Objectives: 1/Know the specific risks of gluteal augmentation by lipofilling
2/Know buttocks anatomy
3/Know how to avoid complications
4/Know how to obtained satisfaying results
Introduction: Gluteal augmentation by autologous fat injection is an intervention that has shown remarkable development in recent years. Severe and even fatal complications have been described and published. Mortality is about 1 case per 3500; making it one of the most risky cosmetic surgery interventions. This presentation describes the main published complications and proposes safe techniques to avoid them.
Materials / method: An analysis of complications and a review of the literature are proposed. The main techniques of liposuction, fat purification and gluteal lipofilling are presented and their specific risks are explained. Knowledge of the anatomical helps to understand the mechanism of complications and to avoid them. Clinical cases illustrate the proposed techniques. The most serious complications described are: fatty embolism by injection into an intramuscular vein and injury of the external iliac artery by perforation of the oval foramen. These complications have led to published cases of death.
Results: The safest techniques are: retrograde reinjection without excessive pressure which avoids bolus, subcutaneous and pre-muscular injection. Injection into the infra-gluteal fold should be careful (risk of intramuscular injection and fatty embolism). A 4 mm diameter blunt cannula is recommended. Techniques are illustrated by photos or short videos.
Obtaining optimal and natural results are explained and illustrated by clinical cases.
Conclusion: Buttock enhancement by lipofilling is a procedure that must be secured by safe and effective techniques, as severe complications such as fat embolism and death have been published and are still too common.
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