The use of implants for breast augmentation has for sometime been recognized as a safe and successful procedure by patients and surgeons alike.  Implants for gluteal augmentation, male pectoral augmentation, and calf augmentation can also be safe and successful procedures, when performed by an experienced, board-certified plastic surgeon.  These types of body implants, which have long been common in other countries such as Brazil, and some areas of Europe, are now becoming much more popular in the United States.  Like any other surgery, however, when the procedures are not executed properly, patients can be unsatisfied with the results.  We would like to provide here some basic informations patients can use to make informed choices about these kinds of procedures.

Gluteal Implants

There are many reasons why patients consider buttock augmentation and/or buttock reshaping.  With aging or weight loss, there is often excessive flattening of the buttocks which can only be corrected by volume addition to the buttock areas.  In addition, there is a great variation in what is a "desirable" buttock shape - from fairly flat to the "J Lo" look.  As in so many other areas of aesthetic analysis, beauty is in the eye of the beholder.  For those patients considering buttock augmentation, there are several options:  autologous flaps (meaning using your own tissue as part of a lower body buttock lift); fat injection; and gluteal implants.  The autologous flaps are extremely useful in the massive weight loss patient, and we do this procedure frequently; but this technique does not apply to the more common, non-weight loss aesthetic patient.  Fat grafting has become popular and is an excellent technique.  We also perform this procedure regularly in the aesthetic patient looking for augmentation. 

Gluteal implants have several theoretical advantages and disadvantages compared to fat grafting, but both are viable and medically acceptable methods of achieving gluteal augmentation.  Gluteal implants do not "sag" or become flat with increasing age of the pressure of sitting and lying on the buttocks.  These problems can occur with fat grafting.  Many patients who desire gluteal augmentation do not have large "fat depots", that is large areas of fat from which we can harvest large volumes of fat for grafting, without leaving depression deformities in the "donor" sites.  Also, gluteal implants can be placed at a single surgery, whereas gluteal fat injection usually requires 2 or 3 rounds of surgery to achieve the desired result.  On the "flip side," gluteal implants can become infected, develop a capsule, need revisions in order to correct malposition or other problems.

In the past, there were a wide variety of techniques for gluteal implant augmentation, some of which gave gluteal implants a "bad name".  For instance, placement of implants above the gluteal muscle resulted in poor aesthetic results and a permanently abnormal foreign sensation while sitting.  Nowadays, we know that in almost all cases, the implants must be placed within the gluteus maximus muscle, rather than above the muscle or below the muscle.  The gluteus muscle is a large muscle and thick in most patients, and good results can be reliably achieved when the surgeon uses a procedure known as the XYZ technique, which was invented by the world's most renowned gluteal implant surgeon, Dr. Raul Gonzalez of Brazil.  I had the great fortune and privilege of visiting Dr. Gonzalez and learning his technique directly from him in Brazil.  I am the only board-certified plastic surgeon in the United States to have this experience.   For selected patients, we believe this is an excellent option.  The small scars associated with the procedure are located in the buttock intergluteal crease, and are hidden by even small bikinis.  

Pectoral Implants

 Pectoral implants in the male are no longer just for body-builders.  Smaller, more modest implants are now available for more routine cases for patients who a looking for more fullness and a natural appearance.  In another separate group - the massive weight loss patients, pectoral implants can provide the fullness lost during the weight loss period, in combination with an upperbody lift to reposition the nipple in the correct location and treat the skin excess. 

Modern pectoral implants are soft and feel very natural.  They are not "hard" like some of the older model implants.  The new implants are "cohesive silicone gel".  The implants do not contain liquid silicone.  We compare the implant consistency to that of a "gummi bear."  Depending on the clinical situation, they may be placed in front of or under the pectoralis muscle.  The procedure takes about 2 hours, requires general anesthesia, and is done as an outpatient.  They are placed through small, approximately 7 cm incisions in the armpit area.  There are no scars over the breast itself.

Calf Implants

Both men and women can suffer from excessively thin calf regions.  The calf contour is formed primarily from two muscle bellies: the lateral gastrocnemius, and the medial gastrocnemius.  Some patients, either through a congenital deformity, or through diseases such as polio, can have a poorly developed calf or asymmetries in these areas.  Calf implants are placed through small, inconspicuous incisions in the back of the knee area (popliteal region).  These are done as outpatient procedures.  Although it is a small procedure, recovery can take longer than for pectoral implants, because there is some pain associated with walking for a few wees.