National report — Styles change. Several centuries ago Rubenesque figures epitomized beauty and femininity. In the 1970s, the slender frame of a model and/or athletic build of a runner became fashionable.
Now a new fashion trend is emerging, popularized by rap and Latin music and made trendy, most notably, by entertainer Jennifer Lopez. The trend is leading both to a new concept in beauty and a growing sensation of a relatively new cosmetic procedure — the buttocks implant.
According to Douglas M. Senderoff, M.D., of New York City, "The desire for curvaceous buttocks never really went out of style. The concept of beauty focuses on the buttocks as a symbol of sexuality and it always has."
It can depend on the community in which you live, but the Latino community seemed to embrace the aesthetic sense of the protruding buttocks first. Having larger buttocks is, in a word, "sexy".
Douglas M. Senderoff, M.D., places a solid silicone implant either intramuscularly or subfascially. He prefers using blunt dissection inferiorly over the sciatic nerve when placing the implant intramuscularly. He prefers the subfascial location because the intramuscular placement needs to be too high to avoid interfering with the sciatic nerve. Photos: Douglas M. Senderoff, M.D.
"The buttocks implant is also an excellent option for people who experienced weight loss or just need more projection," Dr. Senderoff tells Cosmetic Surgery Times. Wasting diseases in patients, such as HIV, can also fuel a decision for a buttocks implant.
Over the past four years, Dr. Senderoff followed 40 of his patients who underwent buttocks augmentation with solid silicone implants.
"At first, I had a couple of patients who requested the procedure so I thought I would see how it worked," he says. "Then, I started getting more demands, so I started doing more cases. A lot of myths were associated with the procedure because most doctors don't understand it."
Dr. Senderoff decided that because of the questions generated by the surgery from patients and fellow surgeons, he would keep statistics on his procedures to determine what problems were actually associated with it and how to deal with the complications if they arose. He presented his results at the American Society of Aesthetic Plastic Surgery's (ASAPS) Aesthetic 2005 meeting in New Orleans. He found that problems were not as numerous as some doctors had thought, and that most of the complications could be treated easily.
Start with template
Dr. Senderoff starts with a template of the implants, placing them on the buttocks to determine the appropriate size and shape for the patient.
"It's impossible to estimate the appropriate implant size unless you put the sizer on the body to see how it is going to fit. Then I draw it on the patient so I know how far to dissect," Dr. Senderoff says.
After placing the patient under general endotracheal anesthesia in the prone position, prophylactic antibiotics are administered and sequential compression devices on the lower legs are applied. Dr. Senderoff makes a single 7 cm midline intergluteal incision, then, using a lighted fiber optic retractor and the newly developed Senderoff subfascial gluteal retractor (Marina Medical Corp.), he places the solid silicone implant either intramuscularly or subfascially. He prefers using blunt dissection inferiorly over the sciatic nerve when placing the implant intramuscularly, but prefers the subfascial location because, he says, the intramuscular placement needs to be too high to avoid interfering with the sciatic nerve.
Recommendations for implant success
"Afterwards, it takes months for the muscles to relax and the implant to lower," he says.
The biggest problem with the subfascial placement is that if the patient is too thin, edges can be visible and palpable. The incision is closed in layers with routine closed suction drains.