Deep Subcutaneous Gluteal Fat Compartments: Anatomy and Clinical Implications
Advances in gluteal fat grafting have improved our understanding of the regional anatomy and technical nuances to diminish risk. To date, there are no anatomical studies identifying presence or absence of buttock fat compartments. The authors performed a cadaveric study to identify and characterize the deep subcutaneous gluteal fat compartments to further our understanding of the nuanced differences between the deep subcutaneous and the superficial subcutaneous fat layers.
Methods/Technique:
A cadaveric study was performed to identify the fat compartments. Iliac artery and vein latex injection prepared 4 fresh (N = 8 hemibuttock) hydrated cadaver dissections. Preliminary work identified the likely position of deep gluteal fat compartments. The cannula was positioned under ultrasound guidance in between the superficial and deep gluteal. Cadaveric buttocks were infiltrated using the static (S.I.M.E) technique with dyed human fat, dyed apple sauce, and dyed saline to identify the gluteal deep subcutaneous fat compartments
Results/Complications:
Dissection identified and characterized 7 discrete deep gluteal fat compartments (Figure 1). These include 3 medial fat compartments (superior, middle, and inferior); a central fat compartment; and 3 lateral (superior, middle, and inferior) deep fat compartments.
Conclusion:
We present our findings of 7 deep gluteal fat compartments that have distinct boundaries and maintain injected contents separate from each other above the gluteal muscle fascia. These compartments can be selectively expanded for buttock augmentation. Knowledge of these compartments enables surgeons to perform gluteal augmentation using static infiltration, under ultrasound guidance in the deep subcutaneous fat layer using autologous fat, while optimizing aesthetic considerations.