Shaping the Future

By: Ruth Donnelly
Created on 12th September 2011

With stars from J Lo to Beyoncé making big butts big news, it’s not surprising that more and more women are seeking buttock enhancement, but the tragic case of Claudia Aderotimi served as a reminder that we need to be careful about what we put in our bodies. So what are our options? CosmeticSurgeryToday investigates...

In February this year, the world’s media went into a frenzy when British student Claudia Aderotimi died after flying to the States for cosmetic buttock injections.

UK newspapers reported that she had bought an injectable body filling product over the internet and had it injected into her buttocks in her hotel room by an unnamed third party – a fairly horrifying thought, but something that most of us can reassure ourselves we wouldn’t be foolish enough to emulate.

The truth, however, is a little more sinister. “She wasn’t injected in a hotel room, that was misreported,” says Mr Christopher Inglefield, an eminent UK plastic surgeon.

“She was actually injected in a clinic, by a cosmetic physician, then went back to her hotel where she collapsed.” When you look at it like that, it’s a bit easier to put yourself in Claudia’s shoes, isn’t it – after all, who doesn’t trust a doctor?

Safety matters
The product used to enhance Claudia’s buttocks was liquid silicone and the pathology report showed that she died from a pulmonary embolus caused by the silicone migrating to her lungs through a blood vessel.

As a cosmetic device, liquid silicone is illegal in the UK and in most of Europe, precisely because of the risk of migration or infection. However, sadly the same rules don’t apply the world over, and even if they did, not all physicians are cautious enough to stick to them if there’s money to be made in doing otherwise.

Body contouring is big business at the moment, as women the world over seek to achieve the pert, rounded buttocks of their celebrity idols, and it doesn’t have to be dangerous, so long as you follow a few simple rules.

Minimising the risk
Before you agree to have anything put into your body, you should make sure you know exactly what it is.

This means that if you have an adverse reaction at home and have to go to your local hospital or GP, doctors will be able to treat the problem more quickly. If they don’t know what’s in there, chances are they won’t know how to get it out.

We know silicone is a big no-no, but which products should you be looking out for? In the UK, there are three main options which are considered safe.

Fat transfer
“The ideal option would be fat grafting,” says Mr Inglefield. This is a procedure performed using the patient’s own fat to enhance their shape.

Fat is harvested from one area of the body, then prepared to clear it of blood, painkillers or anything else that could cause infection and, finally, reinjected into the area that requires more shape.

This is a fairly invasive procedure and needs to be performed by an experienced surgeon, but Mr Inglefield maintains that if done well it provides a safe, natural-looking, long-term solution to body contouring.

However, fat grafting is only applicable to those candidates who have some fat to spare. Without sufficient fat elsewhere on the body which can be used to create your new curves, you have a choice between implants or synthetic injectable products, more commonly known as body fillers.

Implants
Implants work very well in some areas of the body, such as the breasts or calves, but are completely unsuitable for use in hip contouring and although they can be used for buttock augmentation, this is far from ideal.

“Buttock implants don’t present a very good option for the patient,” Mr Inglefield explains. “It’s a very invasive operation, with a very high complication rate – up to 32 per cent – and recovery time is a minimum of three months.”

Another issue with all implants is the possibility of a condition known as 'capsular contracture'. Whenever a foreign object, such as an implant, is placed in the body, a lining or ‘capsule’ isformed around it by your own tissue.

This is the body’s natural  response and is quite normal,   however in some people this lining will tighten and squeeze the implant, causing it to feel hard.

Capsular contracture is not a fault of the surgeon or the type of implant used – although these days there are implants available which are less likely to cause the problem – but, again, it is important to know what make of implant has been inserted in order for any issues to be dealt with more efficiently.

Fillers
That leaves us with body fillers. The current range of injectables is very limited in the body contouring arena, and there are only really two products that are considered safe to use in the UK.

The first is a temporary body filler, which can produce good results but unfortunately they only last for between six and nine months, after which time you will need to go for a top up. At almost three grand a pop, that soon adds up.

The other product is Aquamid. Aquamid is made of 97.5 per cent water and 2.5 per cent polyacrylamide and is one of very few long-acting products available for facial volumising in the UK.

It also comes in a more viscous form, Aquamid Reconstruction, which is designed for use in areas which need a greater volume of product.

Originally designed for use in facial contouring and volumisation, according to Mr Inglefield, Aquamid Reconstruction also offers a safe, long-term solution for body contouring.

Unlike most fillers, it doesn’t break down over time, but actually bio-integrates with your tissue, meaning that, to all intents and purposes, it becomes a part of your own body.

Aquamid is currently pending FDA approval in the States – to put this in perspective, of the 147 dermal fillers available in the UK today, only seven have been approved by the FDA – and is CE marked for use in Europe, having undergone rigorous safety tests.

“Aquamid integrates well with tissue, it feels natural and it lasts a long time,” says Mr Inglefield. “It has a 90 per cent patient satisfaction rate five years after the initial injection, which is very impressive. Breast implants have a five year satisfaction rate of probably 86 per cent, so an injectable product that has 90 per cent satisfaction at five years is pretty good.”

Rules of thumb
Every procedure has its risks and it is vital that all the treatments listed above are performed by experienced surgeons or injectors (injections should really only be carried out by surgeons, doctors or nurses), in sterile conditions.

Many doctors feel comfortable injecting Botox in their consulting room, but for body fillers like Aquamid you should be in a minor surgical theatre at least, as the most likely complication to arise is an infection at the site of injection.

It goes without saying that buttock implants and fat grafting should be performed in a surgical setting.

Wherever you seek treatment, always check out your practitioner’s credentials first – there should be a GMC equivalent in most countries, and many of the more experienced and ethical surgeons will be members of ISAPS (the International Society of Aesthetic Plastic Surgeons) – an international body set up to improve standards in surgery.

Finally, if you decide to have an implant or a filler, ALWAYS check what product will be used and ask the practitioner to write down its name. That way, you can do your research pre- treatment and get help quicker should any complications arise post-procedure.

As long as you follow these guidelines, body contouring can be a very rewarding procedure, so don’t be put off – but don’t put yourself at unnecessary risk, either. Let’s all learn from Claudia Aderotimi’s mistake and get our curves the safe way.