The Surgeon Minute

Gluteal Sculpting: Fat Transfer to the Buttock

Gluteal Sculpting: Fat Transfer to the Buttock

According to the latest statistics collected by the American Society of Aesthetic Plastic Surgeons, there was one procedure that increased by an incredible 84%. That procedure was the Buttock Lift, and it is gaining interest around the world. Dr. Constantino Mendieta who practices in Miami, Florida is the author of a book entitled The Art of Gluteal Sculpting in which he describes his technique and approach to realizing the perfect “booty.” And it’s not just about making the buttock bigger.

by Isabel Bolt
and Constatino Mendieta, MD

What is Fat Grafting?

Dr. Mendieta is fond of saying, “The fat you love to hate, is the fat I love to take.” Essentially fat is extracted via a special liposuction technique from what is called the “donor” site on a patient’s body, a site where there is unwanted fat. The fat is removed, carefully prepared, and subsequently reinjected into other areas of the body that need more volume–in this case, the buttock.

The beauty of using your own fat to augment the buttock is that, unlike using implants, the fat is good for life. Once a grafted piece of fat has “taken”, it never needs to be removed or altered or changed out. It does, however, take a few months for the fat to fully take and for the final result to be revealed. Mendieta boasts a 50-80% survival rate which is testimony to his experience and vetted techniques. Not only do you get a shapelier behind, but you also benefit from the liposuction that is performed on your abdomen, waistline, thighs or hips to obtain the fat for grafting into your buttocks.

The fat you love to hate, is the fat I love to take. – Constantino Mendieta, MD

Shape vs. Size

“It took me about 8 years to really know the buttock,” says Dr. Mendieta. “People think of it as just making the buttock bigger. It is not.” According to Mendieta, size is addressed only after the shape is determined. He takes the whole body into account before reshaping the buttock by fully evaluating where and how the buttock can be enhanced in relation to the rest of the individual’s body. He evaluates the buttock by dividing its anatomy into three sections. Each area –the upper buttock, the mid buttock, and the lower buttock – is studied separately. Patient desires and anatomy dictate one of 4 universal shapes Dr. Mendieta describes as a “square,” a “V,” a “C,” and an “A.” “The “A” with the tiny waist and wider hip is popular, a la Jennifer Lopez.” A narrow shape might emulate Jessica Biel. More hip (a “C”) mimics Nicki Minaj. The larger and wider the buttock, like Kim Kardashian who has both size and projection would call for a large quantity of fat. Some women’s ideas of the perfect backside are restricted by the amount of fat they have to “donate.” Thin women may not have enough.

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The Female Silhouette

Injecting fat is a highly artistic proposition. It is more than just filling up a pocket. Mendieta likens fat to clay and talks about creating a variety of silhouettes. “I want to sculpt…not just the buttock but also work on the stomach and waistline. Some patients want a longer Pilate’s look, others want an athletic 6 pack, and some want a thinner Victoria Secret appearance.” In essence he is reshaping both the front and the back in 3 dimensions. “…so you look good walking in and even better walking out…”

The Care of the Behind

Initially Dr. Mendieta advises patients to stick to a high protein diets and eat every 3 hours. Working out is encouraged only after 2 months because of healing and fatigue associated with the procedure. Within 2 weeks most patients are back to work. Swelling gradually decreases over 3 to 6 months, so shopping for a new wardrobe is best left on temporary hold. Patients often ask Dr. Mendieta what happens with future weight gain or loss. How will the fat behave? “As a patient loses weight, the fat gets skinnier. Weight gain will make fat bigger–but fat never grows back.” In other words, the fat taken from the donor site–example, the abdomen, will not grow back. It is gone forever.

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Buyer Beware

It is important to note that extracting fat is a very technique-dependent procedure. Applying the fat is the ultimate artistic procedure. Few practitioners are considered experts, so it is critical that a prospective patient choose a plastic surgeon with the experience, training and eye of a sculptor. Demand is high, but the results are definitely not mainstream. Techniques have really improved across a wide range in the industry, but it’s still important for patients to choose a board-certified plastic surgeon with extensive experience in this particular procedure.

Dr. Mendieta cites fat as extremely safe. The risk of your body rejecting it is drastically reduced when compared with implants. Some “practitioners” riding the high wave of demand may not be as scrupulous as board certified plastic surgeons. Incidences of silicone and other dangerous injectables have resulted in patient deaths. Even among board certified plastic surgeons, there are varying levels of expertise, so be very sure when and if you choose, to choose wisely.

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