In this article, we explore the different alternatives people have for improving the projection, contour and firmness of their gluteal area. We also explain which dermal fillers are currently available in the American market and are being used off-label for the buttocks, what has recently been called non-surgical Brazilian butt lift. Finally, we discuss what we consider to be the best option for a person to obtain the best and long-lasting results.
What exactly are dermal fillers?
Dermal fillers are gel-like substances that are injected into different planes of the skin, depending on the application (face, neck, cleavage, hands, buttocks & hips). Their purpose is to restore lost volume in face and body tissues, improve expression lines and wrinkles and lift sagging tissues.
Properly used dermal fillers have the potential to give the skin a youthful and fresh look, accentuate facial features such as cheekbones and jawline, volumize buttocks and lips, create contour to the hips, rejuvenate hands and even correct aesthetic nasal deformities.
What dermal fillers are currently available in the United States?
Hyaluronic Acid-based Dermal Fillers
Hyaluronic acid (HA) is a low-viscosity gel-like substance that occurs naturally in the body and helps keep our skin looking plump, hydrated and youthful. Most hyaluronic acid fillers last 6 to 12 months before disappearing due to the resorption process. Within this category we encounter the following fillers available in USA:
- Juvéderm® with all its different variants such as Juvéderm XC, Ultra, Ultra Plus, Vollure, Volbella and Voluma.
- Restylane® and all its versions such as Restylane Silk, Restylane Lyft, Restylane Refyne, Restylane Defyne, Restylane Kysse, Restylane Contour.
- Belotero Balance®, slightly thicker specifically manufactured to improve the appearance of moderate to severe nasolabial folds.
- Revanesse Versa®
- Revance‘s RHA® collection of fillers in RHA 2, 3 and 4 versions.
We digress here to mention that in some European countries a so-called “highly cross-linked” hyaluronic acid is marketed (Macrolane®), supposedly thicker and longer lasting than conventional hyaluronic acid-based fillers suitable for application in the buttocks, but no data is available on its real effectiveness due to lack of studies in large patient cohorts.
Calcium hydroxyapatite based fillers
Calcium hydroxyapatite is a mineral found naturally in our bones. This filler is thicker than hyaluronic acid fillers and typically lasts between 8 and 12 months. Radiesse® is currently the only calcium hydroxyapatite filler available in the US. It is made of tiny calcium hydroxyapatite microspheres suspended in a gel to provide structural support to the skin and underlying tissues. Its main use is to correct deeper lines and wrinkles associated with facial aging and also in hand rejuvenation.
Poly(L)lactic acid fillers
Poly(L)lactic acid (PLLA) (not to be confused with polylactic acid or PLA) is a synthetic filler that instead of passively settling under the skin like other fillers, stimulates the body to produce its own collagen. Sculptra® is the only FDA-approved PLLA filler. It was originally developed to treat severe fat loss in the face. It is commonly used to reverse advanced volume loss in the face and lately off-label for buttock augmentation.
Polymethylmethacrylate fillers (PMMA)
Polymethylmethacrylate (PMMA) is a synthetic, biocompatible substance that has been used for decades in reconstructive surgery, medical devices, intraocular lenses and many other products. As a filler, polymethylmethacrylate is composed of microspheres of this material, perfectly uniform and smooth spherical microspheres suspended in a gel that serves as a transport vehicle for the microspheres. In the United States, doctors recommend it when a more permanent solution for facial wrinkles is desired, as the results can last indefinitely.
Bellafill® (formerly known as Artefill) is the only FDA-approved polymethylmethacrylate filler. It combines polymethylmethacrylate with bovine collagen. The PMMA microspheres stimulate special cells in the hypodermis called fibroblasts to produce new collagen, elastin and fibrin fibers, encapsulating the microspheres and making them part of the patient’s own tissue; This way they provide continuous and permanent support to the tissues as well as volume and firmness. Bellafill is typically used to smooth wrinkles and deep folds, as well as to treat scars.
This is a delicate and controversial subject that should be approached in a serious and unbiased manner.
Silicone has always been a highly questionable substance that in the past was widely used, especially in the world of transsexuals, to simulate a feminine appearance. It was used in buttocks but also in any other part of the body, such as the face and breasts. However, by the end of the 80’s, it became clear that its effects on the human body were pernicious and its use was openly discouraged by the medical community.
However, even today there are health professionals who inject silicone in the buttocks, saying that they use only medical grade silicone; even though there is FDA approved liquid silicone on the market (Silikon 1000), this product is exclusively for ophthalmologic purposes and is used in surgeries to repair certain types of retinal detachment; therefore, its use in the buttocks is off-label and done under the strict responsibility of the physician in charge.
Liquid silicone is a totally inert product and does not produce any triggering effect on the production of connective tissue (collagen and other fibers) in the human body. It is prone to migrate and calcify within the body and become a “dead weight” that will eventually produce sagging and heavy, descended tissues.
What results can be obtained by injecting dermal fillers designed specifically for the face into the buttocks?
Now it’s time to dive into the harsh reality of dermal fillers approved for the face in the United States and used off-label for buttock injections. It’s a thorny subject and we want to address it in as professional and unbiased a manner as possible.
Finding a tissue filler substance suitable to be injected in the gluteal region requires professional, objective and impartial advice, since the subject is complex, lends itself to much confusion and the parties interested in promoting their products will always go out of their way to undermine the truthfulness that the client needs.
Doctors working in the aesthetic field in the United States are faced with a dilemma whenever a person comes to them requesting buttock augmentation with dermal fillers. The crux of the matter is that there is no dermal filler specifically designed for buttocks in the United States.
This is why dermal filler manufacturers and doctors have managed to offer the client an alternative solution that consists of injecting the buttock area with a dermal filler made for the face as if it were also suitable for the butt.
What happens when dermal fillers specifically designed for the face are injected into the buttocks?
As far as health consequences are concerned, there is nothing really harmful, since they are approved substances to be injected into the dermis. hence, safe.
However, in terms of their effectiveness in creating projection, definition and firmness to the gluteal area, their usefulness is practically nonexistent. First of all, facial fillers come in very small presentations, usually in syringes or vials that do not exceed one or a couple of ccs and are quite expensive; hence, in order to have a minimal volumizing effect on the buttocks, a very large number of vials should be used, making the cost of the procedure prohibitive for the client. But even more important is the fact that facial fillers lack sufficient viscosity and consistency to create volume and above all, the body resorbs them over a very short period of time, usually 6 to 8 months.
Lately, Sculptra has been marketed as a suitable filler for the buttocks because PLLA supposedly stimulates collagen production, which may be true in the case of small facial corrections, but from what we have seen in patients who have come to for consultation, this effect is very small and almost negligible. Sculptra has similar characteristics to other facial fillers in that it is not very viscous and its duration in the body does not exceed one year. The body is supposed to replace the PLLA with its own collagen fibers but, we repeat, we have not yet seen patients satisfied with it.
And of course, there’s the issue that in order to achieve any noticeable effect even in the short term, it is necessary to inject large amounts of product and given its unit cost, the total value of the procedure can reach really unattainable limits for the average person.
Given all of the above, what alternative is left for a person seeking to beautify their buttocks through dermal fillers?
After reading this article and also reviewing different alternative sources, since we do not want to boast of possessing the absolute truth and therefore we warmly recommend that you should cross-check everything that has been stated here, if you think about it logically, we believe that there’s no other choice but to agree with us that there aren’t currently viable alternatives in the United States (applicable to many other countries as well), to solve the aesthetic problem of the gluteal area (that is, the buttocks and hips complex).
Having said that, the only reasonable thing to do would be to rely on a product that has the approval of the health authorities in some other country, of course, where it is known that things are done seriously. We are not talking about countries at the tail end of world progress but about a colossus like Brazil, notorious for its long tradition in the field of plastic surgery and aesthetic medicine.
This product exists and it is called “Dermal Filler based on PMMA Microspheres“. Ah, but didn’t you tell me that in the United States there is Bellafill, also based on PMMA microspheres? Yes, indeed that was said, but Bellafill is a dermal filler designed only for the face and the microspheres are contained in a bovine collagen vehicle that has a very short permanence in the human body.
The PMMA that exists in Brazil uses a hydroxyethyl cellulose vehicle that has a much longer permanence than bovine collagen, and exists not only in presentations for the face but is also produced with viscosity and consistency for use specifically in the buttocks. Linnea Safe is a leading brand of Dermal Fillers in Brazil.
As experts in non-surgical Brazilian Butt Lift, we exclusively use this brand with reliable, consistent, long lasting and free of side effects results.