The gluteal surgery is becoming one of the most demanded interventions currently in plastic surgery, which depending on the degree of hypoplasia (low development) and ptosis (fall) of the same is offered to the patient with different procedures to remodel them and where they include: injection of fat or the placement of implants, being able to even combine and apply both techniques in the same patient.
The indication of each one of them is specific and depend on each person, nonetheless, its main objective is to create a new, much more natural and harmonious contour of the gluteal region.
In the case of fat injection, this requires three steps, the first being the fat obtained by liposuction of a certain body area where there is excess fat, then the cleaning and preparation of the fat cells, and finally injecting into the different planes of the gluteus, thus achieving a permanent filling effect.
When it comes to placing prosthesis, and specifically in relation to the dimensions of the gluteal implant, dr. Rosales decides based on the physical characteristics and desire of the patient, proposing the one that allows them to look the same size that balance with the rest of their body. Existing false belief that must be changed every few years is completely untrue since if they do not present any complications or discomforts, they can remain indefinitely in place.
It is important to inform the patient to whom implants are placed should not be given intramuscular injections in the buttocks for the rest of their life, and it is due to the risk of pricking the prosthesis, instead should receive injection in other parts of the body as in the thigh or the arm, contrary to when the gluteoplasty is performed by fat injection, where after the recovery of the patient there is no type of contraindication for injections at that level.
Finally he is always alert and not a victim of procedures in “aesthetic centers” where by injecting assumptions “bioimplants or expansive cells” make patients believe in magic and economic solutions to remodel the glutes or even calves, mammary glands and even fill areas of the face by injecting this type of materials, so you know that all these products are foreign substances (liquid silicone, biopolymers, oils, paraffin, methyl methacrylate, among others) that do not have permits or health records to be used for this purpose, and by not complying with the demanding regulations of the fda in the United States nor by the European community is prohibited its use for such purpose. The time of onset of the disasters and complications produced by these substances varies from a few hours to even after 20 years of being injected, a period during which the patient who feels happy and satisfied, enthusiastically recommends to friends. Complications such as pain, erythema, pigmentation, edema, fibrosis, keloids, infections, fistulae, skin necrosis, displacement of the skin to general manifestations (fever, generalized pain, arthralgia, decay, general malaise, hair loss, depression, even death, etc.), which makes the vast majority of such procedures unfortunately end in negligence or dissatisfaction on the part of the patients.
Are you a good candidate?
Regardless of the sex and once the complete development of the buttocks has already been reached, and these are: small, asymmetrical or fallen, can be considered that person with indication to perform in the same one of the mentioned procedures, obviously must have good state of health and have realistic expectations of the results that will be obtained, where no doubt will be achieved to improve the silhouette by wearing a harmonious and proportionate body.
Anesthesia and Surgical Times
In the case of fat infiltration it can take as an average time of 3 to 4 hours depending on the areas where the liposuction is to be performed, while the placement of gluteal implants has an average time of approximately 2 hours, independently of the procedure performed for gluteoplasty, usually performed under regional anesthesia (epidural block) plus sedation for the tranquility and relaxation of the patient.
Incisions and scars
In the case of fat infiltration, this procedure is performed by means of minimum incisions (0.5 cm), located at strategic points and where special cannulas are connected to a syringe loaded with the fat to be injected, while in the case of implants a vertical incision of approximately 5 cm is made at the level of the intergluteal groove, through which both buttocks are approached, the prostheses are placed and later the drainage being independently in this procedure. The scars are practically invisible and imperceptible happening unnoticed, since they are hidden in natural folds, being able to cover perfectly with the underwear or swimsuit for very small that they are.
Time of hospitalization
The patient usually is maintained in the hospital for 24 hours, this allows more vigilance in the postoperative, in addition to being able to lead a better management of the pain, which is controlled by means of an external infusion pump connected directly to the epidural catheter that was placed to its column for the surgery , and through which special drugs are administered in a continuous form that will allow the patient during the first hours a greater comfort, to be removed until the following day just before being discharged from the center.
The person should plan to stay at home keeping rest, take the prescribed drugs as directed, eat normally according to tolerance and drink plenty of liquids.
Emphasis is made on daily washing of operative wounds and hygiene of the area, since being very close to anus can be infected if these precautions are not taken. Maintaining the proper care of the dressing and drainage, and we recommend not to be exposed to the sun for at least the first 8 weeks. In the special case of gluteal implants, the patient should avoid sitting for the first 10 days, being able to remain on the stomach, to rest laterally or to lie on their back after placing supplements in the form of rolls (one at the waist and one at the subgluteal region) to decrease the pressure in that area.
Recovery and time
In the case of infiltration of fat, this period implies that the patient must maintain a bandage that will keep the operated areas covered, which is removed between the 4th and 5th day after surgery along with the drainage, being able to sit and lie on his back from the 1st day without any type of contraindication, returning the patient to their daily activities one week after the procedure. For gluteal implant surgery, a bandage should be maintained that will keep the buttocks covered, which is removed between the 4th and 5th day after surgery, while the drainage should remain for few more days until it is evident that the drain flowing is minimal in 24 hours. And because of the potential for inflammation of this procedure the patient is subjected to therapies with ultrasound and post-operative lymphatic drainage, being able to return to their daily activities two weeks after the procedure, provided they do not expose to physical effort.
Now regardless of the surgery it is recommended that the patient in 24 hours get up and walk, when the bandage is removed, use of special medical belt 24 hours a day for 8 weeks is necessary. Sutures are removed after 8 days as an average.
Risks and complications are very rare, but there is always a possibility that these occur, and when comparing both surgical techniques are more likely to appear when placing a gluteal prosthesis, since this as a foreign material can present rejection of the prosthetic material, infection, fluid accumulation (seroma) or even causing significant fibrosis around the implant; On the other hand, when fat infiltration is performed because there are no prostheses, it is practically impossible for these to appear, although cases of infection and abscess formation have been reported, which is very rare if the patient follows all the instructions.
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