Dr. Robert F. Centeno & Dr. V. Leroy Young
Images of Lynne, a patient in St. Louis, taken before and after her buttock-implant surgery.
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msnbc.com contributor
updated 2/18/2004 3:18:54 PM ET 2004-02-18T20:18:54

She was browsing through the racks at a local mall several weeks ago when a young man who looked to be in his 20s approached her. “I just wanted to tell you, you look beautiful,” he said.

While a comment like that might lift the spirits of many women, for Lynne, a 44-year-old from St. Louis who asked that her last name not be used, it was proof-positive she’d made the right decision in joining the growing number of American women seeking out gluteal, or buttock, implants.

“I think it makes a bigger difference in a woman’s figure than a breast implant,” she says.

While statistics on the number of gluteal-implant surgeries are only beginning to be collected, officials at the American Society of Plastic Surgeons say 614 of the procedures were performed in the United States in 2002, although the actual number could now be much higher. Doctors are reporting a rising demand for the surgery.

Lynne’s surgeon, Dr. Robert F. Centeno, who has a private practice in St. Louis, credits much of the surge in the procedure’s popularity on the famous fanny of one celebrity in particular -– Jennifer Lopez. “As many people that you might have that criticize her buttocks as being too big, she has impacted on what is perceived to be an attractive buttock,” he says.

The influence of other "bootylicious" pop stars like Beyonce Knowles as well as fashion trends also are transforming the bottom into a top priority for those considering plastic surgery, Centeno says.

“If you have low-rise pants and you don’t have a butt," he says, "it doesn’t look very good.”

What's ideal?
The exact dimensions of the "ideal" backside are still being debated, but Lynne knew she wasn’t quite hankering for something J-Lovely. 

"I think she has some curves and there’s some shape there that looks good," she says. "I just think there’s a little too much of it.” She opted instead for a smaller, but still pert and well-rounded, derriere.

Video: Gluteus maximized Meanwhile, Centeno and his partner, Dr. V. Leroy Young, have been hard at work investigating the precise geometry of the perfect bottom. To this end, they plan a study where a group of objective observers rate the aesthetics of 500 adult heinies.

They’ve already come up with some preliminary conclusions. For women, “maximum projection” -– the point at which the buns stick out farthest from the body –- should be about level with the pubic mound, according to Young. For men, maximum projection would be a bit higher, closer to the navel. 

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Furthermore, Young says, “the gluteal crease, where your buttocks join your thighs, should not go past two-thirds of the way across the thigh.” Finally, every perfect backside should have that pert "dimple" at the top, where the upper curve of the buns meet at the base of the spine.

Better-booty business booming
Whatever the ideal turns out to be, U.S. demand for more fabulous fannies is currently outstripping supply.

While the trend started on the two coasts, plastic surgeons in nearly every state are now being inundated with requests from patients, according to Young, who is also director of the Emerging Trends Task Force at the ASPS.

"It's become much more mainstream," he says.

However, Young estimates that across the country, there are probably only about a hundred surgeons trained to perform gluteal implants. He and Centeno have already passed on their expertise to others. But, says Young, “there’s hardly a week that goes by that someone doesn’t call us and say, ‘Can we come watch you do this?'”

About 90 percent of the people shelling out an average of $6,000 to $10,000 for gluteal implants are women, although surgeons are beginning to see more male patients.

And Beverly Hills plastic surgeon Dr. Adrien Aiache says celebrities are wasting no time in getting their buns in line for implants, either.

“More ‘beautiful people’ are doing it than anyone else,” he says. “If you have a pretty girl who’s been pretty all her life and all of a sudden she’s seeing the big 4-0 coming on, she gets scared and she wants everything to look better. And that’s what we’re seeing a lot of now. They don’t want to lose what they have.”

Complications can occur
Surgeons agree that attempts to maximize one’s gluteus do not come without risk. Studies examining the rate of complications for the procedure are at an early stage, but Centeno estimates that around 10 percent of patients can develop serious, long-term problems.

During the most common type of gluteal implant, the patient is put under general anesthetic while surgeons place anatomically designed, solid silicone implants within the gluteus maximus. Ideally, the hollow into which the implant is positioned should create a snug fit, but in some cases implant rotation can occur, creating what surgeons call the "double-bubble" effect.

Other potential problems include infection of the implant site, capsular contracture (the formation of a hard fibrous shell around the implant) and the ability of the patient to feel the implant over the long-term. In one study, about 6 percent of patients receiving the most common type of gluteal-implant procedure experienced one of these complications.

Post-op, patients are asked to refrain from sitting for about seven to 10 days because pressure can re-open the surgical incision, hidden in the cleft of the buttocks.

Still, compared to the breast augmentation she underwent a few years ago, Lynne described her buttock-implant procedure as “a piece of cake.” Aside from having to lie down for the week after surgery, she says she felt little discomfort and ended up taking none of the painkillers Centeno handed out.

And the lift she received from buttock augmentation was psychological as well as physical. After a lifetime of having a “flat butt,” Lynne says, the full impact of her transformation really hit home when she attended an office party at her husband’s firm. At 44, she was one of the oldest women in a room populated with twentysomethings. Back home after the party, her husband mentioned that “every guy in the room” had something flattering to say about her appearance, including, “Your wife is hot!”

Nevertheless, Lynne says she underwent the surgery for herself, not others. “I did not have expectations that someone was going to love me more or that my life would change,” she says.

She also plays down the impact of pop stars like Lopez and Knowles on her decision to have surgery. Instead, it was the realization that she could actually do something about a drooping, middle-aged posterior that moved her to action.

“Women have been unhappy with their backsides for years,” she says. Now, “they’re realizing that there’s something you can do about it.”

E.J. Mundell is a freelance journalist based in New York City.

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