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Buttock Augmentation Risks and Possible Complications

Oct 18, 2007
Like any non-cosmetic major surgery, buttock augmentation has potential risks and complications. Therefore, you should consider it as seriously as you would any major surgery. Also note that augmentation with implants carries a much higher rate of complications as compared to fat injections.

What Are the Common Minor Complications, or Consequences?
Changes in Skin Sensation: This is a normal consequence that occurs in everyone to a different extent. You may experience "paresthesia," which is an altered sensation at the site of the liposuction. This may either be in the form of an increased sensitivity (pain) in the area, or the loss of any feeling (numbness) in the area.

This sensation is permanent in very rare cases. However, in almost all patients it goes away within the first two to four months after surgery. Massaging the area of liposuction helps increase circulation, and facilitates return of normal skin sensation.

Swelling: This is also a normal occurrence that occurs in every patient. Compression garments and post-operative massage help to minimize this, as well as reducing its duration to less than two months.

Bruising: There will be bruising in many areas that are liposuctioned or grafted, as well as in adjacent or dependent areas. For example, you will also note bruising and swelling in the back of your thighs and your genitalia. This is not because these areas are actually liposuctioned.

However, bruises usually move downward due to gravity, and can thus temporarily accumulate in the genitalia. Some bruising can last a long time or even lead to permanent skin pigmentation. Sun tanning immediately after surgery can cause these bruises to become permanent skin stains.

Skin Irregularities or Dimples: The areas that are injected with fat can develop contour irregularities, including bumps and dimples depending on your skin elasticity and the extent of fat injection. Usually, post-operative massage helps to smooth these areas.

Asymmetry: No two halves of the body are identical. Therefore, following buttock augmentation, there may appear to be very slight differences between the contour and size of the two sides. Scoliosis or other spine derangements can magnify body asymmetry.

Muscle Spasm: It is very common to get temporary muscle spasm or cramps in the buttock muscles. This usually resolves quickly by itself or can be helped by gentle heat and massage.

Pain and Discomfort: You should expect to have pain or discomfort similar to a feeling of having worked out too hard. Some of this may feel like a stabbing pain in the augmented areas, and in adjacent areas. This can usually be managed by pain medications, and it generally lasts for a few weeks. Rarely, and in people with Fibromyalgia, or other forms of chronic pain syndrome, there can be a worsening of the patient's baseline pain.

Depression, emotional, or sexual changes: There have been reported incidents of post-liposculpture depression similar to postpartum depression. While this is usually temporary, patients need to address it with their physician.

Seroma or fluid collection: After fat injection or implant placement, there may be a pooling of serum, the straw colored liquid from your blood, in the buttock areas. Your surgeon can alleviate these by draining them with a small needle in an office procedure.

Fat Absorption and Sclerosis: Approximately 30% of the injected fat does not survive and gets absorbed. If this happens unevenly, there could be areas were you feel or see dimples or dents. Also, in the areas of fat absorption scarring can occur which makes the tissue feel hard. Gentle massage over the buttock area helps even out and smoothen these areas during the recovery phase.

Rare and Severe Complications:
Infection: Infection may happen after any surgery and may rarely occur after liposculpture. The rate of infection increases with an increase in the amount of injected fat, as the risk of Seroma formation increases; but the overall rate still remains very low due to routine use of peri-operative antibiotics.

There have been reports of a significantly increased risk of infection with the use of buttock implants, which can be as high as 25-30%. This is most likely due to the vicinity of the incision to the rectum. If a mild infection develops it might be treated with antibiotics. Otherwise, the implant has to be removed, and the wound has to be left open for it to close gradually, which can take several weeks.

Extremely rarely, infections may be serious or life threatening such as in cases of necrotizing fasciaitis (bacteria that eat away at the tissue) or with toxic shock syndrome, a serious, sometimes fatal infection caused by a bacteria, that is associated with surgery.

Embolism: This is also extremely rare and is lessened by early postoperative mobility so that blood does not have time to become stagnant in calf muscles. Fat embolism may occur when fat is loosened and enters the blood through blood vessels ruptured (broken) during liposuction. Pieces of fat get trapped in the blood vessels, gather in the lungs, or travel to the brain.

The signs of pulmonary emboli (fat clots in the lungs) may be shortness of breath or difficulty breathing. If you have the signs or symptoms of fat emboli after liposuction, it is important for you to seek emergency medical care at once. Fat emboli may cause permanent disability or, in some cases, be fatal.

Visceral Perforations (puncture wounds in the organs): During liposuction or fat injection the physician is unable to see where the cannula, or probe, is. It is possible to puncture or damage internal organs during this procedure. When organs are damaged, surgery may be required to repair them. Visceral perforations may also be fatal.

Skin Necrosis (skin death): The skin above the fat grafted area or at the site of stab wound incisions may become necrotic or "die." When this happens, skin may change color and be sloughed (fall) off. Large areas of skin necrosis may become infected with bacteria or microorganisms.

Implant Protrusion: It is possible for the buttock implants to migrate and gradually extrude through the incision or other areas of the buttock skin. The incidence of this increases if there is Seroma, Hematoma, or Infection. Also, excessive pressure over the implants during the early period of healing can increases the risk of implant protrusion.

Nerve Injury: Buttock implants can either press upon or migrate onto the sciatic nerve which travels in the buttock region. This can potentially cause impingement or injury to the nerve. Treatment may include removal of the implants.

Fluid Imbalance: Fat tissue, which contains a lot of liquid, is removed during liposuction. Also, physicians may inject large amounts of fluids during liposuction.

This may result in a fluid imbalance. While you are in the physician's office, surgical center or hospital, the staff will be monitoring you for signs of fluid imbalance. However, this may happen after you go home and can result in serious conditions such as heart problems, excess fluid collecting in the lungs, or kidney problems as your kidneys try to maintain fluid balance.

Toxicity from Anesthesia: Lidocaine, a drug that numbs the skin, is frequently used as a local anesthetic during liposuction. You may have had a similar drug, Novocaine, to numb your mouth at the dentist. Large volumes of liquid with lidocaine may be injected during liposuction. This may result in very high doses of lidocaine.

The symptoms of this toxicity are lightheadedness, restlessness, drowsiness, tinnitis (a ringing in the ears), slurred speech, metallic taste in the mouth, numbness of the lips and tongue, shivering, muscle twitching and convulsions. Lidocaine toxicity may cause the heart to stop, resulting in death. In general, any type of anesthesia may cause complications and is always considered a risk during any surgery.

Fatalities Related to Liposuction: There are numerous reports of deaths related to the liposuction procedure. Studies conducted to date have not been definitive, so it is difficult to be sure how often death from liposuction occurs.
About the Author
Dave Stringham is the President of LookingYourBest.com an online resource for plastic surgery procedures. Learn more about buttock augmentation and other plastic surgery procedures.
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