Implant-Free BiVOL Buttock Augmentation
for a Beautiful Rear View

What is BiVOL buttock augmentation?

BiVOL creates volume with ADM instead of an implant. Conventional buttock implant surgery places an implant in the buttock to create projection and volume. BiVOL, by contrast, does not insert an implant itself but uses the biomaterial ADM to design volume in the desired areas. Its core idea is not simply "filling something in" but placing a biomaterial that can support tissue and using the process by which it then integrates with tissue. ADM is a biomaterial used in reconstructive surgery such as breast reconstruction, where the cell-free extracellular matrix acts as a supporting structure for tissue. So BiVOL buttock augmentation can be a new option for those who want to create buttock volume and lines without an implant.

Related readingWhat it means that BiVOL buttock augmentation also considers the tissue environment is covered in "BiVOL buttock augmentation: why does it consider the tissue environment too?" (Korean).

How is BiVOL different from conventional buttock implants?

The biggest difference is the material that creates volume and how it remains in the tissue. Buttock implant surgery chooses the size and shape of a manufactured implant to create volume and projection. Its advantage is that it can create a certain volume even in slim bodies with little fat. But because an implant is inserted, complications such as infection, seroma, wound problems and implant malposition must be considered. The biggest difference with BiVOL is that it does not use an implant itself. So if the firm feel or edge outline of an implant concerns you, designing volume without inserting an implant can itself be an advantage. Also, rather than choosing one of a set of silicone implants, ADM is placed to fit the desired areas, so design tailored to the individual body and buttock shape can be emphasized.

In a systematic review of 44 studies on buttock augmentation, overall complications were 21.6% with implants and 9.9% with fat grafting. Newer methods like BiVOL do not yet have such large comparative data, so the level of evidence should also be considered when choosing.^[1]

Can it improve a flat buttock and hip dips?

The key to buttock augmentation is not just creating a buttock that protrudes backward. A flat buttock needs posterior projection, a lacking upper buttock needs upper volume, and if hip dips are a concern, the hollow side line should be smoothly connected. In actual gluteal surgery, body design that considers the waist, pelvis and side line along with the buttock's own volume is used. BiVOL's advantage is that ADM can be placed in the desired areas to aim for this kind of volume design. For example, rather than simply making the center of the buttock bigger, volume can be added to the upper buttock to emphasize a lifted look, or side volume can be added to smooth the line from the hip dips to the thighs. In other words, what matters is not "a big buttock" but "a rear view with good proportions from waist to buttock."

How does it differ from fat grafting, hip fillers and hybrid?

BiVOL is not the only way to create buttock volume. Various surgeries and procedures have been used before.

Fat grafting can be combined with liposuction for a larger overall body change, but part of the grafted fat can be absorbed. In gluteal fat grafting, a safe injection plane and technique are especially important. The hybrid approach combines the clear projection of an implant with the contour refinement of fat grafting, and combined volume design has been used in actual gluteal surgery. BiVOL differs from these in that it uses the biomaterial ADM without a silicone implant.

Who is BiVOL buttock augmentation suitable for?

BiVOL may particularly interest people with the following concerns.

• Those who don't want an implant
• Those who find the foreign-body feel of an implant burdensome
• Those who value natural volume and feel over size alone
• Those who want a design tailored to their body rather than a set implant size
• Those who want to fine-tune volume in specific areas rather than the whole buttock

Especially if you want to improve the waist-to-buttock ratio, hip dips and upper buttock volume rather than only increase size, BiVOL's tailored volume design can be an advantage. Conversely, if the whole buttock needs to be enlarged a great deal, or your body makes it hard to create the desired volume with ADM alone, the surgical method should be decided by comparing it with other options. In the end, BiVOL is best seen not as "the best buttock augmentation for everyone" but as a new option for those who want implant-free volume.

How does volume change after surgery?

BiVOL should not be understood as a method whose final shape is complete right after surgery. ADM is a biomaterial into which cells can migrate and in which blood vessel formation and tissue remodeling can occur in the body, so time is needed for it to integrate with tissue after surgery. Early on, swelling and tissue changes from surgery appear together, and the shape can become more stable over time. In particular, the buttock is constantly under pressure from sitting and walking in daily life, so pressure and posture management and wound care after surgery are important.

BiVOL buttock augmentation: common myths and facts