Questions about Gluteoplasty/Buttock implants

 

When do I return to work, and when will I feel normal?

The recuperation period used to be three to four weeks, however, with the latest advancements in the technique the recuperation period has been greatly improved. Dr. Mendieta uses a combination of ice packs for the first 48 hours, special stretching exercises that Dr. Mendieta will explain to you, and the use of certain medicines that are given during and after surgery. Although it will take one month before you feel completely normal most patients are back to work in one to two weeks.

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Do I need to wear any special garments after my surgery?

For your surgery you will receive prescriptions for pain, antibiotics, and for muscle spasms. After the surgery you will be asked to use ice packs or frozen peas over the buttock area for the next 48 hours, as well as start on your stretching exercises. Dr. Mendieta will place an abdominal binder around your buttock for pressure control and you will use this for about one week. Dr. Mendieta combines many of his gluteal augmentations with liposuction, this is what really accentuates the nice buttock contour, and if you do have liposuction then you will also be asked to wear a body garment for about 3-4 weeks.

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When can I go back to the gym?

Returning to your routing exercise program will depend on how well you recuperate, on the average most patients are back at the gym in one month, however there have been patients that are able to return after only 3 weeks. You will need to start off slow and gradually increase your activities, your body will tell you your limitations. Expect to be sore the next morning and always remember your stretching exercises that Dr. Mendieta will give you.

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How do the stretching exercises help? Won’t this create more pain and discomfort?

One of the biggest improvements in the recuperation period has been the addition of the stretching exercises. You will be able to understand this concept through an example below:

You are someone who enjoys working out, but you have not been able to exercise in a long time. When you finally return to the gym, the following day you find yourself to be sore and in pain. Well, what happens if the following day you decide not to return because you feel too much discomfort? Exactly, you will feel even more discomfort and the soreness persists and gets worse as the week progresses. However, what happens if you decided that even though you are sore you have made the commitment to return to the gym not matter what. Well, when you first start your exercise you are very sore, but as the work out progresses the muscle loosens up and the discomfort improves and almost goes away. It is the same principal with the gluteal augmentation, the quicker you stretch the quicker the muscle will relax and not go into spasm, tremendously improving your recuperation period. All our patients are encouraged to stretch immediately after surgery performing the exercise 5 times a day with a repetition of 5 times.

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When can I sit?

The patient can sit from the first day after the surgery for any of the bodily necessities, however sitting for prolonged periods of time i.e. watching TV, computer work, etc we suggest about one week. This takes the stress off of the suture line and allows for better wound healing. We recommend our patients to lie on their stomachs during leisure time and to sleep on their stomachs for one week you will also be wearing a garment for at least 2-3 weeks.

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Will I be sitting on the implants?

This also is a very common question and the answer is - No. Please perform the following test with me. You are currently sitting so please take your hand and place it on the bottom part of you buttock, the part that you are sitting on. You will notice that this area is bony and it is called the ischial tuberosity. Well, keep your hand on this area and stand up. When you stand, you will notice that your hand is way down there and nowhere near your actual buttock. The implant is placed under the muscle and is way above this area so you are never sitting on the implant.

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Won't the implant rupture, when I sit?

This is a very common question, unlike the silicone breast implants which are made of a silicone gel, which means that the gel of the implant can leak, rupture and ooze into the tissues, the buttock implant is made out of solid silicone, and so it cannot rupture or leak. This is the beauty of this implant, even though it is solid the feel of the implant is soft.

When someone touches your buttock it has a natural feel to it, it will feel like a firm buttock, like you have worked out vigorously for many years.

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Are there any health issues with silicone?

There have been many studies made on the safety of silicone and to this date there is no evidence linking silicone to any autoimmune diseases or causing any medial problems. Most of the studies have been done on breast implants, the liquid silicone type. The solid silicone form has been used for years without any problems. For further review of silicone studies click here.

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What are the complications of the procedure? What to do if a complication develops?

Like any surgical procedures, complications although as rare as they may be, still exist.
The Complications are:

1. Bleeding or Hematoma - This is a collection of blood around the implants. This can occur but it is extremely rare, if it does occur this would require exploration of the wound along with drainage of the hematoma and control of any bleeding if it is still present.
   
2. Infection - Again extremely rare, however if is this occurs the implant will need to be removed and you will have to take antibiotics that are specific to your particular infection. The implant can then be reinserted in about 3 months as long as the infection is cleared.
   
3. Capsular contracture - (hardening of the implant from excessive scaring). This is extremely rare with buttock augmentation; this problem is seen more often with breast augmentation. In the buttocks area because the implant is placed under the muscle and it is an area that is in constant motion, the capsule usually remains soft. However, if this were to occur, then one could try certain medicines like papavarine, vitamin E and indomethecin along with Ultrasound therapy to try and soften the capsule. Sometimes this form of therapy does not work and it may mean re-operating and even perhaps having to remove the implants.
   

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4. Nerve damage or sensation changes in the leg - The specific nerve that we would be concerned about is the sciatic nerve. If this were the case then you may feel some pain, discomfort or electrical type shock that radiates down the leg. This is extremely rare since the implant is placed higher than where the nerve is located. If this occurs then we would try conservative therapy first to let the swelling and wound healing process take place. We could also add ultrasound therapy along with medical therapy, such as neurontin, Vitamin B 6 and B12. However if the problem persists then the implant may need to be removed. As we stated, this is a very rare problem, however what is more common, is that one may experience some temporary skin sensation changes, either numbness or sweating of the buttock area along with temperature changes in the buttock area the sensation of (feeling cool or warm). This usually resolves over a one to three month period, and it is usually from swelling. We could also add ultrasound therapy along with medical therapy, such as neurontin, Vitamin B 6 and B12. These will sometimes help, but consult with your physician first.
   
5. Displacement of the implant - In this scenario the implant moves to far down the buttock area or to far to the side. The reason why is because the implant dissects down the tissues and creates a bigger implant pocket. The correction would require either internal suturing of the capsule to make the implant pocket smaller or removal of the implant. If the implant is removed then we could place the implant back after 3 months.
   
6. Wound healing problems or Wound dehiscence - The wound may open up, requiring dressing changes until it heals. The area in which the incision is placed which is right down the center of the sacrum has tension and is in an area that is difficult to keep clean. Therefore in some patients minor wound problems develop, like the wound opens or has persistent drainage. This problem usually resolves on its own and it just a matter of letting time heal the wound.

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7. Prolonged fluid drainage from the incision site - This usually is localized fluid that is around the incision site and not the implant. Many times it may require the wound to be explored and make sure it is not a more severe infection. Often it is a suture that has become infected and needs to be removed. The solution may be to either remove the suture and the problem is solved or it may require that the wound be left open and allow it to heal on its own over time with the aid of dressing changes.
   
8. Fluid collection around the implant - This is most likely a seroma, which is a clear sterile fluid that the body produces as a reaction. This can easily be drained with a needle. This is a benign problem that usually resolves on its own and may not require drainage. Vary rarely will it require more aggressive therapy like drainage, re-operation or sclerosis. However it is important to distinguish this fluid from an infection. An infection is very different and will require the removal of the implant.
   
9. Bad scaring - This is hardly ever a problem because of the location of the scar. It is in the middle of the sacrum and is very inconspicuous so it is hard to see. Even if you do get a bad scar, it will be hard for anyone to notice. The scar however can itch.
   
10. Asymmetry, one side of the buttock looks different than the other side - this really is not even a complication since it is part of our normal anatomy to have one side of the body different than the other. When we perform the augmentation, you may become more aware of the differences. If you look at your photos before surgery you will see that the differences exited before.

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