Minimally invasive video-assisted submuscular gluteal augmentation with implants. An innovative technique

Gluteal augmentation is one of the most requested cosmetic procedures. This article describes the surgical technique and early results of an innovative minimally invasive video-assisted submuscular gluteal augmentation with implants. The authors aimed to perform a technique that would reduce complications and surgical time. Fourteen healthy women without obesity or relevant pathologic background who requested gluteal augmentation with implants as a single procedure were included. The procedure was performed through bilateral parasacral 5-cm incisions at cutaneous and subcutaneous planes as far as the gluteus maximus muscle fascia. Through a 1-cm incision in the fascia and muscle, the index finger was introduced under the gluteus maximus, and a submuscular space was created by blunt dissection toward the greater trochanter to avoid a sciatic nerve injury, until the middle gluteus level was reached. Next, the balloon shaft of a Herloon trocar was introduced in the dissected space. Balloon dilatation in this submuscular space was performed as required. The balloon shaft was replaced by the trocar, through which a 30-degree 10-mm laparoscope was introduced. Submuscular pocket anatomic structures were observed, and while the laparoscope was being retrieved, hemostasis was verified. The submuscular plane collapsed, leaving the pocket for the implant to be placed. There were no intraoperative complications. The only postoperative complication was a self-limited seroma in one patient (7.1%). This innovative technique was simple to perform and safe, allowing direct visualization and hemostasis, with a short surgical time, low complication rate, and high degree of satisfaction.