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Cao S, Zhu M, Mu L. Aesthetic Preferences for Beautiful Buttocks in Female: A Study on the Chinese Population. Aesthetic Plast Surg 2024:10.1007/s00266-024-04158-z. [PMID: 38867135 DOI: 10.1007/s00266-024-04158-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 05/21/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Many theories referring to the conception of a beautiful buttock have been put forward, but little has been proved, especially in the Asian group. OBJECTIVE To analyse the aesthetic preference for aesthetically pleasing characteristics in the Chinese population. METHODS In the survey, we computerized the buttock image of a Chinese female through the Photoshop software (Adobe Photoshop CS5; Adobe Systems, Inc., San Jose, Calif), and buttocks with and without four features were attained. An online questionnaire was made to rank the most aesthetic buttocks. The data for the various demographic groups were compared using the Pearson Chi-square test. A value of p < 0.05 was used for statistical significance. RESULTS In total, 2348 responses were collected. Over half of the respondents prefer without supragluteal fossettes (56.9%), V-shaped crease (60.4%) and lateral depression (90.1%). The most attractive infragluteal fold option was short type (34.9%), followed by median infragluteal fold (32.7%) and long infragluteal fold (32.4%). Supragluteal fossettes, median or long infragluteal fold and V-shaped crease were more preferred among young people. CONCLUSION Supragluteal fossettes, V-shaped crease and lateral depressions were not preferred in over half of the respondents. The aesthetic preference was influenced by the gender and age. The plastic surgeons should consider the variabilities above when establishing aesthetic aim for beautiful buttocks in gluteoplasty. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Saisai Cao
- Department of Plastic Surgery, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Mengyi Zhu
- Department of Dermatology, Peking University People's Hospital, Beijing, 100044, People's Republic of China
| | - Lan Mu
- Department of Plastic Surgery, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570311, Hainan, People's Republic of China.
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Robles MF. Safety and Efficacy Study of the Application of Redensified Cross-Linked Hyaluronic Acid for Filling Gluteal Volume and Cellulite Depressions. Aesthetic Plast Surg 2024; 48:1181-1192. [PMID: 38110737 DOI: 10.1007/s00266-023-03739-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/23/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE To test the efficacy and safety of cross-linked hyaluronic acid application for filling buttocks and cellulite depressions and its permanence over time. METHODS For a period of a year, 25 patients were applied redensified cross-linked hyaluronic acid in the gluteal area. These patients were all 23-45-year-old women with little fat to be removed. The product used is composed of hyaluronic acid with high cross-linking and redensification which allows it to maintain shape and durability over time. All patients underwent tumescent anesthesia with neuroleptic sedation in the operating room. The procedure was regarded as minimal (container, sterile gloves, and surgical field). The amount applied for gluteal augmentation varied from 50 to 100 ml per application area and according to the patient's needs. For the filling of cellulite depressions, the application was up to 3 cc per depression and up to a total of 40 ml. The maximum volume used per patient in the buttocks did not exceed 200 ml, and it did not exceed 40 ml in cellulite depressions. RESULTS A group of patients was treated in the upper and middle third of the buttocks in superficial and deep subcutaneous layers and in cellulite depressions. Very good results have been obtained without any major complications. CONCLUSIONS The use of redensified cross-linked hyaluronic acid of non-animal origin is therefore an option for gluteal augmentation and cellulite depressions. Although the product degrades over time, after 12 months, 44% of treated patients rated their results as highly or very much improved, 36% as improved, 16% rated the improvement as poor, and one patient (4%) was dissatisfied. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Marcelo F Robles
- Plastic Surgery & Laser Department, Clínica Robles, 2530 Virrey del Pino St, C1426EGT, Autonomous City of Buenos Aires, Buenos Aires, Argentina.
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Teotia SS, Henn D, Lakatta A, Steppe C, Haddock NT. Breast Reconstruction With Simultaneous Bilateral Lumbar Artery Perforator Flaps Improves Waistline Definition and Buttock Projection. Aesthet Surg J 2024; 44:165-171. [PMID: 37706323 DOI: 10.1093/asj/sjad305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND The lumbar artery perforator (LAP) flap is a valuable secondary option for autologous breast reconstruction when abdominal donor sites are not available. OBJECTIVES The aim of this study was to determine how the LAP donor site affects waistline and gluteal proportions, and whether LAP flaps may produce potential secondary benefits concerning donor site aesthetics. METHODS A retrospective review of 50 patients who underwent bilateral breast reconstruction with LAP flaps (100 flaps) between 2018 and 2022 was performed. Patient characteristics and postoperative complications were recorded. Pre- and postoperative standardized frontal and lateral patient photographs were analyzed to identify postoperative changes in waist-to-hip ratio (WHR) to assess waistline definition and buttock projection. The patients' individual perception of postoperative aesthetic changes to their waistline and buttocks was determined by an electronic survey. RESULTS The patients had a mean age of 51 years (range, 24-63 years) and a mean BMI of 26.9 kg/m2 (range, 19.3-37.4 kg/m2). Postoperative donor site complications included seroma (n = 10), wound dehiscence (n = 5), hematoma (n = 4), and wound infection (n = 2). Flap loss rate was 2%. After reconstruction, patients were found to have a more defined waistline, indicated by a significantly decreased WHR on frontal images (mean [standard error of the mean], 0.85 [0.05] vs 0.80 [0.05], P < .005) and a more projected buttocks indicated by a significant reduction in WHR on lateral images (0.92 [0.07] vs 0.87 [0.07], P < .0001). Among the patients who responded to the survey, 73% indicated that their waistline had aesthetically improved, 6.7% felt it had not changed, and 20% felt that it had worsened. An aesthetic improvement of the buttocks was reported by 53%, 40% felt their buttocks had not changed, and 6.7% felt their buttocks appearance had worsened. CONCLUSIONS Bilateral LAP flap breast reconstruction leads to improved waistline definition and buttock projection, bringing patients closer to ideal aesthetic proportions. This reconstructive approach is ideal for patients who are not candidates for abdominal free flaps, but who demonstrate excess flank tissue and seek a more defined waistline and projected buttocks. LEVEL OF EVIDENCE: 4
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Teodoro MDS, Di Sessa D, Barros JHDFA, de Vasconcelos RCF, Miot HA. Buttocks Beautification 3D with Calcium Hydroxylapatite (Radiesse TM): An Individualized Approach to Diagnosing and Treating Contour, Sagging, and Cellulite of the Buttocks in Seven Cases. Clin Cosmet Investig Dermatol 2023; 16:3039-3051. [PMID: 37901152 PMCID: PMC10612506 DOI: 10.2147/ccid.s431391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023]
Abstract
Background The demand for body procedures is increasing, and buttocks beautification is one of the most sought-after procedures in dermatological and plastic surgery clinics. Several aspects affect the beauty of this area, including sagging, cellulite, contour irregularity, and volume reduction. This makes treatment of the area more challenging. Calcium hydroxylapatite (CaHA), which may be injected into the buttocks, stimulates local neocollagenesis, provides volume replacement, increases the strength and elasticity of the dermis, and thickens the underlying superficial fascia. However, no protocol for buttocks beautification tailors the dilution and deep application of CaHA filler simultaneously according to clinical assessments and personal priorities regarding contour, sagging, and cellulite. Purpose To report the results of a minimally invasive protocol using different dilutions of CaHA (Buttocks Beautification 3D) in the buttocks with application in different planes. The treatment was performed according to a previous individualized evaluation to improve the area aesthetically. Patients and methods Six women and one man were submitted to the protocol. An assessment was performed to determine the shape, sagging, cellulite (in women), and patients' preferences for buttocks beautification. The dilution, volume, depth, and injection technique for CaHA were based on these assessments. The results of the treatment were then assessed using standardized photographs and patient satisfaction. Results We reported favorable results in six women and one man with different grades of sagging, female cellulite, and shapes of the gluteal region who were treated with CaHA injections according to a tailored protocol. All participants reported high satisfaction with the procedure. Conclusion Highly satisfactory results were achieved in seven adult patients who were assessed and treated for the buttocks with CaHA using an individualized protocol. Prospective studies should be performed to corroborate our findings and optimize the use of Buttocks Beautification 3D as a reliable modality of treatment for this body area.
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Hoyos Ariza AE, Perez Pachon M. Combining Gluteal Shaping with High-Definition Liposuction: New Concepts and Techniques. Clin Plast Surg 2023; 50:541-552. [PMID: 37704322 DOI: 10.1016/j.cps.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Gluteal contouring has been subject to numerous publications in aesthetic plastic surgery. Not only the female but also the male features that govern such procedures have been thoroughly described by different authors. In this article, we will provide the reader with an updated account of how gluteal contouring blends with High Definition Liposculpture (HDL). We discuss the most current techniques for buttocks reshaping through a holistic approach of new anatomical and artistic concepts. We will dive into new techniques to perform multiplanar and 4-dimensional Fat Grafting and equalization of the buttocks and surrounding areas, which we believe might help plastic surgeons to improve the quality of their patient outcomes. In effect, a proper understanding of the anatomical structures and its variations among different gender and ethnicities, will both help the surgeon to individualize the procedure based on patient preferences.
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César Durán Vega H. Buttock and Full Body Contouring Harmony. Clin Plast Surg 2023; 50:573-585. [PMID: 37704325 DOI: 10.1016/j.cps.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
The concept of the gluteal framework has significantly enhanced our understanding of the gluteal anatomy. The buttock does not constitute a bulging area in the human body. To be attractive, it must harmonize with all elements of the human body around it. Nevertheless, the changes in patient desires and demands, in addition to innovations in surgical technique open a field of opportunity to achieve more beautiful and natural results. In this work, the main updates in the management of body contouring are condensed, including new safe and aesthetic fat infilration techniques.
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Affiliation(s)
- Héctor César Durán Vega
- ASAPS, ASPS, AMCPER, FILACP, Centro Medico de Las Americas CMA, Consultorio#317 Calle 54 #365 x 33-a y Av. perez Ponce Colonia Centro, Merida, Yucatán CP 97000, Mexico; Hospital Eme Red hospitalaria, Calle 33 Número 496, Consultorio 229, Entre 56 y 56 A, Centro, 97000 Mérida, Yucatán, México.
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Oregi P, Khatib M, Cavale N, Rahman SM. Comparing the safety profiles of implants and autologous fat grafting in gluteal augmentation: A systematic review. J Plast Reconstr Aesthet Surg 2023; 83:463-474. [PMID: 37320936 DOI: 10.1016/j.bjps.2023.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 06/17/2023]
Abstract
Gluteal augmentation has become a popular esthetic procedure since its inception. The main methods are augmentation using implants or autologous fat grafting, which is the harvesting and grafting of patients' own fat tissue. The last review comparing the safety of these methods was written 7 years ago, which warrants the writing of a new one. PubMed, Cochrane, and Medline were searched for studies focusing on the methods of gluteal augmentation listed previously. Five search terms were used and 15 studies fulfilled the criteria. The data were cataloged according to the method described and outcomes compared. Seven articles focused on gluteal implants and another seven assessed autologous fat grafting, whereas one detailed both. The most common complications in 524 implant procedures were wound dehiscence (9.16%), excessive implant palpability (5.92%), and seroma (3.82%), with an overall complication rate of 25%. The most common complications in 1788 gluteal fat augmentation procedures were seroma (6.9%), infection (3.0%), and transient sciatic paresthesia (1.0%), with an overall complication rate of 13%. Several articles listed satisfaction figures, but these were not assessed because this article was not powered to assess this outcome. Overall, gluteal augmentation using autologous fat grafting leads to fewer postoperative complications than implants and allows greater contouring of the buttocks and the surrounding areas. However, it can also be a far more dangerous procedure if certain recommendations are not followed.
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Affiliation(s)
- Paul Oregi
- GKT School of Medical Education, King's College London, United Kingdom.
| | - Manaf Khatib
- Lister Hospital - East and North Hertfordshire NHS Trust, United Kingdom
| | - Naveen Cavale
- King's College Hospital and Guy's & St.Thomas' Hospitals, United Kingdom
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8
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Pazmiño P, Garcia O. Brazilian Butt Lift-Associated Mortality: The South Florida Experience. Aesthet Surg J 2023; 43:162-178. [PMID: 35959568 PMCID: PMC9896146 DOI: 10.1093/asj/sjac224] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Brazilian butt lift (BBL) surgery has been the fastest growing aesthetic surgical procedure over the past decade. By 2017, the risk of death from pulmonary fat (PFE) was identified, earning the BBL the highest mortality rate of any aesthetic surgical procedure. South Florida carries the highest BBL mortality by far in the nation. OBJECTIVES The purpose of this study was to explore the factors involved in making South Florida an outlier in terms of BBL mortality. METHODS The anatomic findings of the gluteal dissections from 11 post-BBL surgery autopsies (22 hemibuttocks) were assessed for commonalities. The public records of patients who died from BBL-related fat emboli were examined to determine commonalities. RESULTS All BBL PFE cases had fat grafts injected into the gluteal musculature in multiple different levels. Another commonality involved the location where the surgery took place, with the great majority of patients (92%) undergoing surgery at high-volume, budget clinics located in South Florida. Short surgical times of approximately 90 minutes appeared to be the norm for these cases. CONCLUSIONS South Florida has experienced 25 BBL-related fat emboli deaths between 2010 and 2022; however, 14 of these occurred after publication of the Aesthetic Surgery Education and Research Foundation's 2018 guidelines and the 2019 Florida Board of Medicine's BBL "subcutaneous-only" rule. The working environment at the clinics, and the short surgical times for these cases, may be the most important contributors to the BBL mortality in South Florida.
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Affiliation(s)
- Pat Pazmiño
- Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Onelio Garcia
- Division of Plastic and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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9
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Dai Y, Chen Y, Hu Y, Zhang L. Current Knowledge and Future Perspectives of Buttock Augmentation: A Bibliometric Analysis from 1999 to 2021. Aesthetic Plast Surg 2022; 47:1091-1103. [DOI: 10.1007/s00266-022-03140-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/02/2022] [Indexed: 11/01/2022]
Abstract
Abstract
Background
The number of patients undergoing buttock augmentation surgery has increased rapidly with time, changes in people’s aesthetic perceptions, and the increased concern for their shape. The number of publications regarding buttock augmentation has also continued to increase. However, no bibliometric analysis concerning buttock augmentation has been published. This study aimed to provide a qualitative and quantitative evaluation of buttock augmentation-related publications using bibliometric analysis and information on research hotspots and trends in this field.
Methods
The buttock augmentation-related publications published between 1999 and 2021 were extracted from the Web of Science Core Collection (WOSCC) database for analysis. The data were analysed and presented using VOSviewer and Microsoft Excel.
Results
There were 492 articles in the (WOSCC) database, including 442 (89.84%) original research articles, with the number of publications increasing each year. The USA (208 publications, 42.28%) is the leading contributor in this field and has a high academic reputation. The most productive and co-cited journal on this subject is “Plastic and Reconstructive Surgery” (66 publications, 13.41%, 2200 citations). Cardenas-Camarena (9 publications, 1.83%, 158 citations) was the most published and co-cited author. Research hotspots include the following three topics: experience and technology of buttock augmentation, autologous fat buttock augmentation and its safety, and buttock aesthetics study. There will be more publications in the future, and research trends will focus on silicone implants, safety, satisfaction, and autologous fat grafting.
Conclusion
Buttock augmentation research is rapidly evolving, and this study provides a perspective view of buttock augmentation research in Plastic and Reconstructive Surgery.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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10
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Asokan A, Sudheendran MK. Gender Affirming Body Contouring and Physical Transformation in Transgender Individuals. Indian J Plast Surg 2022; 55:179-187. [PMID: 36017408 PMCID: PMC9398519 DOI: 10.1055/s-0042-1749099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There is a subset of transgender individuals, who after having undergone gender affirming surgeries want body contouring so that the overall body shape is congruent to the body image. Hormonal therapy can bring about a considerable change in the physical transformation. However, there is an increase in requests for specific body contouring procedures because of increased awareness in the society. There are significant differences between the skeletal as well as soft tissue characteristics of male and female body. Body contouring in transgender individuals can be achieved by altering the skeletal structure or the overlying soft tissues or combining both. In this article, we discuss body contouring as an adjunct to gender affirming surgeries, in both male to female and female to male transgender individuals.
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Affiliation(s)
- Arjun Asokan
- Department of Plastic Surgery, Renai Medicity, Cochin, Kerala, India
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11
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Safety and efficacy of gluteal contouring based on stromal enriched lipograft in 194 patients. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-021-01912-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Objectifying High-Definition Brazilian Buttock Lift Results Using the Buttock Assessment Tool. Plast Reconstr Surg 2021; 148:727e-734e. [PMID: 34705775 DOI: 10.1097/prs.0000000000008479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The buttock is an essential feature of the female silhouette. This has led to the rise of the Brazilian butt lift as one of the most popular plastic surgery procedures in recent years. Despite this popularity, there remains no prevailing standard for the ideal buttock size and shape. In fact, a wide range of preferred sizes and shapes among the authors' patients has been observed. The authors hypothesized that age, religious affinity, and ethnic differences may demonstrate different buttock size and shape preferences. METHODS The authors designed the buttock assessment tool, which utilizes digitally altered buttock sizes and shapes to determine desired buttock shape (upper, middle, and lower pole maximum fullness) and buttock size (waist-to-hip width ratio) for both the posteroanterior and lateral views. A survey of 422 patients was completed, evaluating variation of desired buttock size and shape based on patient age, cultural, and ethnic differences. RESULTS There were significant differences in buttock size and buttock shape based on age, ethnicity, and religion. Hispanics and African Americans were twice as likely as Caucasians to request lower pole fullness in the posteroanterior view. Older respondents preferred a smaller buttock in both views. African Americans preferred a larger buttock compared to Caucasians in both views. Hispanics preferred a larger buttock in only the lateral view. Muslim respondents preferred a smaller buttock in the posteroanterior view. CONCLUSION The Brazilian buttock assessment tool has become critical to understanding and delivering prospective Brazilian butt lift patients' goals by objectifying buttock size and shapes.
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Sisti A, Aryan N, Sadeghi P. What is Beauty? Aesthetic Plast Surg 2021; 45:2163-2176. [PMID: 33987698 DOI: 10.1007/s00266-021-02288-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/01/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE In the current study, the authors attempt to thoroughly investigate the concept of beauty from different perspectives in different historical periods and offer their personal thoughts about it. METHODS The authors performed a comprehensive and across-the-board literature review about 'beauty', including beauty from a philosophical perspective, beauty perception by human mind, beauty from a biopsychological perspective, beauty of the face, body and breast, models of beauty and beauty in cosmetic surgery. RESULTS From Plato to modern neuro-psychological studies, the concept of beauty has always been a theme for adamant debates and passionate thoughts. Different aspects of beauty, from intellectual to pure physical, have received a tremendous amount of attention. The true definition of the concept of beauty is still ambiguous, and there is not a unanimous explanation for it. It seems that the definition of beauty differs in every individual's mind and over the history of humankind. CONCLUSION Although beauty is a very important concept and the seek for achieving it is a very natural behavior, one must remember that the importance of beauty should not overshadow the fact that every human being is made up of similar internal organs. We strongly encourage the reader to look beyond the hedge, to be aware that each of us is made up of internal organs, beyond the external appearance. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.
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Hernández JC, Gomez F, Stadheim J, Perez M, Bekele B, Yu K, Henning T. Hourglass Body Shape Ideal Scale and disordered eating. Body Image 2021; 38:85-94. [PMID: 33839648 DOI: 10.1016/j.bodyim.2021.03.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/20/2021] [Accepted: 03/20/2021] [Indexed: 11/18/2022]
Abstract
Disordered eating research has long considered the negative consequences of internalizing sociocultural appearance ideals (e.g., thin ideal, muscular ideal). However, the implications of internalizing a curvy or "hourglass" body shape remains unclear. The Hourglass Body Shape Ideal Scale (HBSIS) is a new self-report questionnaire that was developed and evaluated to appropriately measure the extent women subscribe to an hourglass body shape ideal. The measure was administered to a community and undergraduate sample of women via two separate online studies. Study 1 (N = 916) provided support for the factor structure as well as the convergent and discriminant validity of the HBSIS. The HBSIS was correlated with measures of appearance orientation, overweight preoccupation, and disordered eating. HBSIS was associated with disordered eating even after controlling for age, BMI, thin ideal and muscular ideal internalization. Further, higher HBSIS scores were associated with increased likelihood of having clinical levels of disordered eating symptoms. There were no racial and ethnic group differences on HBSIS. Study 2 (N = 195) replicated the factor structure of Study 1, in addition to its convergent and discriminant validity. The HBSIS allows for more precise examination of appearance-ideal internalization, capturing a unique construct understudied within eating pathology literature.
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Affiliation(s)
| | - F Gomez
- Arizona State University, United States
| | | | - M Perez
- Arizona State University, United States.
| | - B Bekele
- Arizona State University, United States
| | - K Yu
- Arizona State University, United States
| | - T Henning
- Arizona State University, United States
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O’Neill RC, Hanson SE, Reece E, Winocour S. Safety Considerations of Fat Grafting in Buttock Augmentation. Aesthet Surg J 2021; 41:S25-S30. [PMID: 34002766 DOI: 10.1093/asj/sjab092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Autologous fat grafting for buttock augmentation is one of the fastest growing plastic surgery procedures, but has also received significant publicity for the relatively high mortality rate secondary to fat emboli. The literature has grown exponentially in the past 5 years on this subject, helping to clarify our knowledge and providing recommendations to minimize risks, including avoiding intramuscular injections, placing the patient in the jackknife position, and utilizing larger-bore cannulas. Since the application of these recommendations, the rate of pulmonary fat embolism has decreased from 0.097% to 0.04%, with a current mortality of 1 in 14,921, making it statistically safer than abdominoplasty. Despite the evolution in our knowledge, techniques, and outcomes, it remains of utmost importance to properly select and educate patients about the safety of fat grafting for buttock augmentation. Level of Evidence: 4.
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Affiliation(s)
- Rebecca C O’Neill
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Summer E Hanson
- Department of Surgery, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - Edward Reece
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Sebastian Winocour
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
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Abboud M, Geeroms M, El Hajj H, Abboud N. Improving the Female Silhouette and Gluteal Projection: An Anatomy-Based, Safe, and Harmonious Approach Through Liposuction, Suspension Loops, and Moderate Lipofilling. Aesthet Surg J 2021; 41:474-489. [PMID: 32506115 DOI: 10.1093/asj/sjaa157] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Liposuction is the main technique to improve body contour, emphasize appealing curves, and highlight one's muscular definition. The number of procedures in which the harvested fat is utilized for gluteal augmentation has greatly increased. OBJECTIVES The authors aim to demonstrate their technique in order to obtain a sculpted harmonious body through a safe procedure, as well as review their 101 consecutive cases between 2014 and 2018. METHODS Anatomical guidelines and preoperative markings were provided to guide the 3-step procedure: zones of maximal and mild liposuction, barbed wire suspension, and moderate fat grafting. Novel concepts are introduced as the anterior body diagonal, posterior body diagonal as well as other specific axes the pubic unit, and a vertical ratio for the buttock, which are the basic foundations for sculpting the female body into a pleasing hourglass shape with a well projected buttock. Recommendations for location of sacral diamond, sacral dimples, and the maximally projected point of the buttock are given. The authors explain their philosophy through 4 principles: knowledge of anatomy, the relationship between specific body areas and surrounding zones, a balanced gluteal augmentation is not achieved through large volume fat grafting alone, and grafting in the subcutaneous layer. RESULTS A total of 101 patients were treated following the described technique and examples are shown. The complication rate was low. No serious adverse effects were recorded apart from 1 ruptured suspension loop. CONCLUSIONS The described anatomy-based approach, including liposuction, suspension loops, and fat grafting, is a novel and safe technique leading to a desirable, long-lasting outcome. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Marwan Abboud
- Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire de Tivoli, La Louvière, Belgium
| | - Maxim Geeroms
- Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire de Tivoli, La Louvière, Belgium
| | - Hiba El Hajj
- Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire de Tivoli, La Louvière, Belgium
| | - Nicolas Abboud
- Plastic and Reconstructive Surgery Department, Centre Hospitalier Universitaire de Tivoli, La Louvière, Belgium
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The Perception of the Ideal Body Contouring in Mexico. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3155. [PMID: 33425569 PMCID: PMC7787290 DOI: 10.1097/gox.0000000000003155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/05/2020] [Indexed: 11/26/2022]
Abstract
Background: Over the centuries, our appreciation of beauty has changed, as has the social environment that influences our perspective. Currently we are trying to use measurable instruments to achieve a better aesthetic result in each patient, using as a reference the “golden ratio,” which is found in harmonies of all kinds—in art, nature, architecture, and today, in medicine—to aspire to the ideal proportion. Methods: We conducted a survey in which we showed participants 4 digitally modified images of a model with different body proportions, 1 with the golden ratio and 3 with other variable proportions. In total, 900 people were surveyed, of which 131 had attended cosmetic surgery consultation, and 769 respondents were recruited on our social networks. Results: Of the 900 respondents, 607 were women and 293 were men. Fifty-nine percent of the surveyed women chose image C (shown in Fig. 3) and similarly, so did 59.4% of surveyed men, which was not statistically significant; however, when considering age, we found the groups of 21–30, 31–40, and 41–50 chose image C at 46%, 65%, and 67%, respectively, whereas 44% of those over 51 years preferred image B, which is statistically significant. Conclusions: The image whose waist–hip harmony meets the golden ratio (1.61) is most often chosen as “the most beautiful,” by both men and women. It is also the preferred image for all age groups under 50.
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Male Aesthetics for the Gluteal Area: Anatomy and Algorithm for Surgical Approach for Dynamic Definition Body Contouring. Plast Reconstr Surg 2020; 146:284-293. [PMID: 32740577 DOI: 10.1097/prs.0000000000007032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Gluteal prominence is a unique characteristic that is widely acknowledged in female contouring but ignored in the male population. This study focuses on male gluteal aesthetics based on a muscular anatomical approach. METHODS A retrospective review of gluteal contouring in men from January of 2012 to September of 2019 was conducted. Male body sculpting surgery in the gluteal area was performed in most cases. Patients were included according to preoperative assessment and the American Heart Association risk analysis. The gluteal area was divided into four main anatomical contouring zones and classified according to the procedure type. The follow-up period of 3 months to 6 years was included with photographs and medical assessment data. A nonstandardized satisfaction survey was performed postoperatively. RESULTS The analysis included data from 374 consecutive gluteal dynamic definition liposculptures performed in men (mean age, 38.2 years; range, 20 to 66 years). Patients were treated according to the authors' new classification of deformities. Fat extraction, liposhifting, and fat grafting were performed on a regular basis to enhance and define the gluteal area. A satisfaction index of 92.5 percent was reported. Minor complications were reported: seroma, 0.2 percent; prolonged bruising, 1.3 percent; and swelling, 1.8 percent. No necrosis, burns, or infections were reported. CONCLUSIONS Men have been increasingly requesting improvement and definition of the buttocks, and our novel algorithm allows for a reliable method in this regard. The high satisfaction index supports the natural and athletic results accomplished with our new approach.
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O'Neill RC, Abu-Ghname A, Davis MJ, Chamata E, Rammos CK, Winocour SJ. The Role of Fat Grafting in Buttock Augmentation. Semin Plast Surg 2020; 34:38-46. [PMID: 32071578 PMCID: PMC7023974 DOI: 10.1055/s-0039-3401038] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Autologous fat grafting is now considered the gold standard for buttock augmentation. Although a variety of techniques are currently being used by surgeons around the world, methods of fat grafting to the buttocks remain unsystematized, poorly understood, and controversial in terms of their safety and efficacy. Nonetheless, buttock augmentation by fat grafting has a satisfaction rate of 97.1%, and its mean complication rate has been estimated to be around 7 to 10%, with serious complications occurring in less than 1% of cases. Fat emboli are one such serious complication, with several reports in the literature discussing morbidity and mortality, specifically with intramuscular injection. With the increasing popularity of fat grafting for buttock augmentation, it is more important than ever to continue researching and learning to safeguard the satisfaction and safety of our patients.
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Affiliation(s)
- Rebecca C. O'Neill
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Amjed Abu-Ghname
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Matthew J. Davis
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Edward Chamata
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Charalambos K. Rammos
- Division of Plastic Surgery, Department of Surgery, University of Illinois College of Medicine, Peoria, Illinois
| | - Sebastian J. Winocour
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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Reply: The Difference between Trends and Standards on Gluteal Aesthetics: The Impact of Social Media on Beauty Preferences. Plast Reconstr Surg 2019; 144:712e-713e. [PMID: 31568333 DOI: 10.1097/prs.0000000000006039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Carlo M Oranges
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, niversity of Basel, Basel, Switzerland
| | - Salvatore Giordano
- Department of Plastic and General Surgery, Turku University Hospital, University of Turku, Turku, Finland
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Differences in Complication Rates of Gluteoplasty Procedures That Utilize Autologous Fat Grafting, Implants, or Local Flaps. Ann Plast Surg 2019; 82:S342-S344. [DOI: 10.1097/sap.0000000000001765] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lee JS, Eo P, Kim MC, Kim JB, Jin HK, Bae JS, Jeong JH, Park HY, Yang JD. Effects of Stromal Vascular Fraction on Breast Cancer Growth and Fat Engraftment in NOD/SCID Mice. Aesthetic Plast Surg 2019; 43:498-513. [PMID: 30635686 DOI: 10.1007/s00266-018-01304-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 12/23/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND To overcome unpredictable fat graft resorption, cell-assisted lipotransfer using stromal vascular fraction (SVF) has been introduced. However, its effect on cancer growth stimulation and its oncological safety are debatable. We investigated the effect of SVF on adjacent breast cancer and transplanted fat in a mouse model. METHODS A breast cancer xenograft model was constructed by injecting 2 × 106 MDA-MB-231-luc breast cancer cells into the right lower back of 40 NOD/SCID mice. Two weeks later, cancer size was sorted according to signal density using an in vivo optical imaging system, and 36 mice were included. Human fat was extracted from the abdomen, and SVFs were isolated using a component isolator. The mice were divided into four groups: A, controls; B, injected with 30 μl SVF; C, injected with 0.5 ml fat and 30 μl saline; group D, injected with 0.5 ml fat and 30 μl SVF. Magnetic resonance imaging and three-dimensional micro-computed tomography volumetric analysis were performed at 4 and 8 weeks. RESULTS Tumor volume was 43.6, 42.3, 48.7, and 42.4 mm3 at the initial time point and 6780, 5940, 6080, and 5570 mm3 at 8 weeks in groups A, B, C, and D, respectively. Fat graft survival volume after 8 weeks was 49.32% and 62.03% in groups C and D, respectively. At 2-month follow-up after fat grafting in the xenograft model, SVF injection showed an increased fat survival rate and did not increase the adjacent tumor growth significantly. CONCLUSION Fat grafting with SVF yields satisfactory outcome in patients who undergo breast reconstruction surgery. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Joon Seok Lee
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongdeokro, Jung-gu, Daegu, 41944, South Korea
| | - PilSeon Eo
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongdeokro, Jung-gu, Daegu, 41944, South Korea
| | | | - Jae Bong Kim
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongdeokro, Jung-gu, Daegu, 41944, South Korea
| | - Hee Kyung Jin
- Department of Laboratory Animal Medicine, College of Veterinary Medicine, Kyungpook National University, Daegu, 41944, South Korea
| | - Jae-Sung Bae
- Department of Physiology, School of Medicine, Kyungpook National University, Daegu, 41944, South Korea
| | - Jae-Hwan Jeong
- Cell and Matrix Research Institute, School of Medicine, Kyungpook National University, Daegu, 41944, South Korea
| | - Ho Yong Park
- Department of Surgery, School of Medicine, Kyungpook National University, Daegu, 41944, South Korea
| | - Jung Dug Yang
- Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, 130 Dongdeokro, Jung-gu, Daegu, 41944, South Korea.
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Morrison SD, Wilson SC, Mosser SW. Breast and Body Contouring for Transgender and Gender Nonconforming Individuals. Clin Plast Surg 2018; 45:333-342. [PMID: 29908621 DOI: 10.1016/j.cps.2018.03.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Even after long-term hormone therapy, many transwomen still have challenges in the size and shape of their breasts and also of the contour of their trunk areas. Though distinct anthropomorphic differences in skeletal structure exist and pose limitations to an ideal result, considerable improvements can be obtained through breast augmentation and trunk feminization. There are challenges that are unique to the transfeminine chest and trunk, and important considerations for the priority of fat grafting to the buttocks and hips when grafted fat is in short supply.
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Affiliation(s)
- Shane D Morrison
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, University of Washington, Harborview Medical Center, 7th Floor Center Tower Room 73.1, 325 9th Avenue, Mail Stop #359796, Seattle, WA 98104, USA
| | - Stelios C Wilson
- Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, 305 East 33rd Street Lower Level, New York, NY 10016, USA
| | - Scott W Mosser
- Private Practice, The Gender Confirmation Center of San Francisco, Suite 1010, 450 Sutter Street, San Francisco, CA 94108, USA.
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Nteli Chatzioglou G, Govsa F, Bicer A, Ozer MA, Pinar Y. Physical attractiveness: analysis of buttocks patterns for planning body contouring treatment. Surg Radiol Anat 2018; 41:133-140. [PMID: 30167823 DOI: 10.1007/s00276-018-2083-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/06/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND As buttocks region is one of the most characteristic features of the ideal female body figure, the popularity of gluteal region contouring is on the rise. Perception of body form is influenced by its shape and size. Interventions to modify the form of this region are often difficult due to influence. The aim of this study is to investigate the attractiveness of various buttock shapes with the aid of a dedicated software. METHODS Standard personal photographs of the lower body were obtained from 200 healthy volunteers. Linear analyses were made and anatomical perception was calculated according to reference points. RESULTS Compared to males, all measurements concerning buttock dimensions were a significantly greater in females. Proportional assessments revealed that in females, the most attractive buttock waist-to-hip ratio was 0.75 from the posterior view. This ratio was 0.85 in males. From the lateral view, the most attractive buttocks have a waist-to-hip ratio of 0.70 in females. Positioning of the lateral prominence at the inferior gluteal fold was rated by 25% of the respondents as the most attractive in males from the posterior view. From the lateral view, the most prominent portion positioned at the midpoint (a 50:50 vertical ratio) was considered the most attractive for females. CONCLUSIONS These results suggest that utilizing digitalized reference values for a given body region may be an invaluable tool for determination of the correct fat volume, thus individualization of body contouring procedures. With the help of certain software, this research has shown that it is possible to measure the parameters of buttock, which may in turn be used to offer the best solution for any individual in quest for an improved buttocks form. New ideal waist-to-hip ratios of 0.7 update the previous standards.
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Affiliation(s)
- Gkionoul Nteli Chatzioglou
- Digital Imaging and 3D Modelling Laboratory, Department of Anatomy, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Figen Govsa
- Digital Imaging and 3D Modelling Laboratory, Department of Anatomy, Faculty of Medicine, Ege University, Izmir, Turkey.
| | - Ahmet Bicer
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Mehmet Asim Ozer
- Digital Imaging and 3D Modelling Laboratory, Department of Anatomy, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Yelda Pinar
- Digital Imaging and 3D Modelling Laboratory, Department of Anatomy, Faculty of Medicine, Ege University, Izmir, Turkey
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Abstract
BACKGROUND The number of buttock augmentations with fat transfer is steadily increasing, but a number of fatalities caused as a direct result of gluteal fat grafting have been reported. The technical details relating to cannula size, injection angle or trajectory, and plane of injection are critical for avoiding morbidity and mortality. However, the ligamentous anatomy has not been thoroughly explored, particularly how the ligaments are encountered in the clinical setting of fat transfer by means of cannulas. METHODS The gluteal regions of five fresh cadavers were dissected, for a total of 10 hemidissections. All pertinent cutaneous ligaments in the region were identified. In addition, cannulas were used to simulate typical variations in injection planes. RESULTS The osseocutaneous and fasciocutaneous ligaments of the buttocks were identified. CONCLUSIONS The authors describe important ligamentous structures consistently found in the region in cadaveric dissections and discuss the implications while safely performing gluteal augmentation. The anatomical features, boundaries, and soft-tissue attachment points may play a role in cannula-directed fat injection misguidance. The ligaments, when not released, can lead to undesired deep injection and therefore fat lobule migration into the venous system. The density, danger zones, and soft-tissue attachments must be clarified further as we continue to offer our patients improved buttock contour with a higher safety profile.
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Gluteal Augmentation With Intramuscular Implants in Patients With Human Immunodeficiency Virus With Lipoatrophy Related to the Use of Antiretroviral Therapy. Ann Plast Surg 2018; 79:426-429. [PMID: 28604545 DOI: 10.1097/sap.0000000000001158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Lipodystrophy syndrome associated with highly active antiretroviral therapy (HAART) may lead to low self-esteem and poor compliance with the drug treatment on patients infected with human immunodeficiency virus (HIV), which is a matter of concern for the health system. The aim of this study was to evaluate patients with HIV submitted to gluteal augmentation with intramuscular silicone implants to correct gluteal lipoatrophy related to the use of HAART. METHODS This is a retrospective evaluation of 10 patients submitted to gluteal augmentation with intramuscular silicone implant for correction of gluteal lipoatrophy related to the use of HAART, operated between 2012 and 2015. Postoperative complications and the degree of patient's satisfaction were analyzed. RESULTS There were 3 postoperative complications including 1 case of surgical wound dehiscence and 2 cases of seroma. Six months after surgery, 8 patients had an excellent degree of satisfaction, and 2 patients had a good degree of satisfaction related to the procedure. Although this intervention does not offer functional advantages, it improves the body contour, increases patients' self-esteem, and helps them to accept their body image. These advantages can lead to higher compliance with prolonged HAART. CONCLUSIONS Gluteal augmentation with intramuscular silicone implant can be a viable option to treat patients with HIV with gluteal lipoatrophy related to the use of HAART. The patients were satisfied with the outcomes of the procedure, and there were only minor self-limited postoperative complications.
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Vartanian E, Gould DJ, Hammoudeh ZS, Azadgoli B, Stevens WG, Macias LH. The Ideal Thigh: A Crowdsourcing-Based Assessment of Ideal Thigh Aesthetic and Implications for Gluteal Fat Grafting. Aesthet Surg J 2018; 38:861-869. [PMID: 29365056 DOI: 10.1093/asj/sjx191] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As the popularity of aesthetic gluteoplasty continues to grow, there is renewed focus on defining the ideal buttocks. However, the literature lacks studies characterizing an ideal thigh, despite the impact of thigh contour on overall gluteal aesthetic. OBJECTIVES The authors performed the first population analysis of the characteristics of perception of attractive thighs, to identify a role for fat grafting of the thigh in gluteoplasty. METHODS Survey images were digitally modified to create thighs of varying widths and angles relative to fixed buttocks. Thigh-to-buttock ratios and the buttock-thigh junction were studied. Data were stratified and analyzed according to age, gender, and ethnicity of the respondents. Amazon Mechanical Turk was used as a novel crowdsourcing platform for surveying aesthetic preferences. RESULTS A total of 1034 responses were included of whom 54.4% were male, and 45.6% were female. All age groups and ethnicities were represented. Overall, 43.8% of respondents preferred the widest buttock-thick junction angle on posterior view. There was no clear preference between larger or smaller thigh-to-hip ratios on lateral view. CONCLUSIONS Characteristics of the ideal thigh include wider thighs with greater horizontal projection, creating a more natural contour from the augmented buttock. These findings represent a paradigm shift from the traditionally assumed preference for slender thighs. Plastic surgeons should carefully consider thigh anatomy in their gluteal augmentation patients, as simultaneous thigh augmentation may lead to a more aesthetically pleasing outcome. Further research is needed into best practices and techniques to attain ideal thigh proportions.
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Affiliation(s)
- Emma Vartanian
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Daniel J Gould
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ziyad S Hammoudeh
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Beina Azadgoli
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - W Grant Stevens
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Luis H Macias
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Everett M, Morales R, Newall G, Fortes PF, Hustak KL, Patronella CK, Mentz HA. Safest Practices for Autologous Buttock Augmentation With Fat Grafting Using a Roller Pump Injection Technique. Aesthet Surg J 2018; 38:751-762. [PMID: 29040377 DOI: 10.1093/asj/sjx113] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Autologous buttock augmentation with fat grafting has emerged as one of the preeminent modalities for body contouring employed by plastic surgeons today. Since 2009, we have used the roller pump injection technique. OBJECTIVES This procedure can be performed safely without specialized equipment and eliminates the tasks of manual graft preparation and injection. We describe our technique and standard safety measures. The anatomy of and complications associated with liposuction and fat grafting were recorded and reviewed. METHODS Retrospective chart review of 916 patients who underwent autologous buttock augmentation by this method from February 2009 to November 2016 was performed. All procedures were performed under general anesthesia at the same surgical center. Liposuction was performed and using a roller pump, the fat layer was propelled through an open-ended cannula into the recipient site. RESULTS Mean volume of fat removed and fat grafted in each patient was 3156 mL and 1807 mL per patient, respectively. There were complications in 13 patients for a rate of 1.4% with 10 (1.1%) related to fat grafting. Fourteen patients (1.5%) had subsequent procedures for volume and four patients (0.44%) for asymmetry. There were no venous thrombolic events, fat embolic events, or deaths. CONCLUSIONS The roller pump injection technique for buttock augmentation with fat grafting is safe and efficient. This technique minimizes preparatory effort and does not require additional equipment. We were unable to identify variables associated with complication risk due to the power of this study and the low percentage of complications. LEVEL OF EVIDENCE 4
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Abstract
This article focuses on practice-based recommendations for surgeons performing gluteal augmentation with implants (GAI). Preoperative planning, including the indications, precautions, and contraindications to GAI, is discussed. Advantages and disadvantages of subfascial and intramuscular implantation are addressed along with recommendations for implant size, shape, and position. Recommendations for patient management before and after surgery along with operative and nonoperative strategies for postoperative complications, including wound dehiscence, infection, and seroma, are included. Aesthetic concerns and recommendations for the management of poor results are addressed. A comprehensive literature review is included along with illustrative preoperative and postoperative photos.
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Subfascial Gluteal Implant Augmentation. Clin Plast Surg 2018. [PMID: 29519491 DOI: 10.1016/j.cps.2017.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Gluteal augmentation has gained popularity. It might be the only option to increase volume for lean patients without donor tissue for grafting. Subfascial augmentation is a safe treatment with low morbidity when performed in an appropriate setting with the right equipment. It is an anatomically based procedure. It is very important that pocket dissection is limited to the anatomic landmarks. Implants should be placed vertically to allow for proper contouring. The wound should never be closed with tension. One of the most important steps is postoperative care, which should avoid any pressure on the buttocks and stress on the wound.
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Abstract
BACKGROUND The female gluteal morphology is an important secondary sexual characteristic and helps accentuate and define the female body shape. Despite the increasing prevalence of gluteal augmentations in our country, little data exist regarding the morphology of the gluteal region in young Chinese females. This study analyzed a convenience sample of Chinese females and their gluteal region. METHODS Data, measurements, and photos of the following parameters were taken: age, weight, height, and body mass index (BMI). Morphology was classified into four types: A shape, V shape, round shape, and square shape. Aesthetic characteristics of each buttock were recorded. Height, weight, BMI, and gluteal projection ratio differences in different shape groups were analyzed. RESULTS The study sample consisted of 103 women, with ages from 23 to 27 years. The V-shaped buttock was not found in this sample. The A shape, square shape, and round shape occupied 55.3%, 38.8%, and 5.8% accordingly. Short infragluteal fold, supragluteal fossettes, lateral depression, and V-shaped crease appeared in 42.7%, 14.6%, 11.7%, and 2.9% of samples, respectively. Of the 103 samples, 39 (37.9%) fulfilled the aesthetic gluteal projection(ratio ≥ 2). The average BMI was statistically significant between each gluteal shape (P = 0.009). Height, weight, and gluteal projection ratio showed no significant difference with the buttock shapes. CONCLUSIONS We are the first to describe gluteal morphology in young Chinese woman using gluteal anthropometrics. The findings of the study may provide a guideline for plastic surgeons who perform gluteal augmentation in Asian patients.
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Abstract
Gluteal augmentation with fat transplantation is increasing in demand but has been associated with a concerning number of fatality reports. Despite these reports, various surgeons have safely performed gluteal fat transplantation on a large number of patients with no reported mortality. The important aspects of safely performing gluteal fat transplantation are reviewed. Proper patient selection, favorable instrumentation, patient positioning, proper technique, and knowledge of anatomy are critical to improving the safety of this procedure. Adherence to these key principles should allow a reduction in mortality from this procedure, which would safely allow its continued offering in the setting of increasingly high demand.
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Abstract
Buttock enlargement with lipoinjection is a procedure that has had a very high demand in the last 5 years. Changes in aesthetics have made more patients request greater volume in their buttocks and hips. The procedure requires not only liposuction, in which the fat is obtained, but also a systematization off the fat injection process in the buttock to obtain the appropriate aesthetic results according to the characteristics of each patient. The procedure achieves very satisfactory results because it can transform the patient's physical appearance significantly.
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Oranges CM, Tremp M, Haug M, Kalbermatten DF, Schaefer DJ. Response to "Commentary on: Gluteal Augmentation Techniques: A Comprehensive Literature Review". Aesthet Surg J 2017; 38:NP23-NP24. [PMID: 29040372 DOI: 10.1093/asj/sjx146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carlo M Oranges
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Mathias Tremp
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Martin Haug
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Daniel F Kalbermatten
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Dirk J Schaefer
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
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Fat Grafting for Gluteal Augmentation: A Systematic Review of the Literature and Meta-Analysis. Plast Reconstr Surg 2017; 138:437e-446e. [PMID: 27556618 DOI: 10.1097/prs.0000000000002435] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND With the increasing demand for gluteal fat augmentation, reports of fatal complications have surfaced. Therefore, the authors proposed to analyze the published techniques and compare different protocols, to identify those of potential concern. METHODS A systematic review of the literature was performed with a search of 21 terms on the PubMed, MEDLINE, Cochrane, and Scientific Electronic Library Online databases. Nineteen articles meeting our predetermined criteria were analyzed, and data from the different steps of the procedure were classified, allowing evaluation and comparison of techniques. Independent-samples t test and one-way analysis of variance were used for statistical analysis. RESULTS Seventeen case series and two retrospective studies including 4105 patients were reviewed. Most articles were authored in Colombia, Mexico, and Brazil. Most procedures were performed on adult female patients under general anesthesia. Fat was harvested using a tumescent technique from the lower extremities and the back, with machine-vacuum suction. A mean of 400 ml of decanted lipoaspirate was injected into each gluteal region, mostly subcutaneously and intramuscularly with 60-ml syringes. Most patients rated their results as "excellent." The mean complication rate was 7 percent (6.7 percent minor, 0.32 percent major), with no significant relation to the planes of injection. CONCLUSIONS Fat grafting is an effective and predictable way to remodel the gluteal region; however, the procedure is not without risks. Avoiding gluteal vessel damage may prevent most feared complications, such as fat embolism. Accurate analysis, systematization of the procedure, and reporting cases in the fat grafting registry may provide the foundation for optimization of outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Mofid MM, Teitelbaum S, Suissa D, Ramirez-Montañana A, Astarita DC, Mendieta C, Singer R. Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force. Aesthet Surg J 2017; 37:796-806. [PMID: 28369293 PMCID: PMC5846701 DOI: 10.1093/asj/sjx004] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Gluteal fat grafting is among the fastest growing aesthetic procedures in the United States and around the world. Given numerous anecdotal and published reports of fatal and nonfatal pulmonary fat embolism resulting from this procedure, the Aesthetic Surgery Education and Research Foundation (ASERF) formed a Task Force to study this complication. Objectives To determine the incidence of fatal and nonfatal pulmonary fat embolism associated with gluteal fat grafting and provide recommendations to decrease the risks of the procedure. Methods An anonymous web-based survey was sent to 4843 plastic surgeons worldwide. Additional data on morbidity and mortality was collected through confidential interviews with plastic surgeons and medical examiners, public records requests for autopsy reports in the United States, and through the American Association for the Accreditation of Ambulatory Surgical Facilities (AAAASF). Results Six hundred and ninety-two (692) surgeons responding to the survey reported 198,857 cases of gluteal fat grafting. Over their careers, surgeons reported 32 fatalities from pulmonary fat emboli as well as 103 nonfatal pulmonary fat emboli. Three percent (3%) of respondents experienced a patient fatality and 7% of respondents reported at least one pulmonary fat embolism in a patient over their careers. Surgeons reporting the practice of injecting into the deep muscle experienced a significantly increased incidence rate of fatal and nonfatal pulmonary fat emboli. Twenty-five fatalities were confirmed in the United States over the last 5 years through of autopsy reports and interviews with surgeons and medical examiners. Four deaths were reported from 2014 to 2015 from pulmonary fat emboli in AAAASF facilities. Conclusions Despite the growing popularity of gluteal fat grafting, significantly higher mortality rates appear to be associated with gluteal fat grafting than with any other aesthetic surgical procedure. Based on this survey, fat injections into the deep muscle, using cannulae smaller than 4 mm, and pointing the injection cannula downwards should be avoided. More research is necessary to increase the safety of this procedure.
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Affiliation(s)
- M Mark Mofid
- Dr Mofid is an Associate Clinical Professor of Plastic Surgery (Voluntary), University of California, San Diego (UCSD), San Diego, CA; and is Chairman of the ASERF Gluteal Fat Grafting Task Force. Dr Teitelbaum is an Associate Clinical Professor (Voluntary), David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, CA; and is President of ASERF. Dr Suissa is a plastic surgeon in private practice in Los Angeles, CA. Dr Ramirez-Montañana is a plastic surgeon in private practice in Monterey, Mexico. Dr Astarita is a Surgical Consultant, Department of Medical Examiner-Coroner, County of Los Angeles, CA. Dr Mendieta is a plastic surgeon in private practice in Miami, FL. Dr Singer is a Clinical Professor of Plastic Surgery (Voluntary), UCSD, San Diego, CA; and is a Past President of ASERF
- Corresponding Author: Dr M. Mark Mofid, University of California San Diego, Department of Surgery, 4150 Regents Park Row Suite 300, La Jolla, CA 92037, USA. E-mail:
| | - Steven Teitelbaum
- Dr Mofid is an Associate Clinical Professor of Plastic Surgery (Voluntary), University of California, San Diego (UCSD), San Diego, CA; and is Chairman of the ASERF Gluteal Fat Grafting Task Force. Dr Teitelbaum is an Associate Clinical Professor (Voluntary), David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, CA; and is President of ASERF. Dr Suissa is a plastic surgeon in private practice in Los Angeles, CA. Dr Ramirez-Montañana is a plastic surgeon in private practice in Monterey, Mexico. Dr Astarita is a Surgical Consultant, Department of Medical Examiner-Coroner, County of Los Angeles, CA. Dr Mendieta is a plastic surgeon in private practice in Miami, FL. Dr Singer is a Clinical Professor of Plastic Surgery (Voluntary), UCSD, San Diego, CA; and is a Past President of ASERF
| | - Daniel Suissa
- Dr Mofid is an Associate Clinical Professor of Plastic Surgery (Voluntary), University of California, San Diego (UCSD), San Diego, CA; and is Chairman of the ASERF Gluteal Fat Grafting Task Force. Dr Teitelbaum is an Associate Clinical Professor (Voluntary), David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, CA; and is President of ASERF. Dr Suissa is a plastic surgeon in private practice in Los Angeles, CA. Dr Ramirez-Montañana is a plastic surgeon in private practice in Monterey, Mexico. Dr Astarita is a Surgical Consultant, Department of Medical Examiner-Coroner, County of Los Angeles, CA. Dr Mendieta is a plastic surgeon in private practice in Miami, FL. Dr Singer is a Clinical Professor of Plastic Surgery (Voluntary), UCSD, San Diego, CA; and is a Past President of ASERF
| | - Arturo Ramirez-Montañana
- Dr Mofid is an Associate Clinical Professor of Plastic Surgery (Voluntary), University of California, San Diego (UCSD), San Diego, CA; and is Chairman of the ASERF Gluteal Fat Grafting Task Force. Dr Teitelbaum is an Associate Clinical Professor (Voluntary), David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, CA; and is President of ASERF. Dr Suissa is a plastic surgeon in private practice in Los Angeles, CA. Dr Ramirez-Montañana is a plastic surgeon in private practice in Monterey, Mexico. Dr Astarita is a Surgical Consultant, Department of Medical Examiner-Coroner, County of Los Angeles, CA. Dr Mendieta is a plastic surgeon in private practice in Miami, FL. Dr Singer is a Clinical Professor of Plastic Surgery (Voluntary), UCSD, San Diego, CA; and is a Past President of ASERF
| | - Denis C Astarita
- Dr Mofid is an Associate Clinical Professor of Plastic Surgery (Voluntary), University of California, San Diego (UCSD), San Diego, CA; and is Chairman of the ASERF Gluteal Fat Grafting Task Force. Dr Teitelbaum is an Associate Clinical Professor (Voluntary), David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, CA; and is President of ASERF. Dr Suissa is a plastic surgeon in private practice in Los Angeles, CA. Dr Ramirez-Montañana is a plastic surgeon in private practice in Monterey, Mexico. Dr Astarita is a Surgical Consultant, Department of Medical Examiner-Coroner, County of Los Angeles, CA. Dr Mendieta is a plastic surgeon in private practice in Miami, FL. Dr Singer is a Clinical Professor of Plastic Surgery (Voluntary), UCSD, San Diego, CA; and is a Past President of ASERF
| | - Constantino Mendieta
- Dr Mofid is an Associate Clinical Professor of Plastic Surgery (Voluntary), University of California, San Diego (UCSD), San Diego, CA; and is Chairman of the ASERF Gluteal Fat Grafting Task Force. Dr Teitelbaum is an Associate Clinical Professor (Voluntary), David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, CA; and is President of ASERF. Dr Suissa is a plastic surgeon in private practice in Los Angeles, CA. Dr Ramirez-Montañana is a plastic surgeon in private practice in Monterey, Mexico. Dr Astarita is a Surgical Consultant, Department of Medical Examiner-Coroner, County of Los Angeles, CA. Dr Mendieta is a plastic surgeon in private practice in Miami, FL. Dr Singer is a Clinical Professor of Plastic Surgery (Voluntary), UCSD, San Diego, CA; and is a Past President of ASERF
| | - Robert Singer
- Dr Mofid is an Associate Clinical Professor of Plastic Surgery (Voluntary), University of California, San Diego (UCSD), San Diego, CA; and is Chairman of the ASERF Gluteal Fat Grafting Task Force. Dr Teitelbaum is an Associate Clinical Professor (Voluntary), David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, CA; and is President of ASERF. Dr Suissa is a plastic surgeon in private practice in Los Angeles, CA. Dr Ramirez-Montañana is a plastic surgeon in private practice in Monterey, Mexico. Dr Astarita is a Surgical Consultant, Department of Medical Examiner-Coroner, County of Los Angeles, CA. Dr Mendieta is a plastic surgeon in private practice in Miami, FL. Dr Singer is a Clinical Professor of Plastic Surgery (Voluntary), UCSD, San Diego, CA; and is a Past President of ASERF
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Oranges CM, Tremp M, di Summa PG, Haug M, Kalbermatten DF, Harder Y, Schaefer DJ. Gluteal Augmentation Techniques: A Comprehensive Literature Review. Aesthet Surg J 2017; 37:560-569. [PMID: 28203698 DOI: 10.1093/asj/sjw240] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Many studies of gluteal augmentation techniques have been published in recent decades, including case reports, retrospective and prospective case series, and multicenter survey reviews. However, to date, there has been no study of the overall complications or satisfaction rates associated with the broad spectrum of techniques. Objectives The authors performed a comprehensive literature review to determine outcomes and complications of gluteoplasty techniques, including patient satisfaction. Methods A search on PubMed/Medline was performed for clinical studies involving gluteal augmentation techniques. A priori criteria were used to review the resulting articles. Results Fifty-two studies, published from 1969 through 2015, were included - representing 7834 treated patients. Five gluteal augmentation techniques were identified from these studies: gluteal augmentation with implants (n = 4781), autologous fat grafting (n = 2609), local flaps (n = 369), hyaluronic acid gel injection (n = 69), and local tissue rearrangement (n = 6). The overall complication rates of the most commonly utilized techniques were: 30.5% for gluteal augmentation with implants, 10.5% for autologous fat grafting, and 22% for local flaps. Patients' satisfaction was reported as consistently high for all the five techniques. Conclusions Implant-based gluteal augmentation is associated with high patients' satisfaction despite a high complication rate, while autologous fat grafting is associated with the lowest complication rate yet including serious major complications such as fat embolism. Local flaps and local tissue rearrangements are the ideal procedures in case of massive weight loss patients. A paucity of data is available for hyaluronic acid gel injections, which appear to be effective but temporary and expensive. Level of Evidence 4
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Affiliation(s)
- Carlo M Oranges
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Mathias Tremp
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Pietro G di Summa
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Martin Haug
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Daniel F Kalbermatten
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
| | - Yves Harder
- Division of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano (ORL), Breast Centre of Switzerland (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
| | - Dirk J Schaefer
- Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland
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Abstract
BACKGROUND The buttocks are a key element of female beauty, with aesthetic gluteoplasty becoming one of the fastest growing plastic surgery procedures. However, there remains no clear standard for the ideal buttocks. The authors performed a population analysis of the characteristics of the ideal buttocks to guide surgical planning. METHODS Images of buttocks were digitally altered to create buttocks of varying proportions on posterior and lateral views. Waist-to-hip ratios and varying vertical proportions were studied. Data were stratified and analyzed according to age range, gender, ethnicity, and nationality of the respondents. RESULTS A total of 1146 responses were collected. Of 989 respondents who submitted their gluteal preferences, 482 respondents (48.7 percent) were women and 507 (51.3 percent) were men. Overall, the most attractive buttocks waist-to-hip ratio is 0.65 from the posterior view (44.2 percent of respondents). The next most attractive ratio was 0.60 (25 percent of respondents). Positioning of the lateral prominence at the inferior gluteal fold was rated by 26.3 percent of respondents as the most attractive. From the lateral view, the most attractive buttocks have a waist-to-hip ratio of 0.70 (29.8 percent of respondents), with the most prominent portion positioned at the midpoint of the buttocks (45.1 percent of respondents), which is a 50:50 vertical ratio. There were no significant differences in preferences between respondent ages, genders, or ethnicities. CONCLUSIONS New ideal waist-to-hip ratios of 0.6 and 0.65 update the previous standards and indicate a more dramatic and "curvier" new ideal, signaling an important preference paradigm shift. The information derived from this study has the potential to guide gluteoplasty practices and techniques.
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Senderoff DM. Aesthetic Surgery of the Buttocks Using Implants: Practice-Based Recommendations. Aesthet Surg J 2016; 36:559-76. [PMID: 27069241 DOI: 10.1093/asj/sjv251] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 11/12/2022] Open
Abstract
The demand for gluteal enhancement has increased rapidly in the past few years. In this Continuing Medical Education (CME) article, the evaluation, surgical planning, operative technique, and management of potential complications of gluteal augmentation using solid silicone implants are discussed. Practice-based recommendations are presented along with a review of the scientific literature. The intramuscular and subfascial technique is described along with a discussion of the advantages and disadvantages of each approach. Guidelines for implant selection, placement, and revisional procedures are presented along with recommendations for maximizing successful outcomes.
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Aboudib JH, Serra-Guimarães F, Sampaio FJB. Profile of Patients Undergoing Gluteoplasty. Aesthetic Plast Surg 2016; 40:30-7. [PMID: 26578193 DOI: 10.1007/s00266-015-0587-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/14/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gluteal augmentation surgery has grown by 42 % per year; however, the epidemiological profile of patients who seek this treatment has never been studied. OBJECTIVE To establish the epidemiological profile of patients who have undergone gluteoplasty surgery, evaluating their level of satisfaction and the social impact caused by the surgery. METHODS Fifty patients, with ages ranging from 23 to 57 years replied to a specific questionnaire and the esthetic result of the surgery was evaluated. Thirty-seven patients were analyzed prospectively, using CT scans and gluteal reconstruction. The esthetic result was evaluated by eight plastic surgeon specialists from SBCP. RESULTS About satisfaction and quality of life, 98 % of the patients demonstrated improvement in some aspect of life. Analysis of the marital status of patients showed that 24 % of them have changed it. Therefore, all cases showed positive correlations between implant size and monthly income, age and satisfaction of patients. There has also been a positive correlation between implant size and recovery time. There was no statistically significant correlation between the esthetic result and the implant volume or the anthropometric measurements. CONCLUSIONS The epidemiological profile of patients undergoing gluteoplasty augmentation with implants is predominantly white skin, 36 years old, unrelated to the occupation or socioeconomic status. Augmentation gluteoplasty with implants is a surgery with a high level of satisfaction to patients, improving life in many aspects but, mainly, affectively. Its outcome produces a natural look and is hardly noticed by others. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Jose Horacio Aboudib
- Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Fernando Serra-Guimarães
- Pedro Ernesto University Hospital, Rio de Janeiro State University, Rua Visconde de Pirajá 550/1413, Ipanema, Rio de Janeiro, RJ, 22410-901, Brazil.
| | - Francisco J B Sampaio
- Urogenital Research Unit, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Wang G, Djafarian K, Egedigwe CA, El Hamdouchi A, Ojiambo R, Ramuth H, Wallner-Liebmann SJ, Lackner S, Diouf A, Sauciuvenaite J, Hambly C, Vaanholt LM, Faries MD, Speakman JR. The relationship of female physical attractiveness to body fatness. PeerJ 2015; 3:e1155. [PMID: 26336638 PMCID: PMC4556148 DOI: 10.7717/peerj.1155] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 07/14/2015] [Indexed: 01/25/2023] Open
Abstract
Aspects of the female body may be attractive because they signal evolutionary fitness. Greater body fatness might reflect greater potential to survive famines, but individuals carrying larger fat stores may have poor health and lower fertility in non-famine conditions. A mathematical statistical model using epidemiological data linking fatness to fitness traits, predicted a peaked relationship between fatness and attractiveness (maximum at body mass index (BMI) = 22.8 to 24.8 depending on ethnicity and assumptions). Participants from three Caucasian populations (Austria, Lithuania and the UK), three Asian populations (China, Iran and Mauritius) and four African populations (Kenya, Morocco, Nigeria and Senegal) rated attractiveness of a series of female images varying in fatness (BMI) and waist to hip ratio (WHR). There was an inverse linear relationship between physical attractiveness and body fatness or BMI in all populations. Lower body fat was more attractive, down to at least BMI = 19. There was no peak in the relationship over the range we studied in any population. WHR was a significant independent but less important factor, which was more important (greater r (2)) in African populations. Predictions based on the fitness model were not supported. Raters appeared to use body fat percentage (BF%) and BMI as markers of age. The covariance of BF% and BMI with age indicates that the role of body fatness alone, as a marker of attractiveness, has been overestimated.
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Affiliation(s)
- Guanlin Wang
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Kurosh Djafarian
- Department of Clinical Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Chima A. Egedigwe
- Department of Biochemistry, Michael Okpara University of Agriculture, Umuahia, Abia State, Nigeria
| | - Asmaa El Hamdouchi
- CNESTEN, Unité Mixte de Recherche Nutrition et Alimentation, CNESTEN-Université Ibn Tofail, Rabat, Morocco
| | - Robert Ojiambo
- College of Health Science, School of Medicine, Medical Physiology Department, Moi University, Eldoret, Kenya
| | - Harris Ramuth
- Biochemistry Department, Central health Laboratory services, Ministry of Health and Quality of Life, Mauritius
| | | | - Sonja Lackner
- Center of Molecular Medicine, Institute of Pathophysiology and Immunology, Medical University Graz, Graz, Austria
| | - Adama Diouf
- Laboratoire de Nutrition, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Justina Sauciuvenaite
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Catherine Hambly
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Lobke M. Vaanholt
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Mark D. Faries
- Stephen F. Austin State University, Nacogdoches, TX, USA
| | - John R. Speakman
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
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Musculoaponeurotic Area of the Hip and Clinicophotographic Scaling System. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e423. [PMID: 26180724 PMCID: PMC4494493 DOI: 10.1097/gox.0000000000000401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 04/28/2015] [Indexed: 11/26/2022]
Abstract
Background: With the evolution of body contouring, few innovative alternatives have been developed for cosmetic treatment in the hip area. Methods: A multicenter controlled study was conducted, including a prior review of the literature regarding the hip area. Dissections were performed on 4 male cadavers, outlining the “musculoaponeurotic area of the hip.” The area was subdivided into anterior and posterior surfaces. A clinical study was conducted in 79 patients, obtaining a scale by using the most prominent points on the sides of both thighs as the main reference. With the lines marked on photographs and the measurements, a “clinicophotographic scaling system” was designed. Results: The anterior surface corresponds to the tensor fasciae latae and its tendon as well as to the aponeurosis of the gluteus medius. The posterior surface corresponds with the iliotibial tract and the tendon insertions of the gluteus maximus. The average dimensions of the cadaver “musculoaponeurotic area of the hip” are as follows: length, 17.5 cm, and width, 11.5 cm. Using the “clinicophotographic scaling system,” the dimensions are as follows: length, 14.9 cm, and width, 10.3 cm. Conclusions: The “musculoaponeurotic area of the hip” was defined involving muscles, tendons, aponeurosis, fascia, subcutaneous cellular tissue, and skin. The borders were established using important anatomical points that determine the length and width of the area. The “clinicophotographic scaling system” was used to clinically calculate the length and width of the area. By examination and palpation, the borders and dimensions of this area could be determined.
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De Meyere B, Mir-Mir S, Peñas J, Camenisch CC, Hedén P. Stabilized hyaluronic acid gel for volume restoration and contouring of the buttocks: 24-month efficacy and safety. Aesthetic Plast Surg 2014; 38:404-12. [PMID: 24464121 DOI: 10.1007/s00266-013-0251-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 11/20/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Stabilized hyaluronic acid (HA) of nonanimal origin manufactured using the patented NASHA® technology has been developed for use in body shaping. This study was performed to assess the safety and efficacy of stabilized HA gel when used for volume restoration and contouring of the buttocks. METHODS Subjects 20 years of age or older seeking buttock augmentation were recruited to this noncomparative multicenter study (NCT01331408). Gel at a maximum volume of 400 mL per subject was injected during one or two treatment visits. Safety and efficacy assessments (24-month follow-up evaluation) included adverse event (AE) reporting, aesthetic improvement (Global Aesthetic Improvement Scale [GAIS]), and subject satisfaction. RESULTS In this study, 61 subjects received a mean total volume of 340 mL (range 200-420 mL) of stabilized HA gel. According to subject GAIS assessment, buttock appearance was rated as "improved," "much improved," or "very much improved" by 80, 68, 42, and 40% of subjects after 6, 12, 18, and 24 months, respectively. Subject satisfaction with buttock size, shape, firmness, and general appearance was higher than before treatment at all the time points, with a peak of 70% of the subjects satisfied 1 month after treatment. During the 24 months, no unexpected or serious treatment-related AEs occurred. One subject experienced gel dislocation to the sacral area. CONCLUSIONS The data show that stabilized HA gel is a safe and effective treatment for temporary aesthetic augmentation of the buttocks. Although the substance degrades over time, a good proportion of the subjects still rated their buttocks as improved (40%) and expressed satisfaction (33%) 24 months after treatment. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Hoenig JF, Swetje K. Age-related ptosis of the buttock: an anthropometric gender-specific analysis. Aesthetic Plast Surg 2013; 37:1090-9. [PMID: 24114293 DOI: 10.1007/s00266-013-0205-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 06/30/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED Buttock reshaping has received a lot of attention, although to date there are no anthropometric gender-specific datasets to show the aging of the gluteal region from infancy to old age to guide surgical planning of gender-specific buttock reshaping. To make surgical planning easier, we analyzed the characteristics of the aging buttock in 280 volunteers ranging in age from 15 to 85 years and classified the age characteristics of the gluteal region into gender-specific categories to establish a classification system that could guide surgical techniques needed to reshape and rejuvenate the buttock. Based on our measurements it was evident that males showed fewer signs of atrophy and less ptosis of their buttock with less reduction of the gluteal volume as they aged than did females. Based on the results, it is concluded that gender-specific surgical rejuvenation of the buttock area should include shortening of the gluteal crease, lifting the gluteal mass, adding volume, and smoothening of curvature to the lateral sides of the gluteal region. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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