Complications of Buttock Augmentation: A Review of the Literature

Thursday, May 3, 2012: 4:35 PM
Lara Devgan Verdonck, MD, MPH, Division of Plastic and Reconstructive Surgery, New York Presbyterian Hospital, the University Hospital of Columbia and Cornell, New York, NY and John E. Sherman, MD, Division of Plastic Surgery, New York-Presbyterian Hospital, New York, NY


The increasing popularity of buttock augmentation procedures has led both to the refinement of surgical techniques and to the more frequent reporting of complications, sometimes in the context of illegal cosmetic surgery markets. In this article, we review the three major categories of buttock augmentation: implant-based, autologous tissue, and alloplastic filler based procedures, and analyze reported complications in each of these sub-categories.


A retrospective review of the English language literature was performed on November 25, 2011 using PubMed, the exhaustive resource of the U.S. National Library of Medicine. A host of Boolean search terms related to "buttock augmentation complications” were used as inclusion criteria. Articles published in languages other than English, and those not on the topic of buttock augmentation were excluded. Studies, including retrospective and prospective original research, case reports, and review articles were analyzed and aggregated for reported complication rates in buttock augmentation.


(1)Submuscular buttock implants have a 30-80% dehiscence rate, and 2-5% rate of seroma, infection, malposition, and exposure. Subfascial buttock implants have a 15-30% dehiscence rate, though rates of seroma are approximately 20%, and nearly 100% of patients report implant palpability. (2)Autologous fat injection is associated with a 2-3% rate of infection, hematoma, skin necrosis, and localized fat excess; rare complications include pulmonary embolus, aspiration pneumonitis, sepsis, and death. Autologous gluteal flap based buttock augmentation has a 20% rate of seroma, 10% rate of delayed wound healing, and 10% rate of fat necrosis. (3)Injection of hyaluronic acid and silicone is associated with transient sciatic neuropraxia, granuloma, infection, gel migration, fat necrosis, and rarely, pulmonary embolus and death.


As demand for buttock augmentation grows, so too grows the rate of reported complications. Rigorous patient selection, technical adherence to sound surgical principles, and more rigorous prospective data collection are needed to optimize results.