Абстракт

Objectives: To demonstrate the clinical efficacy and aesthetic benefits of a minimally invasive, layered treatment strategy for post-bariatric gluteal remodeling. The goal was to restore volume, improve skin retraction, and refine contour asymmetries without resorting to surgical lifting. By integrating subdermal and intramuscular fillers, diode laser retraction, and targeted liposuction, the approach aimed to offer a reproducible and patient-specific alternative for managing gluteal deformities in massive weight-loss patients. Introduction: Post-bariatric patients frequently present with gluteal volume loss, skin laxity, surface irregularities, and contour asymmetries. Standard surgical lifting may be refused or deferred due to its invasiveness and prolonged recovery. Over the past decade, the author has developed a segmented ambulatory protocol that combines volume restoration, surface correction, and tissue retraction through microinvasive techniques. This case report presents the successful aesthetic reconstruction of a post-bariatric gluteal region using filler, diode laser, and targeted liposuction. Materials / method: Post-bariatric female patient (weight loss >40kg) underwent a customized, stepwise gluteal refinement. The protocol included: 1) Fillers to restore volume and projection; 2) Mini-liposuction in the lateral and lower gluteal compartments to harmonize contour; 3) Dual 980nm/1470nm diode laser (endolaser) for cutaneous tissue retraction in lax zones; 4) Complementary subcision and bioinduction for surface regularization. All procedures were performed with intervals between stages to ensure tissue adaptation and patient comfort. Photographic documentation were registered. Results: The patient showed significant improvement in gluteal shape, firmness, projection, and skin quality. The combined approach allowed a tailored correction of post-weight-loss defects without the need for surgical excision. The result was rated as "excellent" by both the patient and the medical team, with no adverse events. Conclusion: This case illustrates how post-bariatric gluteal deformities can be successfully addressed through a minimally invasive, staged approach. The integration of structural fillers, diode laser retraction, and mini-liposuction offers a viable, reproducible, and patient-centered alternative to surgical gluteoplasty in selected cases. This technique reflects the evolution of gluteal harmonization based on biomaterial science, aesthetics, and clinical precision.