Who is a candidate?
Tight, full, and round buttocks have become increasingly popular, and the demand for procedures to create this look has also increased.
The volume, shape, and skin quality of the buttocks can change with weight gain, weight loss, pregnancy, and aging.
Buttock lift can refer to surgery done to remove excess skin (often in weight loss patients), or it can refer to surgery where fat is transferred to the upper buttocks to improve the volume or shape, otherwise known as the Brazilian butt lift.
The most common reason for a buttock lift is after weight loss, since patients are often left with loose skin of the lower back and buttock region. This is sometimes referred to as a body lift, when done in combination with a panniculectomy or abdominoplasty.
In contrast to excising skin, the Brazilian buttock lift aims to “lift” the buttocks by augmenting the shape and volume.
No skin is removed in a Brazilian butt lift. Rather, the area is filled to create a rounder and more lifted appearing buttock.
These two types of buttock lift can be done in combination if the goal is to remove skin and also augment the volume or make the shape rounder.
There is also the option of auto-augmentation of the buttocks during the buttock lift.
This involves leaving islands of de-epithelialized tissue along the upper buttocks, underneath the area that is lifted.
The risk of this type of surgery is an unnatural upper buttock contour, or fat necrosis or hardening along the area.
An alternative to augment volume and shape is buttock augmentation with Buttock Implants.
Procedure and Incisions for standard buttock lift
The standard buttock lift involves removing excess skin from the lower back/upper buttock region, which in turn lifts the remaining buttock skin to a higher position, lessening wrinkles and smoothing out the buttock contour.
The upper horizontal incision is along the lower back at the upper border of skin to be removed, and the lower horizontal incision is typically along the upper aspect of the buttocks, with a dip in the center above the gluteal cleft.
The ends of the incisions taper to meet on another at the hips. Drains are usually brought out of the skin at the hips.
Incisions for the Brazilian buttock lift are minimal, consisting of very small incisions.
Will insurance cover buttock lift?
Insurance does not typically cover a buttock lift, as it is considered a cosmetic procedure, even in cases of massive weight loss.
If a buttock lift is done at the same time as a procedure that is covered by insurance, it could reduce the overall out-of-pocket costs.
It is best to evaluate these types of situations on a case-by-case basis.
Risks of buttock lift
The standard surgical risks include pain; bleeding; infection; scarring; painful or hypertrophic scarring; hematoma; seroma; injury to vessels, nerves, surrounding structures; asymmetry; poor cosmetic result; contour irregularity; prolonged edema, numbness, parasthesias; fat necrosis; deep venous thromboembolism; pulmonary embolism; death; need for further procedure and out of pocket costs; and risks of anesthesia.
Postoperative follow-up visits
Visits following surgery typically occur the day after surgery (for dressing change and making sure there was no bleeding, fluid collection, or blood supply issues overnight), the week after surgery (for removal of drains if present), 2 weeks after that, and then spread out less frequently thereafter.
The schedule is adjusted based on doctor/patient preferences and needs.
Walking the day of surgery, with assistance as needed, is required. If performed in combination with other procedures, a one night stay in an aftercare facility, or private duty nursing at your home or hotel, is also required for the night of surgery.
Nurses will assist you in getting up and walking, teach you how to take care of your drains and dressings, and give you injectable pain and/or nausea medication if you are not eating enough to take oral medications, or if oral medications are not enough to keep you comfortable.
Often patients with young children or a hectic home schedule find it easier to recover at the aftercare facility, and stay for additional nights to recover and heal in a peaceful environment.
You may shower 24 hours after the drains have been removed. No baths, soaking in tubs, hot tubs, or swimming pools until incisions are fully healed.
Gentle soap (non-perfumed, non-irritating soap preferred) and water over the incision is okay.
Scar gel may be used starting 2 weeks after surgery or once incisions have no open areas, crusting, or scabs.
An abdominal binder is placed at the end of surgery, and wearing it 24 hours a day is recommended for the first 2 weeks following surgery, and then it should be used as needed during periods of activity or as needed to help minimize swelling.
If fat has been transferred (Brazilian butt lift), you should avoid laying on the buttocks during the initial postoperative period.
In general, Dr. Patel recommends avoiding exercise and heavy lifting (>15 pounds) for 6 weeks following surgery, at which time you can ease back into your workouts.
Light activity that does not involve working your core is okay (such as normal walking, but not speed-walking).
Activity should be limited to small periods with adequate rest in between. You may return to work 2 weeks after surgery, depending on your pain level, stamina, and activities required in your occupation.
Often patients like to take more time off due to lifting restrictions, length of work-day, or comfort level with returning to work.
You may drive once you are no longer taking pain medications or muscle relaxers, and allow a 24 hour minimum window between your last pain medication or muscle relaxant dose and driving.
If you notice any pain and or swelling in the legs (especially if only on one side), you should notify Dr. Patel and report immediately to the emergency room to make sure you do not have a blood clot, which can be life-threatening.
All recovery processes and recommendations vary patient to patient, so these general guidelines may not apply to every patient.