The Bottom Line

02/04/2006 | Style: The Sunday Times

It’s not just size that counts, but shapeliness too. Helen Brown reports on plastic surgery and the quest for the perfectly peachy posterior

Which type of bum are you? Dr Constantino Mendieta, a plastic surgeon from Miami who has become an expert in bottom augmentation, recently defined four generic types. There’s the V shape (narrow at the bottom and wider towards the hips), the solid square shape, the round and, lastly, the A shape. And, just as the A list is the ultimate in celebrity, so the type-A bottom is the most lusted-after derrière. “The prettiest buttocks look like As, like upside-down hearts with a wider bottom than top,” says Mendieta.
Voluptuous beauties J.Lo, Dita Von Teese and Kelly Brook (who, if a recent study is to believed, has the butt that women in this country covet most) have prime examples of the type-A ass, and it is this full shape that has led hordes of women to the surgeon’s clinic. That’s not to mention the fact that this season’s 1940s Gucci fashions need a robust rump to cling to if they are to look their womanly best.

Some 2,300 Americans had buttock-augmentation surgery last year, and the procedure is gaining ground in the UK. “Women now recognise that a nicely shaped bottom is a covetable feature,” says the consultant plastic surgeon Dr Douglas Harrison, the UK’s leading authority on buttock surgery. He carries out about 20 such ops a year.

The type-A bum is best achieved through implants, according to Harrison. It’s a method he would apply to what he calls a sad bottom (one that is saggy and flat, perhaps as a result of dramatic weight loss or age), and for someone wanting to make a pert bottom bigger. “You simply make a small incision at the top of the gluteal cleft (that’s the vertical slit between your butt cheeks), then insert the pear-shaped implants,” he says.

“Surgery takes about an hour under general anaesthetic, and you are free to leave hospital the next day.” And, believe it or not, you will even be able to sit down, as the implants are inserted above the bony part we sit on.

Implants are preferable, he claims, to both liposuction and bottom lifts. Bottom lifts involve a crescent of fat and skin being removed, but there is significant scarring to consider, and inserting implants serves to tighten a saggy bottom equally well. Lipo, he claims, can hollow out the bottom too much. However, it can help if saddle-bag thighs are your biggest obstacle to a shapely behind. “If you have a fatty jodhpur area, lipo will get rid of the problem,” says Dr Douglas McGeorge, consultant plastic surgeon and president elect of the British Association of Aesthetic Plastic Surgeons. “It can also be used to reshape the folds beneath the bottom, which makes the thighs look longer.”

So, what’s the last word in bum surgery? Fat grafting is a method pioneered by the South Carolina-based plastic surgeon Dr Thomas L Roberts, who claims it is like sculpting with clay. This form of “art” involves putting on a hefty 15lb of fat (unless you are suitably overweight already), which is then removed from the stomach and thighs via liposuction and re-injected into the bottom. Then there’s the cost of the procedure — an exorbitant £11,500, presumably justified by the eight hours it takes to perform. Should you then acquire the bottom of your dreams, all’s well and good. But what if you are one of the unfortunate patients whose fat, after being re-injected, fails to pick up a blood supply and subsequently passes out of the body?

If you want to avoid getting a bum deal, make sure you do all the usual cosmetic-surgery research: find an accredited plastic surgeon who specialises in buttock surgery; ask to see photographs of his finished work, and to read past patient testimonials; and find out about the risks. Only when all your questions have been answered and you feel entirely confident should you even think about investing in a new behind.

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