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Topic:
Aesthetic Surgery of the Buttocks: What do our patients want?
Natacha Kadlub, MD1, Jerry W. Chang, MD2, Joshua Y. Jacobson3, Grant Thomson, MD2, John A. Persing, MD2, Joseph H. Shin, MD, FACS4.
1University Hospital of Burgundy, Department of Plastic and Maxillofacial Surgery, Dijon, France, 2Yale School of Medicine, Section of Plastic and Reconstructive Surgery, New Haven, CT, USA, 3Albert Einstein College of Medicine, Bronx, NY, USA, 4Montefiore Medical Center, Division of Plastic and Reconstructive Surgery, Bronx, NY, USA.

BACKGROUND:
Aesthetic surgery of the buttocks has become more popular in recent years. The plastic surgeon usually attempts to determine the ideal shape for his patient based on anatomical and cultural knowledge. To date, there have been few articles describing patients’ preferences in buttock aesthetic surgery. The goal of this study is to evaluate our patients’ preferences in buttock aesthetic surgery in relation to ethnic background, age, educational level and level of familiarity with plastic surgery. Another goal is to determine if their preferences differ from plastic surgeons’ preferences.
METHODS:
Four shapes in frontal view were defined: round, square, A, and V shape (Figure 1). Three shapes in profile view were defined: low, medium and high antero-posterior projection (Figure 2). According to these shapes, we simulated 7 black and white tracings (Figure 3) and 7 buttock shape pictures (Figure 4). We conducted a bicentric study in Yale New Haven hospital, US and in the University Hospital of Dijon, France. Patients seeking buttock reshaping and plastic surgeons at both centers were included. The survey collected epidemiological data and evaluation of the different buttock shapes. A statistical analysis compared patients’ and surgeons’ preferences, and then if patients’ preferences were influenced by level of education, age, level of knowledge in plastic surgery and ethnic background.
RESULTS:
Patients and surgeons tended to prefer round buttocks with a mean anteroposterior projection. While surgeons’ evaluations were quite stereotypic, patients’ evaluations varied significantly amongst each other. We found that such a variation amongst patients can be attributed to a few factors, especially ethnic background. Our results highlight drastic differences between the different ethnic sub-cohorts, particularly between Caucasian (North American and European), Hispanic and African-American. Caucasians preferred less fullness laterally and anteroposteriorly, while African-Americans and Hispanics preferred more fullness laterally and anteroposteriorly. However, age, level of education and level of knowledge of plastic surgery did not influence patients’ preferences.
CONCLUSIONS:
This study suggested that plastic surgeons and patients seeking buttock reshaping may have different images in mind regarding what constitutes an attractive, natural, and ideal buttocks shape. It also suggested that patients’ preferences are influenced heavily by ethnic background. These findings have potential implications for patient treatment and satisfaction.


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