LM1 23 Beautifying the buttocks with hyaluronic acid. Jean Pierre AMSELLEM, MD - N°1 French journal for research in aesthetic health

Another look at taboo subjects

BEAUTIFYING THE BUTTOCKS
WITH HYALURONIC ACID

THE DIFFERENT TYPES OF BUTTOCKS

AESTHETIC ANALYSIS OF THE GLUTEAL REGION

GLUTEAL PROJECTION

THE GOLDEN NUMBER

IDEAL BUTTOCKS

GLUTEAL PTOSIS: 5 DEGREES OF SEVERITY

CLINICAL: DIFFERENT METHODS

BBL : Brazilian Butt Lift, liposuction and lipofilling.
gluteal implants.
gluteal liposuction alone.
gluteal lift.

tensor threads.
fillers: hyaluronic acid.

under local anesthesia.
predictable results.
easy to add immediately if the patient is not satisfied.
possibility of correcting certain errors or complications with hyaluronidase.
natural result.
possibility of treating several zones in the same session.
promotes hydration, resulting in plump, moisturized skin.

non-permanent.
high price depending on the number of syringes injected.
rare allergic reactions.

PROCEDURE

The procedure lasts between 30 and 40 minutes
7 days before the operation; stop taking blood-thinning drugs, anti-platelet agents (aspirin)
stop anticoagulants the day before and resume them the day after the operation (with the agreement of the cardiologist).
Start by marking the areas to be treated and in an upright position; avoid using felt pens which may cause hyperpigmentation at the penetration points. Use potassium permanganate in saturated solution instead.
Pure local anesthesia combining lidocaine, adrenaline, bicarbonates in NACL at 0.9%. It is better not to inject too much volume of anesthetic so as not to modify the volumes too much and also to avoid diluting the injected hyaluronic acid.
Injections are not expected to be a problem when HA is injected by a trained practitioner and in reasonable amounts.
Do not exceed 10 x 10 cc syringes per side.
18G cannulas will be used for HA injection.

INDICATIONS

gluteal hypoplasia.
disproportionate buttocks.
gluteal lipodystrophies.

accidents.
post-tumor reactions.
animal bites.
abscesses or post-injection hematomas.

age, sun damage, massive weight loss.
obesity, menopause and skeletal deformities.
Prolonged bed rest after chronic diseases.

after surgery of the trochanter or gluteal region.
after liposuction.
depressions after corticosteroid injections

COMPLICATIONS

hematomas.
Tyndall effect.
nodules.
granulomas.
infections.
abscesses.
scars.
necrosis by vascular occlusion.

CONTRAINDICATIONS

severe lipo-atrophy.
Insufficient covering tissue.
significant ptosis of the lower 1/3 of the buttock.
severe skin laxity.
obesity.

ANATOMY

RESULTS: CLINICAL CASES

CONCLUSION

BIBLIOGRAPHY

Another look at taboo subjects

BEAUTIFYING THE BUTTOCKS WITH HYALURONIC ACID

Jean-Pierre AMSELLEM, MD

INTRODUCTION

Nowadays, having a toned and lifted buttocks is a sign of beauty, youth and sensuality.

In addition, despite a healthy and balanced lifestyle, some patients do not achieve the desired results, often due to genetic factors.

Therefore, one of the solutions is to resort to surgical or non-surgical body procedures in order to obtain the desired buttocks.

If we compare the evolution of the shape of the buttocks between the nineteenth and twentieth centuries, we see a clear preference for generous buttocks.

THE DIFFERENT TYPES OF BUTTOCKS

Just like other parts of the body, the shape of the buttocks varies from one person to another, but also from one ethnic group to another.

There are five types of buttocks:

-squares Hips: are devoid of curves and a certain harmony on the edges, with very marked and short hips. The pelvis is less generous on long and straight buttocks muscles, which gives a square shape from one end to the other of the buttocks.

–heart-shaped or pear shape. Considered the most voluptuous shape. The harmonious symmetry ranks it among the wide buttocks, projecting less to the rear but compensating for its assets with wide hips. It is part of the "canon" type of buttocks.

-in the shape of an A Hips: are rather masculine, with little or no marked hips. Athletic type buttocks, slightly round or small.

V-shaped Buttocks: considered the least attractive, causing discomfort and complexes. These are flat and slouchy buttocks giving them an unattractive shape.

We can already specify that the most beautiful and convincing results are obtained with the square buttocks.

The shape of the buttocks must also be taken into account according to ethnicity. (SLIDE 4)

-Asian buttocks.

-African buttocks.

-Caucasian buttocks.

-European buttocks.

AESTHETIC ANALYSIS OF THE GLUTEAL REGION

Four important points to define:

-the lateral depression; probably the most important one to correct. (1)

-the posterior fossa; also called supra gluteal fossa (2)

the sacral triangle: V-shaped, at the upper part of the gluteal fork. (3)

-the infra gluteal fold (4)

GLUTEAL PROJECTION

Is defined according to several criteria;

A - the greater trochanter

B - the maximum projection of the mount of Venus.

C -the maximum gluteal projection

D - anterosuperior iliac spine

The ideal projection is 2-1: ratio between AB and AC such that AC = 2 AB

The ideal projection is 0.7.

THE GOLDEN NUMBER

The beauty of the buttocks is also defined by the golden ratio, which is an irrational number:

1 + V5

———– = 1,6180339887498948482

2

This golden number is also called PHI (PHIDIAS) sculptor and architect 430 BC.

The ideal shape of the buttocks is the shape of an egg, because the egg contains this golden number.

Let A be the width of an egg and B the length; B/A = 1.618

Thus we can make an analogy between the egg and the hips of a woman, and to obtain perfection, it is necessary to obtain this famous ratio guaranteeing a divine beauty.

Most women have a lateral gluteal depression that can be compared to the shape of a guitar, and correcting this depression will transform the shape of the guitar into the shape of an egg and thus achieve that golden number.

IDEAL BUTTOCKS

GLUTEAL PTOSIS: 5 DEGREES OF SEVERITY

Buttock augmentation is a body contouring procedure that gives the buttocks more volume and contour.

There are several options available to us:

-surgical methods:

BBL : Brazilian Butt Lift, liposuction and lipofilling.

gluteal implants.

gluteal liposuction alone.

gluteal lift.

-non-surgical methods:

tensor threads.

fillers: hyaluronic acid.

Very popular method, giving very good results in expert hands, giving very little pain, few complications, with a very short social eviction.

HA use increased by 15.7% from 2018 to 2019, with more than 4.3 million procedures performed worldwide, making it the second most common noninvasive procedure after botulinum toxin.

Benefits of hyaluronic acid:

under local anesthesia.

predictable results.

easy to add immediately if the patient is not satisfied.

possibility of correcting certain errors or complications with hyaluronidase.

natural result.

possibility of treating several zones in the same session.

promotes hydration, resulting in plump, moisturized skin.

Disadvantages of hyaluronic acid

non-permanent.

high price depending on the number of syringes injected.

rare allergic reactions.

Injections do not necessarily have to be performed in the operating room, but in all cases they must be performed under rigorous aseptic conditions, sterile fields, sterile gloves, disinfection with dermal betadine, and shower with betadine scrub the day before and the day before the procedure.

The procedure lasts between 30 and 40 minutes

7 days before the operation; stop taking blood-thinning drugs, anti-platelet agents (aspirin)

stop anticoagulants the day before and resume them the day after the operation (with the agreement of the cardiologist).

Start by marking the areas to be treated and in an upright position; avoid using felt pens which may cause hyperpigmentation at the penetration points. Use potassium permanganate in saturated solution instead.

Pure local anesthesia combining lidocaine, adrenaline, bicarbonates in NACL at 0.9%. It is better not to inject too much volume of anesthetic so as not to modify the volumes too much and also to avoid diluting the injected hyaluronic acid.

Injections are not expected to be a problem when HA is injected by a trained practitioner and in reasonable amounts.

Do not exceed 10 x 10 cc syringes per side.

18G cannulas will be used for HA injection.

BEAUTIFYING THE BUTTOCKS
WITH HYALURONIC ACID

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**[2] Oranges CM, Tremp M, di Summa PG, Haug M, Kalbermatten DF, Harder Y, et al. Gluteal Augmentation Techniques: A Comprehensive Literature Review. Aesthet Surg J 2017; 37(5): 560-569.**

**[3] Campos L, Humzah D. Buttock augmentation with hyaluronic acid fillers. The PMF A Journal 2021 ; 8(2).**

**[4] Abulezz T. A Review of Recent Advances in Aesthetic Gluteoplasty and Buttock Contouring. Plast Surg Mod Tech 2019; 6(1): 1-10.**

**[7] Trignano E, Baccari M, Pili N, Serra PL, Rubino C. Complications after breast augmentation with hyaluronic acid: a case report. Acorn Surg 2020; 9(6): 2193-2197.**

**[8] Heden P. Update on Body Shaping and Volume Restoration: The Role of Hyaluronic Acid. Aesthetic Plast Surg 2020; 44(4) : 1295-1299.**

**[9] Ono S, Hyakusoku H. Complications after self-injection of hyaluronic acid and phosphatidylcholine for aesthetic purposes. Aesthet Surg J 2010; 30(3): 442-445.**