Staying Safe during Gluteal Fat Transplantation

Abstract

Gluteal augmentation with fat transplantation is increasing in demand but has been associated with a concerning number of fatality reports. Despite these reports, various surgeons have safely performed gluteal fat transplantation on a large number of patients with no reported mortality. The important aspects of safely performing gluteal fat transplantation are reviewed. Proper patient selection, favorable instrumentation, patient positioning, proper technique, and knowledge of anatomy are critical to improving the safety of this procedure. Adherence to these key principles should allow a reduction in mortality from this procedure, which would safely allow its continued offering in the setting of increasingly high demand.

Complications of Cosmetic Surgery Abroad – Cost Analysis and Patient Perception

“…Rohrich et al set the principles of safe practice in terms of patient positioning, proper technique, anatomy, and trained surgeons. 30 Complications with a high mortality risk like pulmonary embolism were evident in our series. This stems from either injury to the deep venous system or fat embolism.…”

Assessment of Different Modalities in Gluteoplasty

“…This was recommended Toledo and Roberts III et al 24,34 However, the new trend advocated by many studies including Villanueva et al, Mofid et al, and Mendieta and Stuzin is to use a wider bore 4-mm cannula for fat injection, which aims at improving safety by reducing the risk of gluteal vessel injury leading to fat embolism. [35][36][37] About half of the fat was injected in an intramuscular plane, thus improving the lifting effect of the lipofilling, giving the buttocks projection as well as volume, as was advised by many authors. The kidney-shaped pattern of deep injection protects the sciatic nerve exit located lateral to the ischial tuberosity.…”

“…24,34 However, recent recommendations are to limit gluteal fat injection to the subcutaneous plane and to keep continuous motion of the cannula during injection, preventing any bolus deposition of fat. [35][36][37][38][39][40] Implant gluteoplasty patient survey results showed a mean value of 4.25 for overall patient satisfaction (over a scale from 1 to 5). Fat transfer gluteoplasty results showed the mean value of 4.75.…”

“…This was recommended Toledo and Roberts III et al 24,34 However, the new trend advocated by many studies including Villanueva et al, Mofid et al, and Mendieta and Stuzin is to use a wider bore 4-mm cannula for fat injection, which aims at improving safety by reducing the risk of gluteal vessel injury leading to fat embolism. 35-37…”

The Role of Fat Grafting in Buttock Augmentation

“…29 Safety recommendations include proper patient selection, avoiding intramuscular injections and the "danger zone," using a blunt cannula, injecting parallel to the buttocks in a retrograde fashion and, and having a strong understanding of the gluteal anatomy. 7,14,34 Most importantly, fat grafting for buttock augmentation should only be performed by experienced, board-certified plastic surgeons.…”