Abstract

Objectives: • To provide practical insights on gluteal anatomical layers, including the superficial and deep fat compartments, and fibrous septa. • To emphasize the anatomical considerations crucial for achieving optimal outcomes and prevent complications in gluteal treatments. • To discuss the role of poly-L-lactic acid (PLLA) and regenerative injectables, with and without energy-based devices (EBDs), in improving skin quality, addressing cellulite, and enhancing contour. Introduction: Effective gluteal rejuvenation requires a comprehensive understanding of anatomical structures to ensure precise product or energy placement and maximize therapeutic outcomes. The strategic application of PLLA or other regenerative injectables, combined with EBDs where appropriate, offers a powerful approach to enhancing skin texture, cellulite, lifting, and contour refinement. Anatomical precision is key to optimizing these effects while minimizing risks. Materials / method: Following an extensive literature review on gluteal region anatomy, structural layers, and available treatment options for aesthetic enhancement, patients presenting with gluteal skin laxity or cellulite received treatment with PLLA or PRP to promote collagen stimulation and restore volume. In select cases, Energy-Based Devices were incorporated to enhance skin tightening and support collagen remodeling. Ultrasound guidance was employed to refine injection techniques and optimize clinical outcomes. Results: All patients exhibited notable improvements in skin texture and laxity, with enhanced gluteal contour, increased firmness, and a reduction in cellulite appearance. Consistent with findings in the literature, combined therapies involving injectables and Energy-Based Devices yielded superior results in enhancing skin quality compared to injectables alone. Optimal outcomes were achieved by precisely targeting anatomical planes, such as the fibrous septa and fat compartments, using ultrasound guidance. Conclusion: Anatomical precision is fundamental to achieving consistent and superior results in gluteal rejuvenation treatments. Tailored application of PLLA and other regenerative injectables, with or without EBDs, ensures optimal product distribution, enhancing both volumetric outcomes and skin quality. Strategic anatomical targeting maximizes collagen induction, improves texture, and refines contour, offering patients improved aesthetic outcomes with long-term benefits and minimize complications.