Cosmetic implants - buttock, fat and pectoral

Cosmetic implant surgery can make some body parts look rounder, fuller and more defined. For example, buttock implants may make a person’s bottom rounder, while pectoral implants are usually performed on men who wish to have a chest that appears muscular.

Buttock and pectoral implants involve surgery to insert shaped silicone pieces into skin cavities. A fat implant involves the collection of fat from one part of the body (such as the thigh), in order to plump out or reshape another area, such as the facial cheeks. This is also known as autologous fat transfer.

If you are concerned about the way you look or are thinking about cosmetic treatments to boost your confidence, there are alternatives. These may include lifestyle changes or accepting yourself the way you are.

Things to consider before implant surgery

Before you opt for implant surgery, some important issues to think about include that:

• The results of implant surgery in your buttocks or chest are permanent, but fat implants are considered semi-permanent. The body can sometimes reabsorb the injected fat and top-up injections may be required.
• Some scarring will always be visible, although it should fade in time.
• There is a financial cost. Cosmetic surgery does not usually qualify for rebates from Medicare or private health insurance.
• Smokers are at increased risk of complications. If you are serious about undergoing cosmetic surgery, you should try to quit smoking.

Finding a cosmetic implant medical practitioner

You may want to ask your doctor for advice about a suitable and reputable doctor or hospital where implant surgery is performed. At your first consultation, you should ask the medical practitioner about their training and experience.

It is preferable to have this procedure done by a reputable professional who is specially trained to perform the type of implant surgery you desire, and has a lot of experience in carrying out this operation.

Medical issues with implant surgery

Before implant surgery, you need to discuss a range of medical issues with your medical practitioner including:

• Physical health– an examination will help your medical practitioner to decide if the treatment is appropriate.
• Medical history – some pre-existing medical conditions and surgery you’ve had in the past may influence decisions about this operation, including the type of anaesthetic that is used.
• Risks and possible complications – it is important that you understand the risks and complications so that you can weigh up whether implants are right for you.
• Preparations and supplements – tell your medical practitioner about any medication that you take on a regular basis or have recently taken, including over-the-counter preparations such as fish oils and vitamin supplements.
• Past reactions to medication – tell your medical practitioner if you have ever had a bad reaction or a side effect from any medications, including anaesthesia.
• Preparation for surgery – the medical practitioner will give you detailed instructions on what you should do at home to prepare for surgery. For example, you may be advised to take a particular medication or alter the dose of an existing medication. Follow all instructions carefully.

Cosmetic implant operation

The details of the operation depend on individual factors, but generally include:

• Buttock implant surgery – you may be treated with a local or general anaesthetic. The operation can take up to two hours, depending on the size of the implants. The medical practitioner will make small incisions (cuts) in the buttock and then create a cavity either under the skin or under the muscle. The solid silicone implants are inserted into the cavities and the incisions are stitched closed.
• Pectoral implant surgery – the surgery is performed under general or local anaesthetic and can take up to two hours for each implant. The medical practitioner makes a small incision underneath the armpit, creates a cavity beneath the muscle and inserts the implant. The implants are made of solid silicone, unlike breast implants for women, which are softer. Incisions are closed with stitches.
• Fat implant surgery – this is performed under local anaesthetic and may take up to two hours, depending on the body area treated and the quantity of fat involved. To ‘harvest’ the fat, the medical practitioner selects an area from the thigh or abdomen and makes a small incision. A metal tube (cannula) is inserted. The fat is extracted through the cannula using a needle or a vacuum pump. The fat is sometimes washed before being injected with a needle into the new area. If the fat is being implanted in the face, a series of tiny needles are used.

Immediately after the cosmetic implant operation

After the operation, you may expect:

• a drainage tube in the wound to help prevent fluid build-up
• bruising and swelling
• possible numbness
• pain and discomfort
• dressings or bandages
• to wear compression garments to help minimise swelling.

Complications of cosmetic implants

All surgery carries some degree of risk. It is important that you understand what the risks and possible complications of your surgery are.

General surgical risks include:

• risks of general anaesthesia including allergic reaction, which (rarely) may be fatal
• surgical risks such as bleeding or infection
• blood clots that may cause potentially fatal cardiovascular complications such as heart attack, deep vein thrombosis or stroke.

Complications of silicone implant surgery

Some of the possible complications of silicone implant surgery include:

• collapsed lung
• scarring that may be severe, raised, reddened and itchy
• a moved, ruptured or infected implant, which may require immediate surgery
• fluid build-up in the area, which has to be surgically drained
• lumpy, uneven skin tone
• damage to underlying tissues such as muscles
• tissue death along the wound or skin loss
• complications that require further surgery.

The precise amount of fat needed to smooth or alter body shape is often difficult to judge, so having a skilled medical practitioner is particularly important.

Risks of fat implant surgery

Some of the risks of fat implant surgery include:

• bruising
• swelling
• infection
• skin discolouration
• lumpiness.

This is not a complete list. For example, your medical history or lifestyle may put you at increased risk of certain complications. You need to speak to your medical practitioner for more information.

Self-care after cosmetic implant surgery

Fat implants have a fast recovery time, usually a few days. For buttock or pectoral implants, recovery may take at least six weeks.

Be guided by your medical practitioner, but general self-care suggestions include:

• Follow all instructions on looking after your wounds.
• Avoid strenuous exercise or heavy lifting.
• Avoid sitting on your bottom for about two weeks if you have buttock implants. Instead, you must lie on your stomach.
• Wear your compression garment for several weeks.
• Report any bleeding, severe pain or unusual symptoms to your medical practitioner.

Long-term outlook after cosmetic implant surgery

Having silicone implants in your buttocks or chest will immediately change and define the body part’s shape and size. The results are permanent. Scarring will also be permanent, but should fade in time. Be patient as improvements to scars may take around a year or so.

A fat implant should result in the skin being smoother or the treated parts of the body having a fuller shape. The results of a fat implant, however, are only semi-permanent because the body can sometimes reabsorb the injected fat. Top-up injections may be required.

Alternatives to cosmetic implant surgery

Most people choose to have buttock or pectoral implants because they think their body part looks small or flat. Yet this may be due to the structure of the person’s body rather than the shape of the buttocks or chest.

Before you consider implants, talk to your doctor about alternatives, which may include:

• weight gain, since a very thin person tends to have thin buttocks and chest
• weight training – this will add size, shape and definition to any body part, including the buttocks and chest
• another type of cosmetic surgery – for example, a fat implant into the buttock area may be a surgical alternative to silicone buttock implants
• accepting yourself – talking to a counsellor or psychologist may help you overcome your concerns about your appearance and you may decide that you like yourself the way you are.

Where to get help

• Your GP (doctor)
• A medical practitioner specially trained and experienced in performing cosmetic surgery
• Cosmetic surgery hub and hotline, Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 361 041
• Cosmetic surgery, Department of Health and Aged Care, Australian Government
• Australian Society of Plastic Surgeons Tel. (02) 9437 9200
• Royal Australasian College of SurgeonsTel. (03) 9249 1200
• Australian Breast Device Registry Tel. (03) 9903 0205
• Australian Health Practitioner Regulation Agency (AHPRA) Tel. 1300 419 495