By C. Downey © 2005-2009
PlasticSurgery.com Staff Writer
Jennifer Lopez and Beyoncé started a craze for an enhanced derriere as more flat or bulky rear ends everywhere are being surgically enhanced into more shapely curves and feminine fullness.
Besides this major attention focused on only a few Hollywood leading ladies, more women everywhere are considering or getting buttock enhancements – lifted, sculpted, or augmented. For one, more women are wearing tighter garments, low-cut sweats, workout pants and leotards in public more often. Plus, thong bathing suits leave absolutely nothing to the imagination.
In Brazil, with its languid, sunny weather and postcard-perfect beaches, the attraction of shapely, female buttocks is nothing new.
Yet another reason more women are having butt implants – or gluteoplasty – results from an excess amount of exercise. Women who work out hard also tend to lose the natural curve and shape of their rears, experts say.
The popularity of the butt lift is not just a U.S. fashion fad. Experts say there are strong reasons why people everywhere are wild about beautiful rears on females and the very feminine inward sweep of the lower back, hips, and waist.
Rooting in prehistory, the attraction of a curvy female rear helped propagate the human race.
Plastic Surgeon Thomas L. Roberts III, M.D. an associate clinical professor of surgery at the Medical University of South Carolina, points to research that reveals why people everywhere find a well-shaped derriere, so, well, bootylicious .
Shapely Bodies Equals Attraction
“At its core, the attraction between men and women is based on reproduction, whether or not you want to be a parent,” Dr. Roberts told PlasticSurgery.com. “One study seems to nail it down. Researchers analyzed 18 separate cultures from hunter-gatherers to computer programmers in cities and found the ideal feminine body – at least in the human eye – has a waist that is 70 percent as large as the hips.”
When the medical records of females with those hip-to-waist proportions are studied, they were found to be healthier with lower rates of breast and ovarian cancer, diabetes and other ailments. In prehistory, it was more likely that that group would survive childbirth and nursing, and live longer to care for offspring.
After he read the study, Dr. Roberts crunched the numbers on his own patients' statistics and found that those who came into his office for a butt lift have a waist 80 percent larger than their hips. But when they leave, the ratio is that highly-desired 70 percent. It just looks good to the human eye.
“The $64,000 question is how we can automatically sense the state of female health by just looking at her shape,” Dr. Roberts says. “We assume it's instinctual behavior.”
In any case, far more women today are having buttocks augmentation, says Dr. Roberts who reports such requests in his office are up six-fold over two years ago.
More Attractive Female Derrieres
Human buttocks can be augmented through two distinct methods: using implants, typically consisting of silicone, or through fat grafting, which means adding a patient's own fat to her rear. Similar to inserting implants, fat grafting also involves transferring a substance through small incisions. While artificial implants are falling from favor, more patients are considering the fat grafting technique.
Buttocks Augmentation surgeons like Dr. Roberts and his colleague Luis S. Toledo, M.D., a plastic surgeon in private practice in Sao Paulo, Brazil, have eschewed buttock implants over using the patient's own fat to create a more attractive female derriere. The duo and one other surgeon, Brazil-based Ana Zulmira Badin, M.D., studied 566 patients who had their buttocks enhanced through micro-fat grafting , which involves the injection of fat versus transferring it.
“Most patients right away tell me they know that injected fat is reabsorbed by the body so the enhancement doesn't last,” says Dr. Roberts. “But that's not true.”
Due to the extremely delicate nature of stubborn, human fat, surgeons who perform transplantation surgery must take caution.
Drs. Roberts and Toledo explain how suctioning shouldn't be too strong, or it will kill the fat cells; nor can the surgeon use too narrow a needle on the syringe to inject the fat cells back into the patient's tush. While bodily tissues, fluids and fat cells extracted during liposuction must be separated in a centrifuge, the device can't whirl too rapidly, least the cells become too damaged. Moreover, the surgeon should not deposit too many fat cells into any one place. Droplets are good – placed at hundreds of different levels – but fat cells the size of a teaspoon put into one place will perish. Also, fat cells cannot be exposed to ordinary air.
Drs. Roberts and Toledo 's study results, printed in a 2001 issue of Aesthetic Surgery Journal revealed that 50 to 75 percent of the grafted fat remains in the rear for the long term – after the operation is done very carefully.
“The fat that remains at one year after the operation, remains with you permanently,” Dr. Roberts says.
The study revealed about four percent of patients had problems – slight infection or small pockets of fluid retention – which cleared on their own. The other possible risks of buttock enhancement, such as lumpiness, bleeding and muscle or nerve damage, did not happen to any of the subjects who wore a compression garment for about six weeks; they were able to resume most normal activities in two to five days. Ten percent of the subjects later requested additional buttocks augmentation.
One possible downside: Not many surgeons perform the procedure due to its difficulty. According to Dr. Roberts, one surgeon, three nurses and six hours are required to properly prepare the extracted fat for re-injection back into a patient's rear.
“If you rush things, the buttocks enhancement can be gone in a year,” Dr. Roberts says. “There are simply too many ways the fat cells can die.”
Finding Buttocks Augmentation Surgeons
Artificial buttock implants may also help to create a lovely backside, but the method tends to sound tricky. According to the American Society for Aesthetic Plastic Surgery (ASAPS), solid and semi-solid buttock implants, while good for some patients, pose disadvantages. These include significant scarring and the possibility that the implants will shift.
“When patients ask about implants, I tell them if I use micro fat grafting, I have greater flexibility in the size and placement, there is less pain, faster recovery and far less risk of complications,” Dr. Toledo says. “I only use synthetic buttocks implants when the patient has no bodily fat to spare.”
If Dr. Roberts has a patient with very little fat, he usually suggests the patient return home, gain some weight and then return for fat grafting. He also tells them that the new buttocks won't waste away if the patient loses weight again; if she drops pounds, the weight comes off the entire body so the rear stays proportional.
“In the past, implants notwithstanding, there wasn't much we could do for women who complained about a flat rear end,” says Dr. Roberts who has given about 120 speeches on six continents about the micro fat grafting procedure.
“Until the last several years, most Americans cared only about larger breasts,” Dr. Toledo says. “But the international trend – which is now affecting the U.S. – has always been a nice balance between buttocks, waist and breasts.”
Many of Dr. Toledo's butt lift patients have lymphatic drainage via a light massage, avoiding the areas where fat has been injected. That usually speeds healing.
Beverly Hills plastic surgeon Anthony Griffin, M.D., as seen on ABC's “Extreme Makeover,” took micro-fat grafting a step further and invented some surgical tools and devices to speed the procedure and reduce the infection rate even more.
“It required about seven years of tinkering and work to create a closed surgical system that basically reduces the operation from eight hours to three,” Dr. Griffin says. Consequently, he patented the term “Brazilian Butt Lift” and says he is the only U.S. practitioner who offers that particular operation.
“The procedure also requires a somewhat artistic eye that can sculpt bodies and a hand that know where best to put the fat for the most flattering results,” says Dr. Griffin, who also admits turning away quite a few patients, instructing them to return home and gain 10 to 15 pounds. The Brazilian Butt lift usually results in at least 50 percent of the re-injected fat remaining in the patient's rear, he says.
But whatever women do their rear ends, the secret might be found in the words of Italian film star Sophia Loren who once explained her take on everlasting beauty. She once told an interviewer:
“Sex appeal is fifty percent what you've got and fifty percent what people think you've got.”