What is the surgery all about?
Although Gluteoplasty has been around for many years it has not gained popularity in the United States until recently. Therefore, only a handful of surgeons are offering this body contouring procedure.
Dr. Ramon Robles, explains that just like breast and calf implants that are used to reshape and augment these body parts. The glutei implants are used to improve the contour of the buttock. The operation is fairly straightforward, a single well-hidden scar is placed strategically so that not even your closest friends can find, and through this the implant that is made of silicone is placed in the buttock area to improve size, shape and contour. Dr. Robles explains unlike the silicone breast implants which are made of a silicone gel, which can leak, rupture and ooze into the tissues, the buttock implant is made out of solid silicone, and so it cannot rupture or leak. The augmented buttock has a firm but natural feel almost as if you had been working out vigorously for many years. It does not affect your sitting since the implant is placed in an area that is well away from the bony aspect of your buttock that you actually use to sit on.
Dr. Robles has had an interest in total body contouring which has lead him to make an in-depth study of the subject, and train under the pioneers of this technique, acquiring the knowledge and experience to be able to offer this new advancement to many women or men that could benefit from this surgical procedure

How to evaluate the buttock area?
The buttock is made of muscle, fat, skin and its underlying support is bone. The shape and contour of the butt depends greatly on the person's framework the so-called -bony structure. However, its main volume and definition comes from fat. It is how this fat is distributed that will make the difference between an attractive, and a not so attractive buttock. For the purpose of this section, we will address only the evaluation of the buttock shape. When evaluating the shape of the buttock, it is best to divide the anatomy into three sections; the upper buttock, the mid buttock and the lower buttock. Each area needs to be evaluated and addressed independently in order to provide the best gluteal harmony.
. The Upper Buttock: In this area, we need to address two factors: how much volume is present, and more importantly, how the fat is distributed. An aesthetic buttock has most of the fat located directly posterior on the buttock and has enough fullness superiorly to give it a lifted round look.
If more fat is located in the upper outer aspect, the so-called hip roles, then the buttock will look square and unattractive. Liposuction alone will improve the contour, but it will not add volume to the buttock. In order to increase the size, an implant or fat is required.

When a gluteal augmentation is performed, the implant is mainly addressing the upper buttock and the upper portion of the mid buttock. It will not address the other areas. In the majority of patients, a careful analysis of the middle and lower buttock needs to be made since complimentary procedures may be required in order to improve the overall shape.
. Mid-Buttock: In some patients, an indentation can be seen in the midsection of the buttock. This is a very subtle finding and needs to be closely examined. If this area is not properly addressed during the procedure, the defect may become more obvious after the augmentation since we have just made the buttock larger. The best way to address this problem, is to transfer a small amount of fat (about 30 cc), in order to fill this slight depression and give it a rounder appearance.
. Lower Buttock: This area typically has some excess fullness giving the buttock its droopy look. This fullness will be even more apparent immediately after the procedure since you are swollen. As the swelling begins to disappear the appearance improves, but the excess always remains. If this area is not addressed, it can give the appearance of dirty diapers or a droopy buttock. The key in improving this area is a careful examination to asses whether the problem is excess skin or fat. The treatment will be either liposuction or removal of the excess skin. In the vast majority of patients, the problem is usually some degree of excess fat. If this is the case, then conservative liposuction will improve the area. If the problem is excess skin, which is hardly ever the case, then it may require removal of the skin.
Now that we understand the areas that need to be evaluated, lets see what decisions need to be made.

The operation itself.
The operation requires that you be placed in the face down position. A 5-6 cm vertical incision is made in the well-hidden buttock center crease (sacrum). The dissection continues on either side of the sacrum until the buttock muscle is reached. At this point the muscle is incised and with careful dissection the implant pocket is created within the muscle. Surprisingly there is very little bleeding. The implants are inserted into the newly created pockets and the muscle is closed over the implants, the midline incision is then closed in layers. If liposuction is to be done, this is performed through separate incisions.

Your new look.
You will need to wear a garment for about 2-3 weeks. This will provide support and help with the skin re-draping especially if liposuction was performed. At first you will notice a definite difference in the gluteus contour, but since you are swollen the buttock will appear very full, and will have a boxy appearance. You may also notice the implants are quite high on the buttock. This is all normal; you must remember that you are swollen. It will take at least 3 months for all the swelling to subside and for the implants to settle into their normal position. You may experience occasional temperature changes, and numbness over the buttock area, this also will improve over the next three months. You may feel a little timed and scared when sitting down, but remember the implant is much higher on the buttock than were you sit, so don't worry.