Is it possible to enlarge or shape the hip?

One of the biggest differences in body contour between man and woman is the shape of the hip. The female hip is rounded and together with the breasts gives the famous guitar shape to the female silhouette.

This shape is mainly due to fat distribution, since the muscle and bone parts are very similar to both sexes. This is very evident when we compare a man and a marathon woman. If we see them running backwards it is difficult to be sure if it is a man or woman, because the fat rate is so low that the hips of both are practically straight, matching the bodies.

Thus, when we think of shaping the hip, feminine we think mainly of giving volume to them and accentuating their curves, both at the back, the gluteus, and at the sides.

Option 1: Liposculpture

The gluteus volume can be increased in several ways. The most used among them is fat grafting. In liposculpture, fat usually removed from the abdomen or flanks is grafted onto the buttock. It is well indicated for patients who have fat in the waist, because when lipo in this region, the gluteus becomes more exposed. After grafting the fat, it is even more evident.

Being a material of the body itself, fat is very well accepted by the body, being very safe its use. Its disadvantage is that fat is absorbed almost 50%, remaining only half in the long run. Because soft fat, while bulging, does not greatly increase the consistency of the buttocks and projects them less than a prosthesis. It can also be used to fill the sides of the hip.

Option 2: Fill with PMMA or Hydrogel

There are other gluteal and hip filling materials, including polymethyl methacrylate (PMMA) and polyamide hydrogel (Aqualift). Both can be applied with local anesthesia or sedation, and return to activities in a few days.

Disclosed as a bioplasty, the use of PMMA is a definite filling option. They are acrylic particles diluted in a gel. Once the gel is absorbed, some volume is lost, but the acrylic remains forever. Although very compatible, being a foreign body, there may be reactions to its use, such as allergy, nodulation, etc. The disadvantage is that it is not possible to remove the material because it is diffusely infiltrated into muscle and fat tissue. As a gel, although it gives volume, it does not greatly increase the consistency of the buttocks.

Polyamide hydrogel (Aqualift) begins to be absorbed after 6 years. It is quite tolerated by the body and in case of any reaction is absorbed over time. With every gel, it increases volume, but the consistency is less than that of a prosthesis.

Option 3: Buttock prosthesis

But the gluteus prosthesis is undoubtedly the option that provides greater projection and consistency to the gluteus. However, it is an uncomfortable postoperative surgery, requiring a month to recover. The risk of the procedure is higher compared to PMMA and Aqualift fills, but can be removed immediately in case of complication.

The prosthesis should be changed, probably after 20 years. By being placed inside the muscle, it projects the back, not the hip at the sides. If necessary, a fat, PMMA or Aqualift fill can be used in this region as a supplement.

Like everything in plastic surgery, each technique has its advantages and disadvantages, as well as its indication. What may be good for one patient may not be good for another. This depends on the biotype, gluteus type, musculature, hip fat distribution, presence or absence of sagging, patient's expectation for projection and hip augmentation.

Thus, only in consultation with the plastic surgeon can the best technique be chosen, taking into account the patient's wishes, indications and risks of each technique.

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