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Differences in Complication Rates of Gluteoplasty Procedures That Utilize Autologous Fat Grafting, Implants, or Local Flaps

Asserson, Derek B., BS*†; Kulinich, Andrea G., BS*‡; Orbay, Hakan, MD, PhD; Sahar, David E., MD*∥

doi: 10.1097/SAP.0000000000001765
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Background Gluteoplasty (gluteal augmentation) procedures are increasing in popularity, but there is not a universally accepted technique to produce optimal outcomes while minimizing risk. In this systematic review, we perform a meta-analysis to evaluate rates of complication from autologous fat grafting, implants, and local flaps, which are the three most common gluteoplasty operations.

Methods A search of the PubMed/MEDLINE database for articles including the terms “gluteoplasty” OR “gluteal augmentation” OR “buttock augmentation” OR “Brazilian butt lift” OR “gluteal autologous fat graft” OR “buttock autologous fat graft” OR “gluteal implant” OR “buttock implant” OR “gluteal flap” OR “buttock flap” generated 229 articles. This number was brought down to 134 after initial screening by title. Inclusion criteria then removed those not written in English, those without access to the full text, those without extractable data on complications, and duplicates, leaving 46 articles to examine.

Results A total of 4362 patients who underwent gluteoplasty between 1992 and 2017 were found. The overall complication rate was 12.4%. Implants had the highest rate (31.4%), whereas fat grafting had the lowest (6.8%); flaps were intermediate (23.1%). A χ2 test yielded a statistically significant (P < 0.001) nonindependent relationship between combined complication rate and type of surgery. Individual complications, such as asymmetry, capsular contracture, fat embolism, hematoma, infection, necrosis, pain, seroma, wide scar formation, and wound dehiscence, were also analyzed.

Conclusions Fat grafting by plastic surgeons might be the best option for gluteoplasty with regard to complications. In certain cases, however, there may only exist one choice for an operation because of anatomical limitations, which predisposes patients to those associated complications.

From the *Surgical Bioengineering Laboratory, Department of Surgery, University of California Davis Medical Center, Sacramento, CA;

California Northstate University College of Medicine, Elk Grove, CA;

University of California Davis School of Medicine, Sacramento, CA;

§University of Maryland Medical Center, Department of Surgery, Baltimore, MD; and

Division of Plastic Surgery, Department of Surgery, University of California Davis Medical Center, Sacramento, CA.

Received August 2, 2018, and accepted for publication, after revision October 14, 2018.

Conflicts of interest and sources of funding: None of the authors have received funding for this article.

Reprints: Derek Asserson, BS, 4625 2nd Ave, Research Building II, Room 3004 Sacramento, CA 95817. E-mail: derek.asserson@gmail.com.

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