Secondary Gluteal Augmentation: Surgical Technique and Outcomes

As interest in posterior body contour has increased, there has been an upward trend in the number of gluteal augmentations performed. However, there has also been a proportional increase in postoperative complications and subsequent revision operations. Nevertheless, there are currently few studies or reports on secondary gluteal augmentation. The purpose of the present study was to identify methods to treat and prevent complications resulting from gluteal augmentation. In this study, the authors review 18 cases of secondary gluteal augmentation. New intramuscular pockets were dissected more deeply than were previous pockets. Capsulotomy or capsulectomy was applied to the deep capsules of the previous pockets to sufficiently expand the new pockets and soft tissue to cover the implants. After triple-antibiotic irrigation, implants were inserted using the "no-touch technique." Next, "hybrid gluteal augmentation" was performed by grafting autologous fat into the subcutaneous fat layer. Among 18 cases of secondary gluteal augmentation performed, nine cases were performed by means of hybrid gluteal augmentation and seven cases were implant-only augmentations. Postoperative complications occurred in two cases. One case involved the hybrid technique (remaining rippling), and the other case involved implant-only augmentation (implant palpability). However, there was no need for surgical correction. Secondary gluteal augmentation can be successfully performed using the hybrid technique if the gluteus maximus is accurately dissected, the capsules are appropriately managed, and infection is rigidly controlled.