摘要

Objectives: To assess the safety, aesthetic outcomes, and patient satisfaction associated with using injectable fillers—hyaluronic acid (HA) and poly-L-lactic acid (PLLA)—for non-surgical gluteal augmentation in patients suffering from Dead Butt Syndrome. By enhancing gluteal projection, volume, and support, the procedure aims not only to improve aesthetic outcomes but also to potentially alleviate discomfort, functional weakness, and postural imbalance associated with DBS. This study explores the anatomical, biomechanical, and clinical rationale for the use of soft tissue fillers in DBS. Introduction: Dead Butt Syndrome (DBS), also known as gluteal amnesia, is a form of disuse atrophy caused by prolonged sitting, immobilization, or neuromuscular conditions. It leads to significant flattening and volume loss in the buttocks , lower back and legs affecting both aesthetics and self-image Over time, this muscular underuse not only affects strength and function but also leads to visible aesthetic changes. The chronic lack of support and movement in the area may reduce local circulation and tissue stimulation, indirectly contributing to skin thinning, loss of elasticity, and volume depletion. Materials / method: Over the past2 years, we treated 50 patients diagnosed with DBS patients were informed that the treatment is part of a comprehensive lifestyle approach, and complementary therapies such as physical therapy and targeted exercises Our injection protocol involved an initial session in which 200cc of H-A Filler and 100cc of PLLA were injected into the gluteal region. Patients were re-evaluated after 3 months, and based on clinical and aesthetic assessment, an additional 100–150cc of H-A and 50–70cc of PLLA were injected .A third session was performed three months later following the same protocol Results: Using this protocol, 78% of patients were rated as “Much Improved” (score 4 GAIS) by both the physician and the patients achieved their desired outcome after the first two sessions, reporting both aesthetic improvement and enhanced lifestyle quality due to reduced discomfort while sitting. An additional 8% required a third session to reach satisfactory results(both physician and patient score 3 GAIS) In the remaining 4%, patients rated their improvement as “no change” (score 2 GAIS),while the physician assessed them as “Improved” (score 3 GAIS), indicating a minor difference in results. Conclusion: The combination of HA filler and PLLA in gluteal injections offers synergistic benefits beyond volume restoration. This approach not only enhances the aesthetic appearance of the buttocks, but also improves skin quality through collagen production. Additionally, by reducing discomfort during sitting and improving posture-related strain, it contributes to a better quality of life for patients. The dual-action effect of immediate volume and gradual tissue regeneration makes this protocol an effective choice for both functional and cosmetic outcomes.