Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Buttock augmentation procedures are performed under general anesthesia. This ensures the patient is completely unconscious, feels no pain, and remains still for the precision required. The anesthesia is administered by a board-certified anesthesiologist who monitors vital signs continuously.
Safety protocols are strictly followed. To prevent deep vein thrombosis (DVT), sequential compression devices are placed on the legs to keep blood moving. The operating room is kept warm to maintain body temperature, which aids in blood clotting and reduces infection risk.
The surgery begins with the patient typically in the prone (face down) or lateral (side) position. Tumescent fluid containing lidocaine and epinephrine is injected into the donor areas. This fluid numbs the area and constricts blood vessels to minimize bleeding.
Using a cannula, the surgeon performs liposuction to harvest fat. This is done with an artistic eye, sculpting the waist and flanks to accentuate the buttocks. The fat is collected in a sterile canister.
The harvested fat is processed to remove fluid, oil, and blood. Only healthy, yellow fat cells are used. The surgeon then injects the fat into the buttocks using a cannula.
Crucially, the fat is injected into the subcutaneous plane (under the skin), never into or under the muscle. The surgeon makes hundreds of tiny passes, depositing microdroplets of fat at different levels to build volume and shape. This ensures the fat has access to a blood supply.
For implant surgery, an incision is made in the gluteal crease. The surgeon dissects down to the gluteus maximus muscle. A pocket is created within the muscle fibers (intramuscular).
The sterile implant is inserted into the pocket. The surgeon ensures it sits correctly and symmetrically. The muscle is then closed over the implant, and the skin incision is sutured in layers. Drains may be placed to remove excess fluid.
For a gluteal lift, the surgeon marks the excess skin to be removed. An incision is made along the pre-determined lines (upper buttock or lower crease). The skin and subcutaneous tissue are undermined and lifted.
The excess tissue is excised, and the remaining skin is pulled taut and sutured. Deep sutures anchor the tissue to the underlying fascia, providing long-lasting lift. This physically removes the sagging.
After surgery, the patient is moved to the recovery room. They are placed in a position that avoids pressure on the buttocks (usually in the prone or side-lying position). A compression garment is applied immediately.
Patients are monitored until the anesthesia wears off. Pain is managed with IV medication. Once stable and alert, the patient is discharged to the care of their escort. Instructions are given on how to protect the surgical site.
The first two days are the most uncomfortable. Patients will experience soreness, swelling, and bruising. Drainage of tumescent fluid from liposuction sites (in BBL) is normal; absorbent pads are used to manage this.
Rest is essential, but patients must get up and walk around the house every few hours to prevent blood clots. They must strictly avoid lying or sitting on their backs.
Pain is typically described as a deep ache or soreness, like a heavy workout. It is managed with prescribed narcotics for the first few days, followed by muscle relaxants and Tylenol.
Patients are advised to avoid anti-inflammatory drugs (NSAIDs) like ibuprofen, as they can increase bleeding. Staying ahead of the pain with scheduled doses helps maintain comfort and mobility.
The “no sitting” rule is critical. For fat grafting, pressure kills the fat cells before they can establish a blood supply. For implants, pressure can cause wound opening (dehiscence) or implant displacement.
Patients must sleep on their stomachs or sides. When they must sit (e.g., for the toilet), they should use a thigh support device to keep the buttocks suspended in the air. This restriction typically lasts 2 to 6 weeks.
The compression garment (faja) must be worn 24/7, except when showering. It reduces swelling, helps the skin retract, and shapes the new contours.
The garment should be snug but not painfully tight. Patients often need to use foam boards (lipo foams) under the garment to prevent creasing and ensure smooth skin healing.
If drains are present, the patient records the fluid output daily. Drains are usually removed when output decreases, typically within 1 week.
Incision sites must be kept clean and dry. Patients can usually shower after 48 hours, letting water run over the wounds but avoiding scrubbing. Soaking in baths or pools is prohibited until fully healed.
Many surgeons recommend professional lymphatic drainage massages starting a week after BBL surgery. These massages help move excess fluid out of the body, reducing swelling and preventing the formation of hard lumps (fibrosis).
This accelerates recovery and improves the final texture of the skin. It is a gentle technique focused on fluid movement rather than deep-tissue muscle work.
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This is normal after liposuction/BBL. It is the tumescent fluid mixed with a small amount of blood. It helps reduce bruising. The leaking usually stops within 24 to 48 hours. Use the absorbent pads provided.
You can sit on the toilet, but you should not put your full weight on your buttocks. Use a squatty potty or hold onto rails to hover. Alternatively, use a BBL pillow placed under your thighs to keep your butt elevated off the seat.
You cannot drive while on narcotic pain medication. Furthermore, you cannot sit normally for weeks. Most patients do not drive for at least 2-3 weeks, and when they do, they must use a BBL pillow to keep pressure off the buttocks.
Signs include fever over 101°F, excessive redness or heat at an incision site, foul-smelling drainage, sudden severe pain in one leg (DVT), or shortness of breath (PE). Seek medical help immediately if these occur.
Swelling is the body’s natural reaction to surgery. It peaks around day 3-5. Your buttocks may look larger or “square” initially. This is fluid, not the final result. The shape will round out as the swelling subsides over the coming months.
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