Tridimensional Combined Gluteoplasty: Liposuction, Buttock Implants, and Fat Transfer.

Background: There are different procedures for gluteal augmentation. The authors describe their gluteal augmentation technique, which combines buttock implant placement, frame liposuction, and lipoinjection in the lateral third of the buttock and a plane superficial to the gluteal implant.
Methods: Patients of both sexes who underwent aesthetic gluteal augmentation with a volume deficit of the lateral third and limited fat available for grafting were included. Liposuction was performed on the periphery of the gluteus, silicone implants were placed, and lipoinjection was performed in different areas.
Results: Fifty-two patients were included between October of 2007 and December of 2018. The average age of the patients was 33.3 years (range, 23 to 49 years); 42 women and 11 male-to-female transgender patients were included. The implants used consisted of anatomical cohesive silicone, with the most commonly used size being 300 cc (range, 200 to 500 cc). The average volume of infiltrated fat in each hip and buttock was 243.1 cc (range, 100 to 370 cc) and 141.6 cc (range, 50 to 200 cc), respectively. Partial wound dehiscence was reported in six patients (11.5 percent). In one patient who had been treated with biopolymers, the implant became exposed. All patients reported that they were highly satisfied with the results of the procedure.
Conclusions: The combination of liposuction, buttock implant placement, and lipoinjection of the buttocks and hips is a safe procedure with a low complication rate and high level of satisfaction. This procedure is recommended in patients who require augmentation of the central and lateral portions of the buttock with insufficient fat tissue for lipoinjection.
Clinical Question/level of Evidence: Therapeutic, IV.