March 2, 2015 - Two of the fastest-growing plastic surgery procedures are gluteoplasty or "butt augmentation," to improve the appearance of the buttocks; and labiaplasty to address cosmetic and functional concerns with the vagina. New insights into the use and outcomes of these procedures are presented in the March issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Muscle Atrophy after Buttock Augmentation Using Implants
Fernando Serra, MD, and colleagues of Pedro Ernesto University Hospital, Rio de Janeiro, Brazil, evaluated changes in the gluteus muscle in women undergoing placement of silicone implants to improve the shape of the buttocks. This and other approaches to buttock augmentation surgery have become increasingly popular in recent years.
Comparing preoperative and follow-up CT scans, the researchers found significant muscle atrophy after implant placement. The volume of the gluteus muscle was reduced by about six percent, although there was no associated change in muscle strength. Atrophy may be at least partly related to "intrinsic compression" of the muscle by the implants. There was evidence that the women started to regain muscle volume after three months--possibly reflecting return to exercise and other activities after recovery from the implant procedure.
Meanwhile, gluteoplasty led to improved body shape, with a curvier, more "gynoid" (female) contour. At follow-up, the women were closer to the "ideal" waist-hip ratio of 0.70.
Thus implant gluteal augmentation meets the goal of providing a more shapely figure, with relatively minor, potentially reversible muscle atrophy, the researchers suggest. "This group plans on continuing their researching into the gluteal augmentation's effects on nerve sensation, quality of life, sexual function, and patient satisfaction," comments Rod J. Rohrich, MD, Editor-in-Chief, in this month's introductory video on the Plastic and Reconstructive Surgery website.
Wide Variation in Labiaplasty Techniques Call for Standard Classification Systems
In the second study, ASPS Member Surgeon Ashit Patel, MB, ChB, of Albany (N.Y.) Medical Center and colleagues analyzed research on the outcomes of vaginal labiaplasty. A review of 19 articles identified nearly 1,950 women undergoing labiaplasty for aesthetic and/or functional reasons.
The analysis showed wide variation in surgical management--the plastic surgeons in the studies used a total of seven different labiaplasty techniques. However, results were good, with patient satisfaction rates ranging from 94 to 100 percent, and acceptably low complication rates.
Yet it's hard to draw conclusions about patient outcomes because of the wide variation in labiaplasty techniques--not just in the type of surgery, but also in anesthesia, wound closure, and postoperative care. Dr. Patel and coauthors propose a simple classification technique to aid in comparing the results of future clinical trials. They believe that this could be a useful first step toward matching patients to the surgical technique that's most appropriate for them.
Vaginal labiaplasty, like gluteal augmentation, is a technique that more women are interested in and discussing with plastic surgeons. In his video commentary, Dr. Rohrich adds, "As this procedure continues to rise in popularity, plastic surgeons are hard at work to make sure the procedure is safe and effective and that the patient experience is the best it can be."
Article: "Volumetric and Functional Evaluation of the Gluteus Maximus Muscle after Augmentation Gluteoplasty Using Silicone Implants" (doi: 10.1097/PRS.0000000000000970)
Article: "Vaginal Labiaplasty: Current Practices and a Simplified Classification System for Labial Protrusion" (doi: 10.1097/PRS.0000000000001000)
About Plastic and Reconstructive Surgery
For more than 60 years, Plastic and Reconstructive Surgery® (http://journals.
The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at http://www.
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