A Single Surgeon's Experience with Large-Volume Gluteal Augmentation Utilizing Autologous Fat Grafting

Goals/Purpose:   To analyze a group of patients who underwent large-volume gluteal augmentation with autologous fat and review their post-operative results and complications. 

Methods/Technique:   A retrospective chart review was performed on patients who underwent suction assisted liposuction and autologous fat grafting to the buttocks between 2005 and 2011.  Volumes of fat injected into each buttock were recorded as well as patient BMI, operative time, and post-operative complications.  Pre- and post-operative photos were taken to assess the aesthetic outcome.

Results/Complications:  A total of 25 patients underwent 27 suction-assisted liposuction and large-volume gluteal augmentation procedures.  24 of these cases were performed in a AAAASF-certified outpatient office operating room.  A predominant number of patients were female (24:1 female:male) and the average age was 32 y/o.  The average volume of aspirate from liposuction was 4,511mL.  The average volume of fat injected into each buttock was 933mL.  The most common post-operative complaint was bruising and/or swelling (52%).  Significant complications occurred in 3 patients.  Two patients had post-operative wound infections in the gluteal region at the fat injection site, one of which required incision and drainage.  One patient, whose case took place in the hospital, suffered a pulmonary embolus three weeks post-operatively and died. 

Conclusion:   Large-volume gluteal augmentation is feasible and can be performed safely, often in a certified outpatient surgical suite.  Patients must be thoroughly counseled on what to expect post-operatively so that they are not surprised by the amount of swelling and discomfort they may have in the gluteal region. Aesthetic outcomes are variable and depend predominantly upon the amount of fat graft take.  Each patient must be assessed for possible co-morbidities and appropriate DVT prophylaxis protocols should be followed for patients requiring surgery in a hospital setting. 

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