Buttock volumisation

A 32-year-old patient contacted my practice to enquire about buttock volumisation. She is a lawyer and someone who thoroughly researches treatments both online and in person beforehand. Prior to approaching me, she had considered different treatment options for her buttocks, including dermal fillers (she realised that the amount of filler you’d need in that area would be an astronomical cost, and in my opinion, extremely dangerous) and surgery, such as fat transfer (which she knew would mean a very high-risk procedure, and, given the risk and cost, she was concerned about the longevity of results). During her research, she’d found information about collagen collagen-stimulating injectable Lanluma, at which point she contacted me.

In her initial consultation she explained that she attends the gym approximately five times per week; however, each time she sheds any weight, she feels that she loses volume from her buttocks disproportionately over other areas of her body.

During this first consultation, the patient asked a lot of questions about the injectable treatment, including how it worked, as well as the healing timeline and aftercare. She loved the fact that it is designed to stimulate natural collagen production. As a clinician, I was also interested to know her opinion of her treatment results, I understood her to be a fastidious person who routinely exercises, measures, and weighs herself, so I believed she would be objective and considered in her assessment of the results.

PRE-TREATMENT OBSERVATIONS AND PROTOCOLS

Prior to her treatment I thoroughly assessed the patient’s medical history, before putting her in front of a full-length mirror and asking her to describe what she saw and her perception of her shape. This discussion is always important to enable me to both learn about how patients perceive their looks and to give advice on whether the treatment they are seeking is going to give them the results they expect.

My client was mostly concerned with the appearance of her superior lateral, gluteal region, namely her ‘hip dips’, and I observed a lower volume of fat across her gluteal area and flanks that resulted in the ‘dips’. We decided to focus on this area for the first treatment. 

Four months post treatment. Patient had received three courses of treatment each one month apart.

Patient on first day of treatment and nine months post treatment. This image clearly illustrates the longevity of Lanluma.

TREATMENT AND TREATMENT CONSIDERATIONS

I treated this patient with one vial of Lanluma per gluteal side over the course of three separate treatments – six vials in total.

The entire treatment is completed under enhanced sterile conditions, using surgical drapes, this is to lower infection risks given this procedure is more at the surgical end of aesthetic, non-surgical treatments.

Lanluma needs to be prepared an hour in advance, a solution is created, and then it must be agitated for the required period of time to ensure it is thoroughly mixed.

After marking up the area to be treated, I used lidocaine to numb the cannula site the cannula used for this treatment is 18G, 70mm, (which is really quite large). Next, I mixed a dilute of the numbing agent and completed a subsection of the area to be treated. This numbs to provide pain relief and allows the product to be placed more accurately.

It can be a physically demanding procedure over a large area of the body, requiring two people to maintain sterility; in this instance, my nurse practitioner worked alongside me for each treatment. On completion, the area was surgically dressed.

Post-treatment, it was important for my patient to keep the area extremely clean to prevent infection. I advised her to look out for any oedema, heat or redness in the treated area, or leaking fluid from the wound – particularly if green or yellow and of course any unusual pain.

The surgical dressings had to remain in place for at least three days before showering; and I reminded her not to have a bath for four or five days, and not to go swimming or to a spa.

Massaging the area treated three times per day for 10 minutes for the first two weeks was also an important post-treatment procedure. In the case of any concerns, I always give patients a 24-hour, manned telephone number and ask them to call no matter how small they think their query or concern is.

TREATMENT RESULTS

Post the first treatment, the intended area filled out very aesthetically. For the second treatment I re-examined her buttocks and focused on a more mid-central area. For the third and final treatment, I focused on her mid-lateral area to increase her gluteal to hip ratio to give her the ‘curvy’ shape she desired.

Following her three treatments she also had a Morpheus8 procedure to her stomach to treat pregnancy scarring. This allowed me to better observe the progress of her Lanluma procedure over a three month period (it generally takes between two and six months for the treatment to have a noticeable effect).

As time went on the patient was increasingly happy with the results and reported seeing them improve over time.

CONCLUSION

Patient selection is key to successful treatment with Lanluma. This type of treatment wouldn’t be suitable for someone who was obese, unable to comply with aftercare, or who had unrealistic expectations of results, however, this patient was an ideal candidate because she is fit and at an ideal weight, but just wanted a little extra shape and volume to her buttocks.

DR. HANNAH HIGGINS

MBChB (Medicine), BSc (Hons), PGCert MedEd is the medical director at doctor-led medispa. The Wellness Space.Having graduated from The University of Sheffield and trained on Harley Street, Dr Higgins is a prescriber of ZO Skin Health and PCA Skin and the winner of the national Lanluma competition in 2023. She is an experienced Injector, specialising in anti-wrinkle injections, dermal fillers, Profhilo and full-face rejuvenation procedures