Subcutaneous Only Brazilian Butt Lift: Do We Need to Choose between Safety and Optimal Outcomes?

Background: In recent years, gluteal fat grafting has exhibited some of the most significant growth among all surgical procedures. However, as the popularity and media attention of gluteal fat augmentation continue to rise, reports of fatalities have raised concerns regarding the safety of this procedure. These fatalities have largely been attributed to fat embolism, which can occur following intramuscular fat injection due to the large caliber of the gluteal vessels, for this reason subcutaneous fat augmentation has been a preference of many. However, there is a lack of prospective studies offering quantitative analysis of gluteal subcutaneous-only fat grafting. 

Objective: We therefore investigated the long-term outcomes of subcutaneous gluteal fat grafting using the ultrasonography. 

Materials and Methods: Fifty consecutive patients were evaluated in this prospective clinical study. All patients underwent gluteal fat augmentation in the subcutaneous plane only, and were submitted to ultrasound analysis of adipose tissue thickness pre-operatively, immediately post-operatively, and 12 months post-operatively.

Results: Immediate post-operative measurements revealed an average increase in gluteal subcutaneous layer thickness of 56.51% (39.5% to 108.6%) (p<0,0001). At 12 months post-operatively, the gluteal adipose tissue thickness decreased by, an average of 18.16% (6.8% to 24.8%) (p<0,0001). Therefore, we observed a volume retention of 81.84% of the injected volume (p<0,0001).   

Conclusion: Subcutaneous only fat injection shows to be as effective as intramuscular fat injection in regards to long-term fat retention in the gluteal region, with satisfactory outcomes and minimal absorption at 12 months post-operatively. 

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