Augmented Safety Profile of Ultrasound-guided Gluteal Fat Transfer: Retrospective Study With 1815 Patients.

BACKGROUND: Gluteal augmentation with autologous fat transfer is among the fastest growing aesthetic surgical procedures worldwide over the past decade. However, this procedure can be associated with high mortality from fatal pulmonary fat embolism events and has received much attention in the media. It has been well established that the injection of fat in the intramuscular space correlates with this complication. Ultrasound guided fat grafting allows visualization of the transfer in the subcutaneous space, avoiding intramuscular injection.

OBJECTIVES: The aim of the current study was to assess the safety and efficacy for gluteal fat grafting utilizing ultrasound (US) guided cannulation.

METHODS: A retrospective chart review of all patients undergoing ultrasound guided gluteal fat grafting at our center was performed from 2019 to 2022. All cases were performed by board certified and board eligible plastic surgeons under general anesthesia in ASA class I or II patients. Fat was only transferred to the subcutaneous plane when over the gluteal muscle. Patients underwent postoperative follow-up from a minimum of 3 months up to 2 years. Results were analyzed using standard statistical tests.

RESULTS: There were 1,815 female patients during the study period with a median age of 34 years old. Controlled medical comorbidities were present in 14% with the most frequent being hypothyroidism (0.7%), polycystic ovarian syndrome (0.7%), anxiety (0.6%), and asthma (0.6%). Postoperative complications occurred in 4% of the total cohort with the most common being seroma (1.2%), local skin ischemia (1.2%), and surgical site infection (0.8%; Table 1). There was 0% macroscopic fat emboli complications or mortalities.

CONCLUSIONS: These data suggest that direct visualization of anatomical plane injection using US guidance is associated with a low rate of complications. US-guidance is an efficacious adjunct to gluteal fat grafting and associated with an improved safety profile that should be considered by every surgeon performing gluteal fat grafting.