Buttocks Fat Grafting: 14 Years of Evolution and Experience

Background: Fat infiltration for gluteal contour improvement is a procedure that is gaining more advocates. This has caused the application technique and the amount of fat infiltrated to change over time. The authors present their buttocks fat grafting technique evolution that occurred over a 14-year period. Methods: From April of 1995 to March of 2009, 789 patients underwent liposuction and buttocks fat grafting. Patients were divided into three stages according to chronologic evolution and amount of fat infiltrated. Results: During the first period (April of 1995 to January of 2004), 120 to 320 cc of fat was infiltrated in the upper gluteal area. During the second period (February of 2004 to February of 2006), 210 to 460 cc of fat was infiltrated in the upper and lower gluteal area. In the third period (March of 2006 to March of 2009), 220 to 1160 cc of fat was infiltrated in the aforementioned areas and in the trochanteric and subgluteal areas. Complications such as fat necrosis, gluteal erythema, infection, and fat embolism syndrome were more frequent and serious in the first stage, despite the authors having infiltrated smaller volumes. Conclusions: Increasing the volume of fat infiltration in the buttocks has resulted in better contour results in the whole area, and distribution of that larger volume in more extensive areas and in different layers has decreased the index and number of complications. Therefore, to obtain better aesthetic results, it is necessary to keep in mind that these larger amounts must be distributed in larger areas and layers to decrease postsurgical morbidity. (Plast. Reconstr. Surg. 128: 545, 2011.)