From otofo to plastic surgery: Evolution of buttocks enlargement

In the northeastern Brazilian city of Salvador da Bahia, it is common to see women walking around town in ceremonial dresses with their buttocks artificially enhanced either with a pillow or a metal girdle. 

The fact that a significant proportion of the inhabitants of Salvador are former slaves from West Africa makes one wonder whether this fashion is in any way connected to the Ga puberty rite of Otofo where young females tie pillows on their buttocks to signify their passage into adulthood.

Whatever the origins, the fact remains that African women and women of African descent tend to be extremely well-endowed when it comes to their “behinds” be it in terms of size, shape or contour.

With such natural endowment, one wonders why some African women undertake medical or surgical procedures to further enhance their buttocks. Is it a case of the rich wanting to be richer or the endowed wanting to protect, project and perfect their endowment?

In 2008, a proliferation of dubious buttocks-enhancing injections and creams created a health scare in Cote d’Ivoire and Mali.

The craving for buttocks enhancement was fuelled by a song called Bobaraba released by two Ivorian musicians — DJ Mix and DJ Eloh. Bobaraba means “big bottom” in the local Djoula language, and the song is full of heavy beats and rhythms with lyrics encouraging revellers to gyrate and shake their behinds as a tribute to womanhood!

In an interview with the BBC’s James Joyce, DJ Mix is reported to have stated that they made the song “as a tribute to women because African women are defined by the shape of their bottoms”.

While this statement is obviously a gross over-generalisation, the popularity of bobaraba and the continuing desire by some African women to acquire bigger buttocks raises several questions. 

Is it ethical to seek to augment the buttocks purely for cosmetic reasons? Is this desire in any way fuelled by cultural expectations, including puberty rites, which present huge buttocks as a sign of womanhood?

Are there medical conditions where plastic surgery of the buttocks is indicated and needed? What, if any, are the risks associated with buttocks enhancement or reduction?

Plastic surgery

Plastic or cosmetic surgery of the buttocks is known medically as “Gluteoplasty”. The buttocks are composed largely of two muscles known as “Gluteus Maximum” and “Gluteus Medius” covered by a layer of fat.

The physiological purpose of the buttocks is to ensure a stable gait and balanced walking. In wasting diseases like kwashiorkor, there is massive loss of fat and tissue from the buttocks leading to deformities which may require correction.

Certain congenital defects or traumatic injuries to the buttocks may also call for plastic or reconstructive surgery to restore gait and promote balanced walking.

When needed

Buttock enhancement is medically recommended when there is deformity and defect of the buttocks due to disease or trauma, including accidents.

The extent of damage and deformity determines the approaches to be used, though most approaches involve surgery of one kind or the other.

The main method for buttocks enhancement is surgery to implant artificial materials into the buttocks or to take fat and tissue from other parts of the body into the buttocks.

The buttocks are linked to nerves and blood vessels, and buttocks enhancement requires extreme care in order not to damage any nerve or blood vessel as this may lead to paralysis or extensive bleeding, which may be fatal.

Buttock enhancement should, therefore, only be carried out by trained and licensed specialists working in approved facilities and institutions. Attempts to surgically enhance the buttocks by using the services of untrained personnel have often led to catastrophic failures and horrible deformities and consequences.

There is currently no effective medicine for buttocks enhancement. Any offers of creams or injections for buttocks enhancement are, therefore, false and irresponsible.

At best, these enhancers contain inactive substances or vitamins, but they may also contain dangerous substances. Moreover, some of these illegal products are prepared in unhygienic and unlicensed premises, making them a health hazard.

Can anything go wrong?

All medical and surgical procedures, including buttocks enhancement or reduction, carry with them a finite amount of risk.

What health professionals do is to carefully ensure that the benefits of each procedure or treatment far outweigh any risks that may exist. In cases where buttocks manipulation is for correction of defect or deformity, the inherent risks of the procedure may be deemed acceptable compared to the pain and suffering the patient has to endure if the procedure were not carried out.

However, where buttocks manipulation is for aesthetic purposes to make the buttocks firmer, rounder, curvier, bigger or smaller, the smallest amount of risk may seem disproportionate to any benefits that may accrue.

Medical risks that have been recorded include side effects to the anaesthetic agents used, numbness in the buttocks, pain, leakage of implants, paralysis and bleeding.

Enhancement of body parts for purely aesthetic or cosmetic purposes is known to be associated with psychological stress and there are several recorded cases where women have found their new buttocks too big, way below expectations, too curvy, too undulating and sometimes downright ugly. 

The writer is the Director-General of the Ghana Standards Authority. 
E-mail: alex.dodoo@gsa.gov.gh