A well-formed buttock attracts the attention of many men and women in most cultures. The curves are a symbol of good nutrition, health and fertility. The buttock area is one of the decisive regions for the beauty ideal of the so-called “hourglass figure” of the woman. The ideal body figure tapers down from the chest to the waist, reaches its maximum width at the hips and tapers further down the thighs (the so-called “hourglass figure”).

The tendency to accumulate fat around the buttocks can be hereditary. There are also clear racial differences. These fat pads are located

• At the dorsal waist area
• On the side (hip) area (“sprawling hips”)
• In the buttock fold area: Excess fat in the area of the gluteal fold causes this to disappear, which causes the appearance of a sagging buttocks. Although the rest of the bottom area is often very muscular and well-formed, this love handle is particularly noticeable when wearing tight clothing and tight pants. Many women therefore prefer to wear wide trousers or skirts
• Lateral thigh (“saddle bags”).

All these regions have a decisive influence on the appearance of the buttocks.

Women

• Smooth, firm skin without skin imperfections (e.g. cellulite) in the buttocks area
• Well-formed buttocks with slightly defined buttock muscles (M. glutaeus maximus)
• Typical female fat distribution (harmonic rounding with maximum convexity (C-point) in the hip area with and clear projection backwards
• Well visible and internally rising gluteal fold at the transition from buttocks (bottom) to rear thighs
• Clearly visible middle line (Rima ani)
• Harmonic retractions in the loin area (“lumbar dimples”)
  

Men

• Smooth, firm skin without skin imperfections (e.g. cellulite) in the buttocks area
• Well-formed buttocks with clearly defined buttock muscles (M. glutaeus maximus)
• thin layer of fat in the bottom area
• Well visible and internally rising gluteal fold at the transition from buttocks (bottom) to rear thighs
• Clearly visible middle line (Rima ani)
• Strongly developed lower part of the straight back muscles

The buttock, like the waist, is one of the areas that are particularly resistant to any diet or exercise. Even very well trained back muscles do not come into their own with a thickened subcutaneous fat layer. The muscle layer only becomes clearly visible through the overlying skin when the body fat percentage is < 12%. With the help of liposuction in the buttocks area, the muscle relief (M. glutaeus maximus) can be clearly worked out and made visible.

The buttocks are made up of a muscular base and a covering of skin and fat. A buttocks that is too small represents a great psychological burden for many women. Buttock augmentation is the cosmetic surgery for women with the highest growth rate (“Kim Kadashian effect”). In slim people, the layer of fat is very thin and the buttocks can appear too small. With the autologous fat injection/lipofilling for buttock enlargement “Brazilian But Lift”, the buttocks volume can be increased almost arbitrarily. In the case of very slim patients, buttock augmentation with implants is the only treatment option, as there is no fat available for autologous fat transpalntation. The buttocks also appear too small if there is not enough muscle. Consistent butt muscle training is required here. With well-trained muscles, the butt looks firm and youthful. In the case of congenital or acquired muscle deficits, volume correction using autologous fat and/or silicone implants is indicated. Corrections of congenital and acquired (especially after intramuscular injections) differences in size and/or shape of both buttocks can be reliably carried out using autologous fat injections/ lipofilling to correct congenital and acquired buttock asymmetries.

There are also areas on the buttocks that prefer to store fat. Like the lower stomach area, the buttocks area is one of those areas that are particularly resistant to any diet or physical activity. The tendency to accumulate fat in the buttocks area can be hereditary. There are also clear racial differences. These fat pads are located on the side (hip) area (“sprawling hips”) and in the buttock fold area. Excess fat on the outside of the thighs (so-called “bulging hips”) makes the bottom look wide and leads to a. plumping of the figure. Excess fat in the area of the buttocks folds out, which causes the appearance of a sagging buttocks. Although the rest of the bottom area is often very muscular and well-formed, this love handle is particularly noticeable when wearing tight clothing and tight pants. Many women therefore prefer to wear wide trousers or skirts. With liposuction in the buttocks (buttocks) area, fat can be permanently sucked out of the fat layer directly under the skin. When the skin is sufficiently elastic, the overlying skin shrinks and the shape changes, which restores a defined appearance and thus improves the buttocks profile overall. The result of the treatment leads to a significant narrowing and beautification of the bottom silhouette. A well-formed and firm bottom gives a younger appearance. After liposuction, patients who used to feel ashamed and hid their figure under their clothes feel noticeably better and dare to show themselves in public with tight-fitting clothes again. Of course, the clothes also fit better again.

Especially with weight gain and in the course of aging, fat can be stored in certain places in the buttocks and leg area, since these areas are particularly resistant to any diet or physical activity. These fat pads are on the buttocks in the lateral (hip) area (“sprawling hips”) and in the area of the buttock fold. Excess fat in the area of the buttock crease causes this to disappear, which causes the appearance of a sagging buttocks. Although the rest of the bottom area is often very muscular and well-formed, this love handle is particularly noticeable when wearing tight clothing and tight pants. Many women therefore prefer to wear wide trousers or skirts. With liposuction in the buttocks (buttocks) area, fat can be permanently sucked out of the fat layer directly under the skin. When the skin is sufficiently elastic, the overlying skin shrinks and the shape changes, which restores a defined appearance and thus improves the buttocks profile overall. The result of the treatment leads to a significant narrowing and beautification of the bottom silhouette. A well-formed and firm bottom gives a younger appearance. After liposuction, patients who used to feel ashamed and hid their figure under their clothes feel noticeably better and dare to show themselves in public with tight-fitting clothes again. Of course, the clothes also fit better again.

Whether we find a bottom attractive or not depends on its proportions (basic harmony) but also on its small asymmetries. However, the mathematically precisely calculated bottom proportions only represent a certain basic harmony. A more precise analysis of the two bottom halves shows that the right and left bottom cheeks are not completely symmetrical. Small differences between the two butt cheeks make the butt appear much more expressive and interesting. Larger differences, on the other hand, disturb the basic harmony and make the bottom appear less attractive. There are several treatment options for correcting the different sized buttocks, which are used depending on the extent of the asymmetry and the wishes of the patient. Autologous fat injection / lipofilling to correct congenital and acquired buttock asymmetries is the therapy of choice today. Alternatively, buttock enlargement with a silicone implant, buttock tightening on the smaller side or equalizing liposuction / liposuction in the Buttocks can be performed on the larger side.

Operations can lead to changes in the shape of the buttocks. Silicone poimplants can lead to the formation of what is known as capsular fibrosis. There are several treatment options for the therapy of capsular fibrosis: After removal of the capsular fibrosis, the buttocks shape can be restored by changing implants for capsular fibrosis or autologous fat injection/lipofilling to restore the buttocks shape with autologous tissue without additional major scarring after removal of a buttock implant.

After massive weight loss, there is a significant excess of inelastic skin in the stomach and back area and often also in the adjacent areas of the chest, the pubic mound and the buttocks (bottom). Excess skin in the abdominal and back areas appears on the front of the abdomen (“hanging abdomen or fat apron), pubic area (2nd fold or fat apron), the lateral abdominal wall (lateral skin sacs) and the back (posterior skin sacs). Many patients feel severely restricted as a result and even perceive this as an impairment of their quality of life, they no longer want to wear tight-fitting T-shirts or shirts. The sagging abdomen or the fat apron can be reliably corrected by the fat apron resection, as well as the lateral skin sacs with the help of body shape restoration in the lateral abdominal area and the rear skin sacs with the help of body shape restoration in the lower back area. Excess skin in the area of the pubic mound can be reliably removed with the help of restoring the body shape in the area of the pubic mound. All four deformities can be reliably corrected in one operation with the help of restoring the body shape in the lower body area (“lower body lift”). Patients can be restored to a normal body shape.

In the area of the lower extremities, lipoedema leads to significant disproportionate thickening of the buttocks, thighs and) or lower legs, with the exception of the feet. Decompression through liposuction in the case of lipedema in the buttocks area, decompression through liposuction in the case of lipedema in the thigh area and decompression through liposuction in the case of lipedema in the lower leg area (usually in several operations) have proven effective for efficient and sustained pressure relief (decompression) and, above all, to reduce symptoms. Since a lifelong increase in fatty tissue is to be expected in lipoedema, an operation should be sought at an early stage as soon as the first typical symptoms appear. In many patients, liposuction relieves the symptoms, often over a period of years, or they disappear completely. In any case, an increase in the quality of life, a reduction in the compression class of the compression clothing and a reduction in the frequency of manual lymphatic drainage can be expected. In addition, an operation as early as possible can prevent the development of dangerous secondary diseases.

Tissue aging causes characteristic age changes in the buttocks area: age-related loss of volume and/or tension in the buttock muscles, increase in buttock fatty tissue, coupled with a loss of elasticity in the skin, and changes in volume and shape of the bones ( Reduction in body size (reduction in the height of the intervertebral discs in the spinal column area) allow the soft tissue to become larger than the contents.

Empty and/or sagging buttocks often disturb a positive body image. The choice of corrective procedure depends on the extent and localization of the sagging buttocks skin (ptosis), the quality of the soft skin layer and the wishes of the patient. The autologous fat injection/lipofilling to correct an incipient loss of volume in the buttocks area is the therapy of choice. Alternatively, the missing buttocks volume can be achieved by buttock augmentation with implants. In the case of advanced ptosis, the buttocks need to be reshaped by a buttock lift.