We have read the article published recently by Dr. Wong et al.1 The authors intent was to define patterns of ideal buttocks aesthetics in a most innovative way, taking into account preferences of an anonymous lay male population by their choices over a series of digitalized photographs.
We consider it has been a great asset of the authors taking into account cultural differences in the appreciation of beauty. Although only one respondent is from our country, ethnicity of our common patient population has been included (11.8 percent).
Of note, to clarify an aspect pointed out by the authors, although in our previous report presumed aesthetic ideals were set on beautiful model bodies in photographs, subsequently, when these ideals were put into practice at our department, none of our patients was a model; all of them were upper middle class women, mainly housewives already with children. The only atypical trait was possibly a tendency toward healthier nutritional and exercise habits.2,3
In our opinion and experience, aesthetic canons evolve as a result of shifts in cultural values. As a matter of fact, mainstream media role models have shifted preferences to a wider hip. Indeed, regional patterns also exist in our country, with northernmost colleagues performing even lateral hip implants in contrast with a slender appearance that is sought in the central region of the country. Of course, patient size and body habitus must be emphasized to avoid generalizations; as a rule of thumb, aiming at projecting the central aspect of the buttock is of utmost importance, always preserving proportion.
As the authors point out, and like everything on earth, beauty paradigms evolve or even shift completely from time to time. Always having safety as the main value, it is part of our task as plastic surgeons counterbalancing that which is most desirable to the patient with that which is permitted in the context of a natural and sophisticated appearance.
The authors declare that there is no conflict of interest related to any aspect treated in the text. There were no royalties nor economic benefits.
Miguel Angel Gaxiola-García, M.D.
Ignacio Lugo-Beltrán, M.D.
Plastic and Reconstructive Surgery Department
Centro Médico Nacional 20 de Noviembre ISSSTE
México City, México
1. Wong WW, Motakef S, Lin Y, Gupta SCRedefining the ideal buttocks: A population analysis. Plast Reconstr Surg. 2016;137:1739–1747.
2. Cuenca-Guerra R, Lugo-Beltran IBeautiful buttocks: Characteristics and surgical techniques. Clin Plast Surg. 2006;33:321–332.
3. Cuenca-Guerra R, Quezada JWhat makes buttocks beautiful? A review and classification of the determinants of gluteal beauty and the surgical techniques to achieve them. Aesthetic Plast Surg. 2004;28:340–347.
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