Gluteal Augmentation With Fat: Retrospective Safety Study and Literature Review.

BACKGROUND: Use of gluteal augmentation with fat increased by 3267% from 2002 to 2015, and the rate of death is highest compared with other aesthetic procedures: 1 in 3448 patients dies, compared with 1 in 55,000.

OBJECTIVES: To retrospectively investigate patients who underwent this procedure at Oslo Plastic Surgery Clinic, to review international data to determine factors causing mortality, and to provide guidelines for safety.

METHODS: Patient data were searched for reason for the procedure, assessment of patients, techniques performed, and safety measures used. In 60 cases, a vibration machine was used for fat harvesting. Review of the international literature, with special emphasis on fatal complications, was performed on Medline, Google Scholar, and PubMed.

RESULTS: Mean patient age was 32 years. Mean amount of grafted fat was 422 mL (range, 210-850 mL). Sedation, local and tumescent anesthesia were used in all patients, with mobilization directly after surgery. Mean operation time was 89 minutes. Eighteen patients required a second surgery. Minor complications occurred in 8 patients. Average follow-up was 8 months. Ninety percent of patients were satisfied. Review of international literature showed that the main reason for death in 2015 was fat lung embolism related to muscular and submuscular grafting.

CONCLUSIONS: Gluteal augmentation with fat is one of the most popular procedures, with an internationally high mortality rate. Patient safety is a priority, and preventive measures should improve safety because appropriate patient selection, avoiding muscular and submuscular grafting, avoiding infragluteal incision, moderate grafted volume, and direct postoperative mobilization are essential.