Gluteal auto-augmentation is a procedure that is performed at the same time as a lower body lift, and attempts to restore projection and roundness of the buttocks by using the patient’s own tissues. Patients requiring a lower body lift have generally undergone massive weight loss. Because of this, even after removing the extra skin and tissue from the lower back and lifting the buttock, the buttock still appears flat and deflated, and needs restoration of volume. During a lower body lift, there is a strip of extra skin and fat generally removed between the lower back and the upper buttock. In a gluteal auto-augmentation the skin is removed but the fat is left attached to its blood supply and it is then rotated down into a pocket over the buttock muscles. In a sense, this tissue is functioning almost like natural gluteal implants. It can provide restoration of projection and roundness to the gluteal area utilizing tissue that would otherwise be thrown away. The augmentation usually has good durability. It can also be a good option for a patient that does not have a significant amount of donor fat on the rest of the body to be used for fat grafting. We will ask you to purchase a compression garment before your surgery. If you wish to get a butt lift in Houston, visit us at Lift Plastic Surgery.
What happens during surgery? On the day of surgery, the proposed incisions and areas of fat removal will be marked in the pre-operative area. During the surgery, you will be placed on your stomach. The area of extra tissue will be marked as two ellipses or “flaps”. The skin over the flaps will be removed, and then the flaps will be lifted off of the underlying muscle just enough so that they can rotate but the blood supply is maintained. Two pockets are then made under the skin, but over the muscle of the buttock, and the flaps are rotated into these pockets and secured with sutures. Drains are placed, and then then skin is closed with absorbable sutures and covered with tapes and skin glue. You will then be placed into a compression garment. Depending on your preference, you can either go home or stay a night in the hospital.
What will my recovery be like? Drains usually stay in for 1-2 weeks and are later removed in the office. You will be able to start showering the day after surgery. Postoperatively, you will have some discomfort, almost like muscle soreness after a workout, but it is usually not significantly painful. Additionally, you will not be able to bend very much at the waist and must stay fairly straight for several weeks until the tissues stretch out. You should shift your weight frequently and use a padded seat to prevent placing too much pressure on the flaps. You must wear a compression garment at all times other than showering for the first 6 weeks to limit swelling and improve your results. No vigorous exercise or activity is allowed for the first 6 weeks after surgery. Expect that you will have swelling, and this will gradually decrease over the next few months.
What are the risks? With massive weight loss patients, there is generally a circumferential excess of skin, which can be hard to contour completely after a lower body lift. Additionally, tissues tend to look different when a patient is positioned on the operating room table in comparison to standing, especially with an auto-augmentation. Because of this, after surgery there may be a skin fold present in the remaining lower back skin which can give the appearance of an elongated gluteal cleft. If this does occur, it can usually be fixed by another small procedure which re-arranges the tissue in the area. Depending on the gluteal shape that you desire, it is possible that you may also need some additional fat grafting to the buttocks, since the auto-augmentation really only addresses the central gluteal area.