New Artistic Concepts and Treatment of the Gluteal Area in Male and Female
The Gluteal muscles are responsible for the leg movement but they play an important secondary sexual function as an erogenous area. Current gluteal treatments include: Use of implants, autologous fat transfer, excisional procedures, autologous gluteal augmentation with tissue flaps and liposuction. Implants have a high incidence of complications and results remain unnatural; and reports with fat grafting show poor outcomes and high incidence for additional procedures. Current gluteal sculpting approaches consider complex divisions of the gluteal anatomy leading in many cases to confusion and modest results. Based on the natural anatomy acknowledgement, considering the artistic point of view concerning the buttocks and the aesthetically desired outcomes, the authors present a new classification and a new method to approach the gluteal aesthetic treatment and the distinguished problem zones, using fat extraction and /or fat grafting to improve the buttocks appearance and get a more feminine shape in women and a muscular shape in men with improved long term results.
Methods/Technique: From January 2010 to September 2013 a total of 627 consecutive procedures were performed. Patient criteria included: Healthy men and women, without previous surgery on the gluteal area, ages between 16 and 60 years, Body Mass Index (BMI) <30 Kg/m2 and normal gluteal muscles anatomy. The technique requires a careful marking of the gluteal and peri-gluteal area based on the knowledge of the common fat tissue accumulation spots and the artistic anatomy. After tumescent solution infiltration, third generation ultrasonic emulsification is performed on the deep and superficial areas. Vacuum powered extraction is used by carefully following of the markings: Green areas where the fat can be freely extracted and Red areas where the extraction must be careful to avoid rude contour changes. Fat grafting was performed to improve projection and contour and furthermore long term results.
Results/Complications: Most patients were satisfied with the procedure. Minor complications included prolonged swelling and bruising. No major complications were reported. Pre-operative, 1, 3, 6 and 12-month postoperative pictures were performed in order to evaluate results. Follow up included Computerized Tomography (CT) Scan of the gluteal area testing the fat graft survival in selected cases.
Conclusion: The new gluteal area classification and technique is an easy method to apply artistic anatomy to reproduce an appealing, feminine smooth contour in female and an athletic on in male. A step-by-step approach makes the sculpting easy in every region, as the results are reproducible in every case. The use of third generation ultrasound emulsification with the adequate anatomic and artistic knowledge, improve the final outcomes, reduces the postoperative recovery time and the overall satisfaction with the procedure.