The 2 Minute Drill – Buttock Implants and Fat Grafting

In the latest 2 Minute Drill from the PSC, 4 board certified plastic surgeons answer questions rapid-fire style regarding buttock augmentation procedures and how surgeons mark patients prior to breast augmentation. Dr. William P. Adams Jr. of Dallas is joined by Dr. Richard Restifo of Conneticut, Dr. Dan Del Vecchio of Boston, Dr. Steven Camp of Ft. Worth, and Dr. Richard Zienowicz of Rhode Island.

Buttock Implants

When it comes to buttock augmentation, one of the fastest growing plastic surgery procedures, implants are out and fat grafting is in. A video of a patient able to visibly move her buttock implant shows why, and the surgeons respond.

“Looks horrible. Implants are too superficial, you can see it. This is why people shouldn’t have buttock augmentation with implants unless it’s ABSOLUTELY the last resort.” – Dr. Del Vecchio

“Buttock implants; just say no.” – Dr. Restifo

“Agreed. The pictures of this buttock implant turned upside are really hard to watch.” – Dr. Camp

“NTA. Nothing to add.” – Dr. Zienowicz

Fat Grafting to the Buttocks

Fat grafting is the technique that has skyrocketed buttock augmentation procedures to the mainstream. While the short-term success is visible, what might augmented behinds look like in a decade? While the verdict is still out, the surgeons way in on their expectations.

“When we do cosmetic surgery, we have to caution people to not gain weight afterwards. If you gain weight after you’ve had something done, you know what’s going to happen, right? It’s like the reverse of Tweety Bird’s head.” – Dr. Zienowicz

“I think it’s still early, we don’t know what these patients are going to look like 10, 15, 20 years down the road yet. I do think there’s some differences in the consistency of the tissue in the buttock that will make it respond differently long term. We don’t have answers to all of that yet. However, to date, it’s been a procedure that’s got great reproducibility and people that are experienced are getting good results for their patients.” – Dr. Camp

“We just don’t know.” – Dr. Restifo

“I’ve been doing fat grafting to the breast now 11 years and I don’t see sagging breasts from fat. And I don’t think we’ll see in 10 years sagging buttocks.” – Dr. Del Vecchio

Levelers for Surgery Markings

Breast augmentation in particular is a relatively straight forward procedure for surgeons. The most technical and difficult part is everything leading up to surgery – choosing the look with 3D imaging, breast size, implant type, etc. On the day of surgery, do surgeons make use of a leveler tool to mark a patients breast for the best aesthetic outcome?

“I have one in the back of my Jeep. Every breast case I do I take it into the hospital and take it out. I think they’re great.” – Dr. Del Vecchio

“When I look at a woman’s breast to decide whether or not they’re attractive, I do not pull out a laser-level. I think your eye is good enough.” – Dr. Restifo

“I think some degree of marking is important – whether you use a leveler or something more similar.” – Dr. Camp

“I use a Vectra pre-op to really statistically and very precisely decide whether or not there’s asymmetry.” – Dr. Zienowicz.