- by E. Nriezedi
- 10:43 AM January 23, 2022
A plastic and reconstructive surgeon, Dr Uzoma Gbulie, tells ALEXANDER OKERE about the intricacies of breast, butt and penis enlargement and the issues surrounding the procedures
Can you explain what breast and butt enlargements mean?
These refer to any procedures done to increase the size of the breasts and buttocks, typically in women. Such procedures typically are part of techniques used to enhance the appearance of the breasts and buttocks.
Is it the same as augmentation?
Yes. Augmentation means enlargement and, therefore, the terms are interchangeable.
It is said that there are social reasons why women opt for breast and butt enlargement. What are the major reasons?
The ideal reason for a woman to seek breast or buttock enhancement is for their benefit and self-image improvement. In practice, however, in many cases, the desire for these procedures is driven by pressure from their partners, their peers, and indeed society. Social pressure comes from the trends of the times. With celebrities like Kim Kardashian, curves are now more than ever in vogue which encourages women to enlarge their breasts and buttocks to get more curves. And this is a worldwide phenomenon.
Are there medical reasons that require a woman to undergo the two procedures?
Breast and buttock enlargements are typically sought out for cosmetic and not medical reasons. In the case of patients treated by mastectomy (breast removal) for cancer, they may undergo breast reconstruction with implants, but this would not be described as breast augmentation. So, cases in which a woman would like her breasts or buttocks enhanced are not typically regarded as medically necessary as the procedures are not addressing any physical illness.
Generally, what should a patient consider before deciding to go for breast and butt enlargement?
The patient should have realistic goals and expectations which need to be candidly discussed with the surgeon. Once the intention to pursue surgery is reached, it is important to always first consider safety. To that end, patient factors are important, so controlling one’s weight and medical co-morbidities (diabetes, hypertension, thyroid problems, etc) is very important to avoid complications. The avoidance of tobacco and nicotine is very important as this has negative effects on wound healing. And the choice of surgeon and facility is very important as it is advisable to choose a qualified and board-certified surgeon and an accredited facility to undergo these procedures.
Is age a factor to consider?
Yes. Medical history is important for the reasons stated above. Old age, by itself, is not a disqualifying factor for undergoing breast or buttock augmentation or indeed any other cosmetic procedures. An older yet healthy patient is as good a candidate for aesthetic augmentation procedures of the breasts and buttocks as anyone else. However, per the United States Food and Drug Administration guidelines, the minimum age for a patient to undergo breast augmentation is 18 years for saline implants and 22 years for silicone implants.
It has been over five decades since the first documented breast enlargement was done in Texas, United States. Do you think it is gaining traction in Nigeria?
Yes. Plastic surgery in general, and breast enhancement in particular, are gaining traction all over the world, including Nigeria. There is less stigma associated with cosmetic procedures in general and Nigerians are having these procedures performed more frequently both at home and abroad.
Would you say the same for butt enlargement?
Buttock enlargement is also gaining traction especially in the last few years, but likely not as much as breast augmentation, as breast augmentation has been around for longer.
Many Nigerians consider breast and butt enlargements expensive. How costly are these procedures?
Plastic surgery is not inexpensive and is an investment that should not be undertaken on the cheap.
Why is that so?
The cost in the US for breast augmentation ranges from $6,000 to $8,000, while Brazilian butt lifts range from $8,000 to $12,000. The cost is about the same or occasionally more expensive in Nigeria. The relatively high cost is driven by the expertise required for the surgeon and staff, cost of the facilities, and implants, to name a few factors. Most people prefer to have their surgery at home in Nigeria. But with the world being a global village, we do have many patients who fly into the US to have surgery.
What are the most common sizes that women opt for in breast enlargement?
There is no common breast size. Rather most women would like to be one to two cup sizes larger than they are, with the goal being to have fuller and more voluptuous breasts. The final bra cup size is a function of the original size, the chest width, and how expandable the breast is to accommodate an implant. Hence, women that have had children and experienced deflation of the breasts are likely more able to tolerate larger implants and may go for bigger final bra cup sizes.
Is size also applicable to butt enlargement?
There are no applicable buttock sizes as there are breast cup sizes. The goal remains to achieve a bigger and shapelier backside.
Perhaps, to cut costs, some women opt for breast enlargement creams, oils, pills, and machines. Are these methods effective?
No, they do not work.
What are the risks involved?
The risks of such treatments would depend on what materials the remedies contain but topical creams may cause skin irritations and rashes, and even burns; while pills may cause different physiologic problems.
Can you please explain the risks or side effects of breast enlargement?
Breast enlargement risks include bleeding, infection, asymmetry of the breasts, abnormal breast position, loss of nipple sensation, and capsular contracture (breast hardening). Infections from breast enlargement are typically bacterial infections from skin contamination. The patients may present with pain, swelling, and redness of the breast and may also develop draining wounds. These require urgent treatment with antibiotics, and, sometimes, surgery.
Capsular contracture is breast hardening which may occur from scar tissue formation within the breast. It is best avoided by good surgical technique and placement of the implants under the chest muscle.
Does breast enlargement affect breastfeeding?
Breast enlargement typically does not affect breastfeeding which may be a concern for a younger patient.
Are there certain things a woman scheduled to undergo breast enlargement should avoid weeks or days to the procedure?
It is important to avoid blood thinners and medications that may delay blood clotting, such as herbal medications.
How risky is butt augmentation?
Buttock augmentation, when properly done, is no more dangerous than any other cosmetic procedure. However, there are risks of bleeding, infection, fat necrosis (liquefaction), and even blood clots that can be fatal.
Are there different types of this procedure?
Buttock enlargement is achievable either by fat transfer (Brazilian Butt Lift– BBL) or by the use of implants. BBL (fat transfer) is typically performed by liposuction of the abdomen and waist to thin out these areas, processing of the fat, and injection of the fat into the buttocks and hips to achieve a curvier, more voluptuous shape. Buttock implant surgery is performed through an incision in the cleft between the buttocks and the placement of the implants underneath the gluteal muscle to achieve augmentation. BBL is prone to decreasing buttock size with time as some of the fat is broken down, while implants are more reliable in terms of achieving a larger buttock size.
What are the things to do or avoid in the post-surgery period for breast and butt enlargements?
Excessive activity should be avoided in the first few days after surgery for both breast and buttock enlargement, though ambulation (walking) is encouraged to minimise the risk of blood clots. In the case of buttock augmentation, sitting is to be avoided without an offloading cushion to avoid compromising the fat cells which were transferred for the enlargement. This restriction in sitting is usually lifted after about three to four weeks.
There have been reports about butt enlargements resulting in serious infection and death. What could be responsible for that?
Infections are typically from contamination at the time of surgery – the buttocks are not a clean area to start with, so improper sterile technique would predispose the patient to infections. This is a more serious potential problem with buttock implant surgery than with fat transfer. Also, injection of fat deep into the gluteus maximus (the largest and heaviest muscle in the body) during a BBL can cause an embolism (blockage of the artery) which may be fatal. Proper technique of fat injection is, therefore, extremely important to avoid this serious potential complication.
There are also concerns about quacks posing as cosmetic and plastic surgeons. Is this something Nigerians should be wary of?
Yes! Unfortunately, there are many unqualified ‘surgeons’ practising in Nigeria. They may have learned how to do the surgery but do not have the exposure or experience to safely handle problems. There are many cases of botched plastic surgery, especially in Nigeria but also even in the US because patients mainly focus on the procedures they want to get and not on the training and expertise of the surgeon and facility. There have been a few deaths in Nigeria from plastic surgery which are avoidable. So, patients should do their homework.
Are there foolproof ways of identifying fake cosmetic surgeons?
Not in this day and age of social media. People should be wary of all they see online and on Instagram. Prospective patients are advised to do their homework to find out where the surgeon trained, how many years of experience they have, and if they have had any problems or complications. They should also research the facilities where the surgery is planned to be performed to find out what experience they (surgeons) have with such surgeries and handling any potential complications.
Is penis enlargement real or is it a myth?
Penis enlargement is not as common but is achievable using filler injection which may last up to one year. There are also techniques of penile implantation not necessarily to increase penile size but rather to help achievement and maintenance of erections.
Why do some men think they need to increase the size of their penis?
Penile size is regarded as a sign of virility and indeed manhood, hence the focus on attempts to increase the size.
How long should a man abstain from sexual intercourse after penile enlargement?
Depending on the technique used (filler injection or implant), about two to three weeks should suffice for as long as no problems arose from the procedure.
What exactly are the risks involved?
Risks of penile enlargement include bleeding, infection, wound healing problems, and damage to the urethra (the tube that drains the bladder through the penis). That is why it is very important to have this procedure performed by a seasoned plastic surgeon or urologist.