Enhancement of the buttocks is most consistently done with a gluteal implant. Despite its predictable revising in the size and shape of the buttocks, buttock implants are not without complications. Intramuscular implant placement makes saving more uncomfortable and having to sit on the implant predisposes it to positional shifting and the formation of fluid collections and potential infection.
Because of these concerns, the alternative medicine of fat injections or free fat grafting has emerged. Fat grafting to the buttocks has numerous potential advantages such as the elimination of the need for a synthetic implant, the use of a patient's own body tissues, an easier saving with few limitations, a simultaneous advantage of cosmetic enhancement of the donor site, and a very low risk of bleeding or infection. All of these advantages of free fat fat grafting is counterbalanced by one primary disadvantage....an unpredictability of after surgery shape and size. How much fat survives and is retained is widely variable. No plastic surgeon can certify or predict with 100% accuracy how much fat will survive on a consistent basis. I prefer to inject no more than about 300cc per buttock as I think much volume than that results in greater volume loss.
The burning quiz, through the past any decades is...how to make fat grafting work better. The injection technique is, of course, prominent but is only half of the answer. How the fat is prepared after harvest in the operating room is the other half. Everyone agrees that attention is very prominent after harvest. This is the mechanical process of removing the liquids from the more solid fat components. Whether this is done by a centrifuge or passing the fat aspirate through a strainer or sieve are two methods of which one has not been proven to be best than the other. Additives to the fat are theoretically consuming but there is no universal magical additive. Currently, I add platelet-rich plasma (Prp) to the concentrated fat prior to injection. Whether this aids fat survival is not proven but since it is a stock of the patient, there is no risk in so doing. Prp is a incorporate of a patient's own blood done at the time of surgery. While there is no standardized whole of Prp to add to fat, I typically use 3cc of Prp per buttock graft site.
If a outpatient opts for buttock augmentation with fat injections, they must accept that the whole of fat that will survive is unpredictable. It may need more than one injection session to collect the best result. Most fat grafting methods will not perform the degree of volume enhancement that a gluteal implant will.
Skin Graft Surgery:Fat Injections For Buttock Enhancement
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