It may seem counterintuitive, but the major weight loss that occurs following bariatric surgery such as Lap Band or gastric bypass can also result in a loss of fullness in the buttocks. A butt lift combined with butt augmentation may help. Several options are available to help add volume back into your buttock, including fat flaps taken from your back, silicone butt implants or fat grafting to the buttocks.
If you're thrilled with your weight loss and all the positive health changes it heralded, but dissatisfied with the look of your behind, a butt lift with buttock augmentation may help restore attractive contours to your derriere. This procedure is often performed in combination with a total body lift or lower body lift.
Your Butt Lift / Augmentation Surgery Candidacy
You may be a candidate for butt lift or augmentation if you have successfully adhered to your weight loss regimen for 12 to 18 months following bariatric surgery. You should be at a stable weight for at least three months (preferably six months).
The best way to determine which procedure is best for you is to consult with a board-certified plastic surgeon who is experienced in all buttock augmentation procedures. The surgeon will take your medical history, examine your buttocks and listen to your concerns. Based on this information, he or she will determine if you are healthy enough for surgery and determine which butt augmentation procedures — if any — are right for you. Start your search for the right surgeon now.
During your consultation, your surgeon will also provide you with detailed information about the procedure and what you should do before and after surgery to ensure the best results. If you are a smoker, your surgeon will likely ask you to quit for at least a few weeks before and after surgery, as smoking interferes with the body's healing process.
The Buttock Lift Procedure
The buttock lift procedure is typically performed with general anesthesia. It requires at least one overnight stay. Time in surgery is about two hours, but increases to up to six hours if the buttock lift is paired with a lower body lift.
To perform the procedure, your surgeon makes an incision from hip to hip along the lower back. Excess skin is then pulled and removed to elevate the buttocks and outer thighs, and the incision is closed with sutures.
Following surgery, you will likely experience some pain and swelling. Your surgeon will prescribe medications for pain and ask you to wear abdominal binders for about six weeks to help with swelling. The full aesthetic results of the surgery should be apparent after six months.
Butt Augmentation with Fat Flaps
One popular procedure among individuals who have lost a significant amount of weight following bariatric surgery is butt augmentation using lower back fat flaps.
The lower back fat flap procedure is an option if you are undergoing both lower body lift and butt lift procedures simultaneously. It requires additional time and is performed under general anesthesia.
During this procedure, the surgeon uses flaps of fat that are removed from your lower back during the body lift procedure. These flaps are then rotated, reshaped and placed under the buttock tissue, where they will add volume.
Augmentation with Butt Implants
Buttock (gluteal) implants are solid, soft silicone prostheses that are placed in or near the main buttock muscle (gluteus maximus) to fill and round out the upper and outer parts of the buttocks. Although effective in restoring fullness, buttock implants are less frequently used as a standalone procedure in people who have lost massive amounts of weight. They may, however, benefit individuals who have lost a significant amount of weight if they have already had a buttock lift (without lower back flaps). In addition, these implants may have a role among people who do not have much fat to use for augmentation. They are natural feeling and come in a variety of shapes and sizes.
The butt implant procedure is typically performed under general anesthesia at an outpatient surgical center. It can take from two to three hours.
Your surgeon first makes a three-inch incision at the midline of the buttocks. Working through this incision, he or she creates pockets either between the muscle and fat or in the main buttock muscle. The implants are then placed in these pockets, where they will be held in place by scar tissue. The incision is closed after the surgeon is satisfied that the buttocks are symmetrical and natural looking.
Fat Injections for Buttock Enhancement
Butt implants can help shape the upper and outer buttocks, but they don't affect the lower butt. Your surgeon may be able to add volume to your lower derriere with fat injections, a procedure also known as Brazilian butt lift. This procedure is also often performed after a butt lift that did not include augmentation.
Your surgeon uses liposuction to remove fat from another part of your body, such as your abdomen, lower back, hips or thighs. This fat is then purified and re-injected into your backside. In addition to the lower butt, fat injections can also be used to shape and contour other parts of your buttocks.
Risks of Buttock Lift and Augmentation
The risks of buttock lift and/or augmentation vary depending on the exact procedure(s) you choose. All butt enhancement procedures carry a risk of infection, pain, scarring, asymmetry and dissatisfaction with the aesthetic results. Anesthesia complications are possible with any procedure involving general anesthesia, including butt lift and butt augmentation.
Some specific risks are associated with particular procedures. Risks of the back fat flap procedure include delayed wound healing and fat death resulting in temporary tissue hardening. Butt implant patients may feel pain due to the stretching of tissues, especially if the implants are placed beneath the muscles.
Brazilian butt lift also involves unique risks. Because only about half of the injected fat survives in its new location, surgeons must estimate the amount of fat to inject, with mixed success. Repeat treatments are often required. In addition, fat injection should not be performed at the same time as the insertion of silicone butt implants due to the increased risk of infection. Additional risks may be associated with liposuction.
Antibiotic and anti-inflammatory medications prescribed by your surgeon will help prevent infection and manage pain. Your surgeon may also insert drains to help remove fluids from the surgical site. He or she will also likely ask you to wear a compression garment for a few days after surgery to help the tissues heal.
The best way to minimize risks is to choose an experienced, board-certified plastic surgeon and follow his or her pre- and postsurgical instructions carefully. Start your search for a surgeon now.
Cost of Butt Lift / Augmentation Surgery
The cost of buttock lift/augmentation includes the surgeon's fee, the anesthesia fee, the operating facility fee and the implant fee (if applicable). According to the American Society of Plastic Surgeons, the average surgeon's fee for butt lift in the United States is $4,379, while the average for buttock implants is $4,500. The cost of butt lift / butt augmentation will be higher if other procedures are included, such as lower body lift or full body lift. While your total cost is higher if you have multiple surgeries performed at once, your price is lower than if these procedures were performed at separate times because you only pay one anesthesia and facility fee.
Cost is also higher in densely populated urban areas where overhead is more expensive and surgeons are in greater demand. Costs of preoperative screening tests, bandages and medications are not usually included in estimates. Make sure you get as complete a quote as possible so there are no surprises down the road.
Buttock lift and augmentation are typically not covered by medical insurance. However, many surgeons offer finance plans to meet the expense of the procedure. In addition, several lending companies offer loans specifically for elective surgical procedures.
(Visit our sister site Consumer Guide to Plastic Surgery to learn more about plastic surgery procedures)
About the Reviewer of This Article
Siamak Agha-Mohammadi, MD, PhD, FACS, is a board-certified plastic surgeon in Orange County, California. He received his medical degree and completed his doctor of philosophy degree at the University of Cambridge in England and did his residencies in general surgery and plastic and reconstructive surgery at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania. An expert in aesthetic surgery after massive weight loss, Dr. Agha-Mohammadi has published articles in many prestigious journals and is a frequent presenter at major medical meetings.
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