Abstract

Background The buttocks region has been associated with allure and sex appeal for centuries. Although gluteoplasty employing silicone implants has been practiced for more than 30 years, little has been written on how to evaluate and reshape the area or how to select and place the various implants that are available. Objectives In this article, the clinical anatomy of the buttocks area is reviewed, the properties of silicone elastomer gluteal implants are summarized, and an approach to evaluation and augmentation of the gluteal area involving solid silicone elastomer implants is presented. Methods The buttocks were augmented through a single intergluteal incision with the use of implants placed in the intramuscular position. Lipoplasty and fat transfers were also performed in most patients to further contour the gluteal region. Results Between February 2002 and May 2003, 73 gluteal augmentations were performed, with a high rate of patient satisfaction. Although wound dehiscence remained an issue (30%), implant removal and implant infection rates were low (2%). Conclusions An understanding of implant shapes, sizes, and firmness will aid the surgeon in the selection of the most appropriate implant on the basis of the individual patient's gluteal anatomy. Intramuscular implant placement will result in a more natural shape, help prevent implant migration, and, most important, help reduce implant removal rates. (Aesthetic Surg J 2003;23:441-455.)

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