Major complications may arise from gluteal augmentation using fat grafting if care is not taken to avoid gluteal vessel damage, according to a review of case reports and studies published in Plastic and Reconstructive Surgery.
To evaluate the fat grafting technique for gluteal augmentation, Alexandra Condé-Green, MD, and colleagues conducted a systematic review and meta-analysis of 17 case series and two retrospective studies. The data included 4,105 patients with a mean age of 33.63 ± 5.94 years (range, 16 to 72 years). Mean BMI was 24.3 ± 3.72 kg/m2 (range, 17 to 32 kg/m2). A majority of the patients were female (98.2%).
The researchers reviewed the procedural steps of the cases, particularly the preoperative period, fat harvesting, fat processing and injection methods, postoperative period, methods of evaluation, and any reported complications. Some cases did not include all steps of the procedure.
Results showed a minor complication rate of 6.7%. The most common complications were seroma (2.4%), erythema (1.3%), pain (0.76%), contour irregularities (0.64%), and fat necrosis (0.56%). Major complications occurred at a rate of 0.32%, and included fat embolism (0.12%), anemia (0.12%), symptomatic hypovolemia (0.05%), and septic shock (0.02%).
Not included in these calculations were 22 reported mortalities consequent to fat embolism.
While the authors were unable to obtain a significant result comparing injection site to major complications, the evidence found suggests that subcutaneous and superficial muscular injections can lead to fewer complications than injections into the intramuscular plane.
“Fatalities reported recently in the literature have made our peers more conscious of reporting their cases through yearly questionnaires and surveys from medical specialty societies. Accurate analysis and systemization of the steps of the procedure provide the foundation for precise operative planning and great results,” the authors wrote in their conclusion. “This article ideally will orient plastic surgeons on their choice of techniques and encourage them to report all future cases in the fat grafting registry to further optimize outcomes and limit complications.” – by Talitha Bennett
Disclosure: The authors report no relevant financial disclosures.